Human papillomavirus infection among transgender women and sex workers in Bangladesh.

Introduction: Transgender women (TGW), Male Sex Workers (MSW) and Female Sex Workers (FSW) are disproportionately affected by Human papillomavirus (HPV), but the risk among these populations remains understudied, especially in low and middle-income countries. Methods: Between September 14 to November 30, 2022, anorectal-swabs (AS) from 484 TGW, 220 MSW and cervical-swab from 126 FSW were collected from Dhaka and Jessore districts of Bangladesh. Testing for HPV DNA was conducted on the specimens by using a commercial real-time PCR kit (Hibribio Ltd, Hong Kong) for the detection of 17 high-risk (HR) and six low-risk (LR) HPV genotypes (GTs). Results: The median age of TGW and MSW was 27 years, and FSW, 30 years. Any HPV was detected in 74% of TGW, 72% of MSW and 39% of FSW. HR-HPV infection was detected in 65% of the TG, followed by 62% MSW and 31% FSW. At least one HR-HPV was detected in 59% of the participants. Among HR-HPV, GT-16 was the most predominant (32%) followed by GT-58 (18%), GT-52 (17%), GT-18 (14%), GT-33 (5%), and GT-31 (4%) which are present in the current vaccines. In contrast, one-third of the HR-HPV genotypes identified in this population are not covered by the current HPV vaccines, such as GT-39 (17%), GT-59 (12%), GT-53 (11%), GT-82 (9%), GT-56 (5%), GT-51 (3%), GT-35 (2%), GT-68 (2%), and GT-73 (1%). The HPV detection rate was significantly higher in anal specimens than in cervical swabs. The anal specimens were also significantly less likely than cervical swabs to be naïve to GT-16; the scenario is just the opposite for GT-18. Conclusions: This study reports, for the first time in Bangladesh, high rates of HPV infections and their genotypes in TGW, MSW and FSW. These results warrant routine vaccination among these populations who are still naïve to any HPV vaccines.