Prevalence of other sexually transmissible infections in patients with newly diagnosed anogenital warts in a sexual health clinic
Elizabeth A. Sturgiss A D , Fengyi Jin B , Sarah J. Martin A C , Andrew Grulich B and Francis J. Bowden A CA Canberra Sexual Health Centre, The Canberra Hospital, Yamba Drive, Garran, ACT 2605, Australia.
B National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Level 2, 376 Victoria Street, Sydney, NSW 2010, Australia.
C Academic Unit of Internal Medicine, The Australian National University Medical School, Canberra, ACT 2600, Australia.
D Corresponding author. Email: elizabeth.sturgiss@act.gov.au
Sexual Health 7(1) 55-59 https://doi.org/10.1071/SH09023
Submitted: 2 March 2009 Accepted: 20 November 2009 Published: 15 February 2010
Abstract
Background: Anogenital warts are a common initial presentation to the Canberra Sexual Health Centre. It is anticipated that the introduction of human papillomavirus vaccination will reduce the incidence of anogenital warts. The present study determines the prevalence of other sexually transmissible infections in patients newly diagnosed with warts who may not have presented for screening without the impetus of a genital lump. Methods: The prevalence of other sexually transmissible infections in new patients presenting to the Canberra Sexual Health Centre diagnosed with anogenital warts was determined from a retrospective clinical audit from 2002 to 2007. Results: A total of 1015 new patients were diagnosed with anogenital warts. Of this total cohort, 53 (5.2%) were found to be co-infected with either chlamydia and/or gonorrhoea. Only 13.2% of co-infected patients reported symptoms other than genital lumps. Of co-infected patients 11.3% reported contact with a partner with chlamydia and/or gonorrhoea. Not all patients were screened for other sexually transmissible infections: 762 (75.1%) were screened for chlamydia and 576 (56.7%) were screened for gonorrhoea. Of those tested, 6.8% of men and 6.9% of women were positive for chlamydia highlighting the importance of offering full sexually transmissible infection screening in those newly diagnosed with anogenital warts. Chlamydia was more common in younger patients who reported a higher number of sexual partners. Conclusions: It is anticipated that human papillomavirus vaccination will lead to a decline in anogenital wart incidence as well as other human papillomavirus associated disease. Although one opportunity for testing for other sexually transmissible infections may be lost in this population, the decrease in anogenital warts will leave clinicians with more time to pursue other screening programs. Education and screening campaigns should continue to focus on the asymptomatic nature of the majority of sexually transmissible infections.
Additional keywords: Australia, genital warts, human papillomavirus, vaccination.
[1] Garland SM, Hernandez-Avila M, Wheeler CM, Perez G, Harper DM, Leodolter S, et al. Quadrivalent vaccine against Human Papillomavirus to prevent anogenital diseases. N Engl J Med 2007; 356 1928–43.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[2]
[3]
[4] Adams M, Jasani B, Fiander A. Human papilloma virus (HPV) prophylactic vaccination: challenges for public health and implications for screening. Vaccine 2007; 25 3007–13.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[5] May J. HPV vaccination: a paradigm shift in public health. Aust Fam Physician 2007; 36 106–11.
| PubMed |
[6] Dempsey AF, Koutsky LA, Golden M. Potential impact of human papillomavirus vaccines on public STD clinic workloads and on opportunities to diagnose and treat other sexually transmitted diseases. Sex Transm Dis 2007; 34 503–7.
| PubMed |
[7] Mapagu MC, Martin SJ, Currie MJ, Bowden FJ. Screening for hepatitis C in sexual health clinic attendees. Sex Health 2008; 5 73–6.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[8] Currie MJ, Bowden FJ. The importance of chlamydial infections in obstetrics and gynaecology: an update. Aust N Z J Obstet Gynaecol 2007; 47 2–8.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[9] Currie MJ, Martin SJ, Soo TM, Bowden FJ. Screening for chlamydia and gonorrhoea in men who have sex with men in clinical and non-clinical settings. Sex Health 2006; 3 123–6.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[10] Regan DG, Wilson DP, Hocking JS. Coverage is the key for effective screening of Chlamydia trachomatis in Australia. J Infect Dis 2008; 198 349–58.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[11] Sturrock CJ, Currie MJ, Vally H, O’Keefe EJ, Primrose R, Habel P, et al. Community-based sexual health care works: a review of the ACT outreach program. Sex Health 2007; 4 201–4.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[12] Currie M, Bowden FJ. An epidemic of infection, not just testing: chlamydia prevalence estimates in the Australian Capital Territory 1998–2004. Aust N Z J Public Health 2006; 30 286–7.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[13]
[14] Jin F, Prestage GP, Kippax SC, Pell CM, Donovan B, Templeton DJ, et al. Risk factors for genital and anal warts in a prospective cohort of HIV-negative homosexual men: the HIM study. Sex Transm Dis 2007; 34 488–93.
| PubMed |