From the Faculty of Medicine, University of British Columbia.
BC Centre for Disease Control.
Sex Transm Dis. 2020 Oct;47(10):691-697. doi: 10.1097/OLQ.0000000000001235.
In 2008, British Columbia (BC) implemented a school-based quadrivalent human papillomavirus (HPV-4) immunization program for girls born in 1994 or later. In 2015, an expanded clinic-based program included men who report sex with men (MSM) born in 1989 or later. To evaluate the impacts of HPV-4 programs on anogenital warts (AGWs), diagnosis rates were measured among women who report sex with men (WSM), men who report sex with women (MSW), and MSM.
Diagnoses of AGW were ascertained from 16 sexually transmitted infection clinics. Rates were calculated as new AGW diagnoses over person-years (py) at risk and stratified by age group, calendar period, and birth cohort. Adjusted relative rates (aRR) were estimated using multivariable Poisson regression.
There were 204,832 clinic visits by 85,158 individuals: 28,366 (33%) WSM, 35,688 (42%) MSW, and 14,534 (17%) MSM. After adjusting for age and period, AGW rates in the 1994-1996 birth cohort decreased by 56% overall (1.21 vs. 2.72 cases/100 py; aRR, 0.44; 95% confidence interval [CI], 0.34-0.59), 65% among WSM (0.97 vs. 2.77 cases/100 py; aRR, 0.35; 95% CI, 0.22-0.57), 58% among MSW (1.60 vs. 3.78 cases/100 py; aRR, 0.42; 95% CI, 0.28-0.65), and 41% among MSM (1.14 vs. 1.19 cases/100 py; aRR, 0.59; 95% CI, 0.38-0.91) versus the 1991-1993 birth cohort.
The HPV-4 programs had significant impacts on lowering AGW rates in BC. The greatest decrease was among WSM eligible for the school-based program, followed by birth cohorts of men who likely have sex with HPV-4 eligible women. The smallest decrease among MSM may reflect the later introduction of the clinic-based program.
2008 年，不列颠哥伦比亚省（BC）为 1994 年或以后出生的女孩实施了基于学校的四价人乳头瘤病毒（HPV-4）免疫接种计划。2015 年，扩大的基于诊所的计划包括报告与男性发生性行为（MSM）的 1989 年或以后出生的男性。为了评估 HPV-4 计划对肛门生殖器疣（AGW）的影响，在报告与男性发生性行为（WSM）的女性、报告与女性发生性行为（MSW）的男性和 MSM 中测量了 AGW 的诊断率。
通过 16 个性传播感染诊所确定 AGW 的诊断。根据年龄组、日历期和出生队列，以新的 AGW 诊断数除以风险人年（py）计算发病率。使用多变量泊松回归估计调整后的相对发病率（aRR）。
共有 85158 人进行了 204832 次就诊：28366 人（33%）为 WSM，35688 人（42%）为 MSW，14534 人（17%）为 MSM。在调整年龄和时期后，1994-1996 年出生队列的 AGW 发病率总体下降了 56%（1.21 与 2.72 例/100 py；aRR，0.44；95%置信区间[CI]，0.34-0.59），WSM 下降了 65%（0.97 与 2.77 例/100 py；aRR，0.35；95% CI，0.22-0.57），MSW 下降了 58%（1.60 与 3.78 例/100 py；aRR，0.42；95% CI，0.28-0.65），MSM 下降了 41%（1.14 与 1.19 例/100 py；aRR，0.59；95% CI，0.38-0.91）与 1991-1993 年出生队列相比。
HPV-4 计划对降低卑诗省的 AGW 发病率产生了重大影响。降幅最大的是符合学校计划条件的 WSM，其次是可能与 HPV-4 合格女性发生性行为的男性的出生队列。MSM 中降幅最小可能反映了诊所计划的推出较晚。
