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Anogenital Warts Knowledge and Counseling Practices of US Clinicians: Results from a National Survey.
Sex Transm Dis 2007; 34(9):644-652.
Henderson Z, Irwin KL, Montano DE, Kasprzyk D, Carlin L, Greek A, Freeman
C, Barnes R, Jain N.
Abstract
OBJECTIVES: To examine messages US clinicians use when counseling patients
diagnosed with anogenital warts. STUDY DESIGN: In mid-2004, we conducted a
confidential mail survey of nationally representative samples of physicians
practicing internal and adolescent medicine, family/general practice, obstetrics/gynecology,
urology, or dermatology; nurse midwives; physician assistants; and nurse practitioners.
The survey assessed knowledge and counseling practices of clinicians who had
diagnosed anogenital warts. RESULTS: After adjusting for survey eligibility,
81% responded. Most (89%) were aware that human papillomavirus (HPV) causes
anogenital warts, but only 48% were aware that oncogenic and wart-related
HPV genotypes usually differ. Most (>95%) clinicians reported telling patients
with warts that warts are an STD, are caused by a virus, or that their sex
partners may have or may acquire warts. Many clinicians (>/=85%) also reported
discussing STD prevention or assessing STD risk with such patients. Most reported
addressing ways to prevent HPV (89%), including using condoms; limiting sex
partners or practicing monogamy; or abstinence. Many also reported recommending
prompt (82%) or more frequent (52%) Pap testing to female patients with anogenital
warts. Potential barriers to counseling included providing definitive answers
on how HPV infection was acquired, dealing with patients' psychosocial issues,
and inadequate reimbursement. CONCLUSIONS: Most surveyed clinicians appropriately
counseled patients about the cause and prevention of anogenital warts. However,
many clinicians were unaware that oncogenic and wart-related HPV types usually
differ, and this may explain why many reported recommending more aggressive
cervical cancer screening for female patients with warts.