Barriers and Facilitators to HPV Vaccination Completion among Transgender Women in Mexico: Implications for HPV Prevention and Education.

Human papillomavirus (HPV) vaccination is a key strategy for preventing anogenital cancers. However, coverage among transgender women remains poorly documented, particularly in Latin America. This study examined barriers and facilitators to completing the HPV vaccination schedule among transgender women in Mexico City. We conducted a mixed-methods study with 138 transgender women receiving care in two public clinics. Quantitative, qualitative, and geospatial analyses were integrated. Vaccination completion and HPV prevalence were estimated; 14 semi-structured interviews explored perceived barriers and facilitators, and geographic mapping identified completion patterns. Overall, 32.6% (n = 45) of participants reported completing the vaccination schedule. Older age and higher education were associated with higher completion, though not statistically significant. Reported barriers included personal, organizational, cultural, and geographical challenges. Facilitators included accessibility and promotion of vaccines, clear information from healthcare providers, and participants' interest in health. These findings underscore critical opportunities to enhance HPV prevention through tailored interventions, culturally competent services, and consistent follow-up. Importantly, they highlight the need for educational and communication strategies to improve vaccination uptake and reduce the HPV-related cancer burden in this high-risk population.