title: Decreased management of genital warts in young women in Australian general practice post introduction of national HPV vaccination program: results from a nationally representative cross-sectional general practice study.
abstract: OBJECTIVE
  Since the introduction of Australia's human papillomavirus vaccination program, the management rate of genital warts in sexual health clinics and private hospitals has decreased in women of vaccine-eligible age. However, most genital warts in Australia are managed in general practice. This study examines whether a similar decrease occurred in Australian general practice after the introduction of the program.
  
  
  METHODS
  Analysis of a nationally representative cross-sectional database of Australian general practice activity (1,175,879 patient encounters with 11,780 general practitioners). Genital warts management rates were estimated for the periods before and after introduction of the program (Pre-program, July 2002-June 2006; Post-program, July 2008-June 2012). Control conditions included genital herpes and gardnerella/bacterial vaginosis in female patients and genital herpes and urethritis in male patients. Trends in management rates by year, pre-vaccine (July 2000-June 2007) and post-vaccine (July 2007-June 2012) were also calculated.
  
  
  RESULTS
  Management rate of genital warts among women potentially covered by program (aged 15-27 years) decreased by 61% from 4.33 per 1,000 encounters in the Pre-program period to 1.67 in the Post-program period. Trend analysis of the post-vaccine period showed, among women of vaccine eligible age, a significant year-on-year reduction in the rate of genital warts management (p<0.0001) and a significant increase in the management rate of control conditions per year (p<0.0001). For all other age-sex groups there was no significant change in the management rate of genital warts between the Pre- and Post-program periods.
  
  
  CONCLUSIONS
  The large decrease in general practice management of genital warts in women of vaccine-eligible age highlights the success of the program in the wider community.
authors.affiliation: Family Medicine Research Centre, School of Public Health, University of Sydney, Sydney, Australia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Harrison
authors.affiliation: Family Medicine Research Centre, School of Public Health, University of Sydney, Sydney, Australia.
authors.forename: Helena
authors.initials: H
authors.lastname: Britt
authors.affiliation: Microbiology & Infectious Diseases, The Royal Women's Hospital, Parkville, Australia.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Garland
authors.affiliation: Health Economics, bioCSL, Parkville, Victoria, Australia.
authors.forename: Lynne
authors.initials: L
authors.lastname: Conway
authors.affiliation: bioCSL, Parkville, Victoria, Australia.
authors.forename: Alicia
authors.initials: A
authors.lastname: Stein
authors.affiliation: Department of General Practice, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Marie
authors.initials: M
authors.lastname: Pirotta
authors.affiliation: Central Clinical School Monash University and Melbourne Sexual Health Centre, Carlton, Victoria, Australia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Fairley
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D003218:Condylomata Acuminata / Q000276:immunology* / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005260:Female; D058006:General Practice; D006801:Humans; D008875:Middle Aged; D053918:Papillomavirus Vaccines / Q000276:immunology*; D014611:Vaccination; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines