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Many U.S. health care providers lack basic knowledge of HPV infection.(SEX RESEARCH UPDATE)(human papillomavirus)

The Canadian Journal of Human Sexuality

| September 22, 2005 | McKay, Alexander | COPYRIGHT 2005 SIECCAN, The Sex Information and Education Council of Canada. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan.  All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)Copyright

Human papillomavirus (HPV) is the most common sexually transmitted infection in Canada and around the world. Misconceptions about HPV prevalence, natural history, and outcomes are common not only among the general population but perhaps within the health care community as well. In a recent review of the research, Baseman and Koutsky (2005) address many of the aspects of HPV upon which people are often uncertain. For example, they point out that HPV infection is extremely common, with more than half of all sexually active women becoming infected at some point in their lives. HPV infection is most common among young people with studies suggesting that about a third or more of both male and female university students are infected with HPV at any one time. Baseman and Koutsky also point out that HPV is usually asymptomatic, that the vast majority of infected individuals will clear the infection within 18 months, that only a small percentage of infections in females will progress to precursors of cervical cancer, and that the viral types that result in genital warts are different from the HPV types associated with cervical cancer. With respect to viral clearance, in a review of the literature on HPV relevant to the provision of health care to adolescents, Shew and Fortenberry (2005) suggest that

    Most infections (70-90%) are contained by    the host  immune responses and become    undetectable within 6 to 10 months. Thus,  

when counseling adolescents about HPV, an important point to bear in mind is that the most common outcome of infection is clearance of the virus (p. 169).

Furthermore, the role that condoms play in reducing the risk of HPV transmission is uncertain. While some studies have not found an association between condom use and rates of HPV infection, other studies have shown an association between condom use and a reduced likelihood of genital warts and cervical dysplasia as well as a more rapid regression of HPV-related lesions which suggests that consistent condom use does reduce negative outcomes of HPV.

In a study prepared for the U.S. Centers for Disease Control and Prevention, Montano, Kasprezyk, Carlin, and Freeman (2005) assessed the knowledge of these and other HPV related issues among health care providers in the United States. For the study, a nationally representative sample of 6906 health care providers (response rate = 81%) who provide clinical health care to sexually active patients was surveyed on knowledge and practices related to HPV. Clinicians from nine specialties were selected to participate: family and general practice physicians, general internal medicine physicians, adolescent medicine physicians, obstetricians and gynecologists, dermatologists, ...

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