Neovaginal Cytologic and Molecular Screening Findings for Human Papillomavirus and Sexually Transmitted Infections Among Transgender Women.

Evidence regarding optimal screening strategies for neovaginal health in transgender women remains limited. Data describing cytologic and molecular detection of human papillomavirus (HPV) and sexually transmitted infections (STIs) in neovaginal tissue are scarce, particularly in populations with high burden of HIV and STI. We conducted a descriptive observational study of transgender women with neovagina receiving care at a specialized sexual health clinic in Mexico City. Neovaginal samples were collected for cytologic evaluation and polymersase chain reaction (PCR)-based molecular testing for HPV and sexually transmitted pathogens. Sixteen transgender women were included (median age 44.5 years; range 31-52 years). Cytology samples were obtained in 13 participants and were negative in all cases. Despite universally negaive cytology, PCR-based molecular testing identified high-risk HPV in 38.5% of tested participants and detected other sexually transmitted pathogens (Chlamydia trachomatis, Mycoplasma hominis, Neisseria gonorrhoeae, and Ureaplasma urealyticum). Molecular screening identified HPV infection and other sexually trnsmitted pathogens in neovaginal samples despite negative cytology. These findings highlight potential limitations of cytology-based screening and support the integration of molecular diagnostics as part of comprehensive sexual health care for transgener women.