Potential impact of human papillomavirus vaccines on public STD clinic workloads and on opportunities to diagnose and treat other sexually transmitted diseases

Background: Eradicating genital warts through HPV immunization could decrease STD clinic utilization but may result in missed opportunities to diagnose other STDs. Objectives: To define the proportion of STD clinic visits attributable to HPV and to describe the prevalence of other STD diagnoses among visits for HPV-related presenting concerns. Study Design: Cross-sectional analysis of medical records (1994-2004) from a single STD clinic. Prevalences of STDs were calculated for male and female patients with and without HPV-related presenting concerns. Results: Of the 66,537 visits included in the study, 10.3% were HPV-related. Of the 3085 HPV-related "new problem" visits, only 281 non-HPV diagnoses were made, with nonspecific urethritis and CT being the most common diagnosis for males and females, respectively. Nearly 25% of the 14,574 follow-up visits were for HPV. Conclusions: Newly developed HPV vaccines may substantially decrease public STD clinic workloads with little associated lost opportunity to diagnose and treat other STDs.