{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T20:50:23Z","timestamp":1791838223664,"version":"4.3.4"},"reference-count":28,"publisher":"BMJ","issue":"5","funder":[{"DOI":"10.13039\/501100002141","name":"Public Health England","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002141","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2018,11,29]]},"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>In 2008, a national human papillomavirus (HPV) vaccination programme for females was introduced in England using the bivalent vaccine (HPV16 and 18 only). In 2012, the programme changed to offer the quadrivalent vaccine that includes protection against the two HPV types that cause the majority of anogenital warts (AGW; HPV6 and 11). We present data reporting AGW diagnoses in sexual health clinics (SHCs) in England to the end of 2017, including diagnoses among birth cohorts offered the quadrivalent vaccine.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using data from all SHCs across England, we performed ecological analyses to consider rates of AGW diagnoses by age, gender and sexual orientation. We tested for trends over time of diagnoses of AGW in young females, heterosexual males, and men who have sex with men (MSM) between the ages of 15 and 24 years during both bivalent (2009 to 2013) and quadrivalent (2014 to 2017) vaccine time periods using Poisson regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between 2014 and 2017, there was strong evidence for a decreasing trend in the rate of AGW diagnoses at SHC among females aged 15\u201317 years from 257.5 to 45.7 per 100\u2009000 population (82.3% decline) and same aged heterosexual males from 59.1 to 19.1 per 100\u2009000 population (67.7% decline). The reductions in the incidence of AGW diagnoses in MSM aged 15\u201317 years were less clear (decreased by 13.6% between 2014 and 2017, from 129.9 to 112.2 per 100\u2009000 population).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The moderate, unexpected declines in AGW seen since the introduction of a high-coverage HPV vaccination programme using the bivalent vaccine are being followed, as expected, by much larger declines among females offered the quadrivalent vaccine and same-aged heterosexual males. Surveillance plans are in place to continue to monitor AGW diagnoses to evaluate the impact of both female and targeted MSM HPV vaccination on early disease outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2018-053751","type":"journal-article","created":{"date-parts":[[2019,2,5]],"date-time":"2019-02-05T22:15:33Z","timestamp":1549404933000},"page":"368-373","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":33,"title":["Declines in anogenital warts diagnoses since the change in 2012 to use the quadrivalent HPV vaccine in England: data to end 2017"],"prefix":"10.1136","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1398-9017","authenticated-orcid":false,"given":"Marta","family":"Checchi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Mesher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2060-7286","authenticated-orcid":false,"given":"Hamish","family":"Mohammed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Soldan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,2,5]]},"reference":[{"key":"2024092304402302000_95.5.368.1","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1016\/S0140-6736(06)68439-0","article-title":"Sustained efficacy up to 4\u00b75 years of a bivalent L1 virus-like particle vaccine against human papillomavirus types 16 and 18: follow-up from a randomised control trial","volume":"367","author":"Harper","year":"2006","journal-title":"The Lancet"},{"key":"2024092304402302000_95.5.368.2","unstructured":"Public Health England . Human Papillomavirus (HPV) Vaccine Coverage in England, 2008\/09 to 2013\/14. A review of the full six years of the three-dose schedule. 2015. Available: https:\/\/www.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/412264\/HPV_Vaccine_Coverage_in_England_200809_to_201314.pdf [Accessed May 2016]."},{"key":"2024092304402302000_95.5.368.3","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1097\/OLQ.0b013e31827aa9b3","article-title":"Human papillomavirus typing in reporting of condyloma","volume":"40","author":"Stureg\u00e5rd","year":"2013","journal-title":"Sex Transm Dis"},{"key":"2024092304402302000_95.5.368.4","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(05)70101-7"},{"key":"2024092304402302000_95.5.368.5","unstructured":"Public Health England . Human papillomavirus vaccination for men who have sex with men: year 1 evaluation report. 2017. Available: https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/678987\/HPV_msm_year1_evaluation_report.pdf"},{"key":"2024092304402302000_95.5.368.6","unstructured":"Health Protection Agency, Health Protection Report . Trends in genital warts and genital herpes diagnoses in the United Kingdom, 2007, 2007."},{"key":"2024092304402302000_95.5.368.7","unstructured":"Health Protection Agency, Health Protection Report . Trends in genital herpes and genital warts infections, United Kingdom: 1999 to 2008, 2009."},{"key":"2024092304402302000_95.5.368.8","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jit361"},{"key":"2024092304402302000_95.5.368.9","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2016-052626"},{"key":"2024092304402302000_95.5.368.10","unstructured":"Public Health England . Continuing trend of declining genital warts diagnoses in young women in England: update to end 2015, 2016."},{"key":"2024092304402302000_95.5.368.11","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.f2032","article-title":"Genital warts in young Australians five years into national human papillomavirus vaccination programme: national surveillance data","volume":"346","author":"Ali","year":"2013","journal-title":"BMJ"},{"key":"2024092304402302000_95.5.368.12","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2014-051813"},{"key":"2024092304402302000_95.5.368.13","first-page":"9","article-title":"Trends in genital warts diagnoses in New Zealand five years following the quadrivalent human papillomavirus vaccine introduction","volume":"130","author":"Oliphant","year":"2017","journal-title":"N Z Med J"},{"key":"2024092304402302000_95.5.368.14","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES2014.19.48.20981"},{"key":"2024092304402302000_95.5.368.15","unstructured":"Public Health England . Genitourinary medicine clinic activity dataset (GUMCADv2). 2015. Available: https:\/\/www.gov.uk\/guidance\/genitourinary-medicine-clinic-activity-dataset-gumcadv2 [Accessed 26 Apr 2017]."},{"key":"2024092304402302000_95.5.368.16","unstructured":"Public Health England . Annual HPV vaccine coverage 2016 to 2017: by local authority, local team and area team. 2017. Available: https:\/\/www.gov.uk\/government\/statistics\/annual-hpv-vaccine-coverage-2016-to-2017-by-local-authority-local-team-and-area-team [Accessed Feb 2018]."},{"key":"2024092304402302000_95.5.368.17","unstructured":"Office for National Statistics . Population Estimates for UK, England and Wales, Scotland and Northern Ireland: mid-2015, 2016."},{"key":"2024092304402302000_95.5.368.18","doi-asserted-by":"crossref","first-page":"1781","DOI":"10.1016\/S0140-6736(13)62035-8","article-title":"Changes in sexual attitudes and lifestyles in Britain through the life course and over time: findings from the National Surveys of Sexual Attitudes and Lifestyles (Natsal)","volume":"382","author":"Mercer","year":"2013","journal-title":"The Lancet"},{"key":"2024092304402302000_95.5.368.19","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyn216"},{"key":"2024092304402302000_95.5.368.20","unstructured":"Public Health England . Sexually transmitted infections (STIs): annual data tables. 2016. Available: https:\/\/www.gov.uk\/government\/statistics\/sexually-transmitted-infections-stis-annual-data-tables [Accessed 7 Sep 2017]."},{"key":"2024092304402302000_95.5.368.21","unstructured":"Public Health England . Sexually transmitted infections and screening for chlamydia in England, 2017. 2018. Available: https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/713944\/hpr2018_AA-STIs_v5.pdf"},{"key":"2024092304402302000_95.5.368.22","first-page":"580","article-title":"Impact and cost-effectiveness of selective human papillomavirus vaccination of men who have sex with men","volume":"64","author":"Lin","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2024092304402302000_95.5.368.23","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(10)70225-5"},{"key":"2024092304402302000_95.5.368.24","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ364"},{"key":"2024092304402302000_95.5.368.25","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2012.301182"},{"key":"2024092304402302000_95.5.368.26","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2010.048421"},{"key":"2024092304402302000_95.5.368.27","unstructured":"Public Health England . Table 3: Attendances by gender, sexual risk & age group, 2013\u20132017. 2018. Available: https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/713322\/2017_Table_3_Attendances_by_gender__sexual_risk___age_group.pdf [Accessed 30 Oct 2018]."},{"key":"2024092304402302000_95.5.368.28","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e3181a74c2c"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2018-053751","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T11:40:58Z","timestamp":1727091658000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2018-053751"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,5]]},"references-count":28,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2019,7,18]]},"published-print":{"date-parts":[[2019,8]]}},"alternative-id":["10.1136\/sextrans-2018-053751"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2018-053751","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,5]]}}}