ABSTRACT
Purpose: The objectives of this study were to assess the knowledge of HIV and pre-exposure prophylaxis (PrEP) in transgender adolescents and young adults (AYAs) and to test the acceptability of rapid HIV testing among transgender adolescents in a multidisciplinary gender clinic. Methods: Participants enrolled on the same day as their mental health or medical appointment in a multidisciplinary gender clinic. They completed survey questions regarding HIV and PrEP knowledge and were also offered an optional same-day, rapid, fourth-generation HIV test. Participants who had an HIV test answered additional questions about their testing experience. Results: We enrolled 61 participants; just over half (n=31) were assigned female at birth. Less than a third (n=20, 32.8%) scored 80% or above regarding HIV knowledge. Nearly half of the participants (n=29, 47.5%) were not interested in PrEP. Forty-one percent of participants chose to have a rapid HIV test; all were "satisfied" with the testing experience. There were no positive HIV results. Conclusions: Transgender AYAs have gaps in their understanding of HIV acquisition and transmission. Rapid HIV testing in the setting of gender care is well received by those who desire testing and may be a way to increase knowledge of transgender AYA HIV status.
ABSTRACT
Objective: There are limited studies evaluating anal cytology results or the prevalence of anal human papiloma virus in adolescent and young adult (AYA) men who have sex with men (MSM). The purpose of this study was to review anal cytology screening results and determine whether abnormal findings resulted in completion of anoscopy in AYA MSM (13-26 years old). Patients and Methods: This was a retrospective study evaluating 84 anal Papanicolaou screening results among 36 AYA MSM patients aged 13-26 years who had an anal Papanicolaou test completed at an outpatient Adolescent/Young Adult Medicine Practice at Boston Children's Hospital, an urban, nonprofit, academic, free-standing children's hospital, from January 1, 2010, to December 31, 2020. Results: The findings of anal Papanicolaou screening included atypical squamous cells of undetermined significance (ASCUS) (37%), negative for squamous intraepithelial lesion (31%), inability to read (21.3%), and low-grade squamous intraepithelial lesion (10.8%). Most patients who had ASCUS results were referred for anoscopy (n = 28, 90.3%), and of those referred only 6.5% (n = 2) completed an anoscopy. Of those with low-grade squamous cell intraepithelial lesion results, 88.9% (n = 8) were referred for anoscopy, and among those who were referred, only 3.3% (n = 3) had completed an anoscopy. Conclusion: This study showed that there were abnormalities in cytology when anal Papanicolaou test screening was performed in this population, and the completion rates for anoscopy were low.
