Incidence of genital warts in adolescents and young adults in an integrated health care delivery system in the United States before human papillomavirus vaccine recommendations.

BACKGROUND: Information on genital wart incidence in adolescents and young adults before human papillomavirus (HPV) vaccination is important for understanding the impact of the vaccine on the epidemiology of this early outcome of HPV infection. METHODS: The study population included 11- to 29-year-old enrollees of Northern California Kaiser Permanente between July 1, 2000, and July 1, 2005, before the availability of the HPV vaccine. We identified genital warts with an algorithm combining genital wart-specific International Classification of Diseases, Ninth Revision, Clinical Modification codes (078.10, 078.11, and 078.19) with physician-recorded anatomic locations. We calculated sex- and age-specific incidence rates of genital warts and described the specific anatomic location of presentation, as well as recurrences of genital warts. RESULTS: We identified 1,682 cases of genital warts among 181,264 individuals. The incidence rate was highest among women (6.3/1000 person-years) and men (2.9/1000 person-years) aged 20 to 24 years old. Among women (n = 96,792), 63.4% of the 1240 incident genital wart cases occurred on the vulva and 21.1% on the cervix. Among men (n = 84,472), 91.6% of the 442 incident genital wart cases did not have a specific anatomic location recorded. Most people with an incident genital wart diagnosis (87.2%) did not have a recurrence during the observation period. CONCLUSIONS: Our study found that the incidence of genital warts was highest among persons aged 20 to 24 years using a unique method to identify the location of the wart. Information on incidence of genital warts before vaccine use provides baseline data that can be used to measure HPV vaccine impact.

Diagnostic classification, viral sexually transmitted infections and discourses of femininity: limits of normalisation to erase stigma.

Clinicians in the field of women's sexual health typically classify the two most common viral sexually transmitted infections (STIs), the human papilloma virus and the herpes simplex virus, as relatively innocuous infections. Teaching interventions include 'normalising' adult sexual activity and the epidemiological ordinariness of infection. Normalising is intended to disarm the potential stigma of the diagnosis. In this study, in-depth email interviews were conducted with 26 women with a viral STI diagnosis and 12 sexual health clinicians. Data were analysed thematically using a feminist, poststructuralist approach. Normalising is contextualised as an example of the workings of western philosophical thought whereby dualistic classifications privilege certain terms and subordinate other terms. In this instance, the relative medical normalcy of viral STIs is given primacy compared to the social abnormality experienced by women. Although these viral STIs infect women and men, this research concentrates on women's learning about viral STIs. For women, beliefs about femininity, sexuality, health, morality and responsibility influence effects of a viral STI diagnosis. These discourses are clinically significant because beliefs that specifically link to ideas about how to be a woman are overlooked when clinicians devise educational interventions.

Seropositivity to multiple sexually transmitted infections is not common.

BACKGROUND: Seropositivity for several sexually transmitted infections (STIs) is often used as a surrogate measure of sexual behavior. The authors assessed the concomitant seropositivity for STIs in women. GOAL: To estimate the excess of concomitant seropositivity for four STIs among fertile-aged women assuming no coinfections above what would be expected at random. STUDY DESIGN: Antibodies to herpes simplex virus type 2, human papillomavirus type 16, HIV, Chlamydia trachomatis, and Treponema pallidum were determined from a random sample of 1110 pregnant women in Tallinn, Estonia. RESULTS: A total of 310 combinations of the concomitant seropositivity were observed, whereas only 193 were expected by chance. Among persons seropositive for two STIs, 78 extra combinations were observed, whereas for three STIs, 35 extra combinations were observed. For four STIs, 3.8 extra combinations were found. CONCLUSIONS: Seropositivity to multiple STIs is not common. This fits the concept of different transmission probabilities and the spread of the STIs, and suggests that seropositivity alone should be used with caution as a surrogate to sexual behavior in women.

Resultado preliminar del estudio seminologico. pacientes ambulatorios 1984-1987 Instituto de Genetica / Preliminary report of a semiologic study in out patients 1984-87. Genetic Institute

En el laboratorio de Reproducciòn Humanadel Instituto de Genètica Humana, se procesaron cerca de 300 exàmenes semiològicos durante los ultimos años (1984-1987): en la mayoria de las consulta privada de Urologia y Ginecològia, y otras en menor proporciòn, provenientes del Ministerio de Previsiòn Social y Salud Pùblica. Para homogenizar la muestra fuè seleccionado un grupo de pacientes cuyo resultado semiològico tuviere el nùmero de variables preestablecido: los pacientes privados o no, que por cualquier circunstancia no completaron el nùmero de variables establecido, fueron excluidos. Los resultados fueron condensados en 18 diagnòsticos semiològicos (tabla No.2), donde aparecen individualmente y combinados entre ellos, hasta un màximo de 4 combinaciones posibles. Llama enormemente la atenciòn la observaciòn tan frecuente de bacterias y piocitos, en màs de 85 porciento de todas las muestras de semen examinadas, lo que supone la alta prevalencia de enfermedades infecciosas del tarcto urogenital, muchas de las cuales seguramente corresponden a enfermedades sexualmente transmitibles. Debido a las caracteristicas metodologicas de este trabajo, no se realizaron determinaciones hormonales, exàmenes anatomo-patològicos, citogeneticos, microbiològicos, etc. que coadyuven al estudiante clìinico y sus posibilidades terapèuticas. El hallazgo de combinaciones en las alteraciones del semiograma constituye una importante contribuciòn para el estudio y esclarecimiento de los transtornos de la fertilidad masculina