Henderson Zsakeba, Irwin Kathleen L, Montaño Daniel E, Kasprzyk Danuta, Carlin Linda, Greek April, Freeman Crystal, Barnes Rheta, Jain Nidhi
Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Sex Transm Dis. 2007 Sep;34(9):644-52. doi: 10.1097/01.olq.0000258434.08035.ca.
To examine messages US clinicians use when counseling patients diagnosed with anogenital warts.
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.
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.
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.
研究美国临床医生在为被诊断为肛门生殖器疣的患者提供咨询时所传达的信息。
2004年年中，我们对从事内科、青少年医学、家庭/全科医学、妇产科、泌尿科或皮肤科的医生、助产护士、医师助理和执业护士进行了一次全国代表性样本的保密邮件调查。该调查评估了已诊断出肛门生殖器疣的临床医生的知识和咨询实践。
在调整调查资格后，81%的人做出了回应。大多数人（89%）知道人乳头瘤病毒（HPV）会导致肛门生殖器疣，但只有48%的人知道致癌性HPV和与疣相关的HPV基因型通常不同。大多数（>95%）临床医生报告说，他们告诉疣患者疣是一种性传播疾病，由病毒引起，或者他们的性伴侣可能有或可能感染疣。许多临床医生（≥85%）还报告说，他们会与这些患者讨论性传播疾病的预防或评估性传播疾病风险。大多数人报告说他们提到了预防HPV的方法（89%），包括使用避孕套、限制性伴侣或实行一夫一妻制，或禁欲。许多人还报告说，他们建议患有肛门生殖器疣的女性患者进行及时（82%）或更频繁（52%）的巴氏试验。咨询的潜在障碍包括就HPV感染的获取方式提供明确答案、处理患者的心理社会问题以及报销不足。
大多数接受调查的临床医生就肛门生殖器疣的病因和预防向患者提供了适当的咨询。然而，许多临床医生并不知道致癌性HPV和与疣相关的HPV类型通常不同，这可能解释了为什么许多人报告说建议对患有疣的女性患者进行更积极的宫颈癌筛查。
