title: The near disappearance of genital warts in young women 4 years after commencing a national human papillomavirus (HPV) vaccination programme.
abstract: BACKGROUND
  Australia provided free quadrivalent human papillomavirus vaccines to 12-18-year-old girls and women aged ≤26 years from mid-2007 until the end of 2009. After this time, only girls aged 12-13 years had access to free vaccines.
  
  
  METHODS
  Before and after the study, of the proportion of new patients attending Melbourne Sexual Health Centre from mid-2004 to mid-2011, diagnosed with genital warts (GW) by risk group.
  
  
  RESULTS
  From July 2004 to June 2011, 52 454 new patients were seen at Melbourne Sexual Health Centre and 5021 (9.6%, 95% CI 9.3% to 9.8%) were diagnosed with GW. From July 2004 to June 2007, the proportions with GW either increased or did not change in all groups. Comparing the two 12-month periods of 2007/2008 and 2010/2011, GW declined in women under 21 years from 18.6% to 1.9% and in heterosexual men under 21 years from 22.9% to 2.9%. The ORs per year for diagnosis of GW adjusted for number of sexual partners from July 2007 until June 2011 in women and heterosexual men <21 years were 0.44 (95% CI 0.32 to 0.58) and 0.42 (95% CI 0.31 to 0.60), respectively. There was no significant change in GW in women ≥30 years (OR 0.97, 95% CI 0.84 to 1.12), heterosexual men ≥30 years (OR 0.97, 95% CI 0.89 to 1.06) or in homosexual men (OR 0.95, 95% CI 0.85 to 1.07).
  
  
  CONCLUSIONS
  The dramatic decline and near disappearance of GW in women and men under 21 years of age, 4 years after commencing this programme, suggest that the basic reproductive rate has fallen below one.
authors.affiliation: Department of Public Health, Melbourne Sexual Health Centre, Alfred Hospital and School of Population Health, University of Melbourne, Carlton, Victoria, Australia.
authors.forename: Tim R H
authors.initials: TR
authors.lastname: Read
authors.forename: Jane S
authors.initials: JS
authors.lastname: Hocking
authors.forename: Marcus Y
authors.initials: MY
authors.lastname: Chen
authors.forename: Basil
authors.initials: B
authors.lastname: Donovan
authors.forename: Catriona S
authors.initials: CS
authors.lastname: Bradshaw
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Fairley
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D050936:Basic Reproduction Number / Q000706:statistics & numerical data; D002648:Child; D003218:Condylomata Acuminata / Q000453:epidemiology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D014611:Vaccination / Q000379:methods*; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines