title: Human papillomavirus vaccination and genital warts in young Indigenous Australians: national sentinel surveillance data.
abstract: OBJECTIVE
  To examine the impact of the national human papillomavirus (HPV) vaccination program (available to girls and women [12-26 years] since 2007 and to boys [12-15 years] since 2013) on the number of diagnoses of genital warts in Australian Aboriginal and Torres Strait Islander (Indigenous) people.
  
  
  METHODS
  Analysis of routinely collected data from patients attending 39 sexual health clinics (SHCs) in the Genital Warts Surveillance Network for the first time.Major outcome: The average annual proportion of Indigenous and non-Indigenous SHC patients diagnosed with genital warts during the pre-vaccination (2004-2007) and vaccination periods (2008-2014), stratified by age group and sex.
  
  
  RESULTS
  7.3% of the 215 599 Australian-born patients with known Indigenous status and seen for the first time at participating SHCs during 2004-2014 were Indigenous Australians. The average proportion of female Indigenous patients diagnosed with warts was lower during the vaccination period than during the pre-vaccination period (in those under 21, summary rate ratio [SRR], 0.12; 95% CI, 0.07-0.21; P < 0.001); in 21-30-year olds: SRR, 0.41; 95% CI, 0.27-0.61; P < 0.001); there was no significant difference for women over 30 (SRR, 0.84; 95% CI, 0.51-1.36; P = 0.47). The proportion of male Indigenous heterosexual SHC patients under 21 diagnosed with warts was also lower during the vaccination period (SRR, 0.25; 95% CI, 0.12-0.49; P < 0.001), with no significant changes among older Indigenous men over 30.
  
  
  CONCLUSIONS
  There were marked declines in the proportions of diagnoses of genital warts in young Indigenous women and men attending SHCs after the introduction of the HPV vaccination program. If high levels of HPV vaccine coverage are sustained, HPV-related cancer rates should also decline.
authors.affiliation: The Kirby Institute, University of New South Wales, Sydney, NSW hali@kirby.unsw.edu.au.
authors.forename: Hammad
authors.initials: H
authors.lastname: Ali
authors.affiliation: The Kirby Institute, University of New South Wales, Sydney, NSW.
authors.forename: Hamish
authors.initials: H
authors.lastname: McManus
authors.affiliation: Sexual Health Service, Sydney Local Health District, Sydney, NSW.
authors.forename: Catherine C
authors.initials: CC
authors.lastname: O'Connor
authors.affiliation: The Kirby Institute, University of New South Wales, Sydney, NSW.
authors.forename: Denton
authors.initials: D
authors.lastname: Callander
authors.affiliation: The Kirby Institute, University of New South Wales, Sydney, NSW.
authors.forename: Marlene
authors.initials: M
authors.lastname: Kong
authors.affiliation: University of Melbourne, Melbourne, VIC.
authors.forename: Simon
authors.initials: S
authors.lastname: Graham
authors.affiliation: The Kirby Institute, University of New South Wales, Sydney, NSW.
authors.forename: Dina
authors.initials: D
authors.lastname: Saulo
authors.affiliation: Melbourne Sexual Health Centre, Alfred Hospital, Melbourne, VIC.
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Fairley
authors.affiliation: The Kirby Institute, University of New South Wales, Sydney, NSW.
authors.forename: David G
authors.initials: DG
authors.lastname: Regan
authors.affiliation: The Kirby Institute, University of New South Wales, Sydney, NSW.
authors.forename: Andrew
authors.initials: A
authors.lastname: Grulich
authors.affiliation: Institute of Social and Preventive Medicine, Universität Bern, Bern, Switzerland.
authors.forename: Nicola
authors.initials: N
authors.lastname: Low
authors.affiliation: The Kirby Institute, University of New South Wales, Sydney, NSW.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Guy
authors.affiliation: The Kirby Institute, University of New South Wales, Sydney, NSW.
authors.forename: Basil
authors.initials: B
authors.lastname: Donovan
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001315:Australia / Q000453:epidemiology; D002648:Child; D003218:Condylomata Acuminata / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D005260:Female; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D008297:Male; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D053918:Papillomavirus Vaccines / Q000627:therapeutic use*; D015397:Program Evaluation; D018571:Sentinel Surveillance; D017678:Sex Distribution; D055815:Young Adult; D000095283:Australian Aboriginal and Torres Strait Islander Peoples
chemical_list: D053918:Papillomavirus Vaccines