title: Prevalence of Neovaginal High-Risk Human Papillomavirus Among Transgender Women in The Netherlands.
abstract: Worldwide, transgender women are a high burden population for sexually transmitted diseases. Neovaginal high-risk human papillomavirus (hrHPV) infection has been documented among transgender women, but its prevalence remains unclear. The objective of this study was to determine the prevalence of neovaginal hrHPV in a sample of transgender women in The Netherlands.
  
  
  
  Between June 2015 and December 2015, neovaginal samples were obtained from all transgender women who underwent vaginoplasty and attended our outpatient clinic for postoperative follow-up at least 1 year after surgery. High-risk HPV DNA detection and partial genotyping was performed by the HPV-risk assay. Genotyping of non-16/18-hrHPV-positive samples was subsequently performed by GP5+/6+-PCR followed by Luminex suspension array technology. Physical examination and standardized (sexual) history taking was conducted.
  
  
  
  Valid neovaginal swabs were obtained from 54 transgender women (median age, 40.7 years [range, 19.2-60.3]; median postoperative time, 2.4 years [range, 1.0-34.2]). No transgender women were employed in the commercial sex industry. Of 28 sexually active transgender women, 6 (20%) tested positive for neovaginal hrHPV including types 16, 45, 51, 59, 66, and X. There were no concomitant neovaginal lesions nor neovaginal symptoms. All sexually inactive transgender women tested negative for neovaginal hrHPV.
  
  
  
  A prevalence of neovaginal hrHPV infection of 20% is observed in Dutch transgender women, who self-reported to be sexually active. The clinical consequences neovaginal hrHPV infection in transgender women require further attention.
authors.affiliation: From the *Department of Plastic, Reconstructive and Hand Surgery, †EMGO + Institute for Health and Care Research, ‡Center of Expertise on Gender Dysphoria, and §Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Wouter B
authors.initials: WB
authors.lastname: van der Sluis
authors.forename: Marlon E
authors.initials: ME
authors.lastname: Buncamper
authors.forename: Mark-Bram
authors.initials: MB
authors.lastname: Bouman
authors.forename: Lian
authors.initials: L
authors.lastname: Elfering
authors.forename: Müjde
authors.initials: M
authors.lastname: Özer
authors.forename: Martijn
authors.initials: M
authors.lastname: Bogaarts
authors.forename: Renske D M
authors.initials: RD
authors.lastname: Steenbergen
authors.forename: Daniëlle A M
authors.initials: DA
authors.lastname: Heideman
authors.forename: Margriet G
authors.initials: MG
authors.lastname: Mullender
mesh_terms: D000328:Adult; D005260:Female; D005838:Genotype; D052162:Human papillomavirus 16 / Q000235:genetics / Q000302:isolation & purification*; D052161:Human papillomavirus 18 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D011477:Sex Work; D012747:Sexual Partners; D063106:Transgender Persons / Q000706:statistics & numerical data*; D014621:Vagina / Q000821:virology; D055815:Young Adult; D008297:Male