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SSuN: Genital Wart Surveillance

SSuN: Genital Wart Surveillance. L. Newman, D. Datta SSuN Call #12 Jan 29, 2009. SSuN Call Schedule. Feb 5: Catch-up on misc issues: STD clinic, population, and trich Feb 12: Dissemination of SSuN data, potential analysis topics Feb 19: WINTER BREAK? Feb 26: Analysis methods for SSuN data.

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SSuN: Genital Wart Surveillance

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  1. SSuN: Genital Wart Surveillance L. Newman, D. Datta SSuN Call #12 Jan 29, 2009

  2. SSuN Call Schedule • Feb 5: Catch-up on misc issues: STD clinic, population, and trich • Feb 12: Dissemination of SSuN data, potential analysis topics • Feb 19: WINTER BREAK? • Feb 26: Analysis methods for SSuN data

  3. Genital Wart (GW) and HPV Vaccine Monitoring – Objectives • Describe demographic & clinical characteristics of patients with GW attending STD clinics • Monitor trends in characteristics over time • Monitor the impact of GW diagnosis & treatment on STD clinic resources • Monitor trends over time • Monitor HPV vaccine coverage of eligible populations (REMOVE?) • Vaccine administration in STD clinics • History of HPV vaccination Goal 3, Objective 3a.1: Monitor vaccine impact on HPV related outcomes, including monitoring prevalence of genital warts

  4. Genital Wart Data Elements • Should we include these variables in the standardized data element list for the GW/HPV activity? • PRESENTGW • GWDXDATE • HPVVAX • HPVDOSE • HPVVAXPROV • HPVVAXAGE • VAXTYPE • HPVVAXADMIN

  5. Completeness of GW/HPV Data in Cycle 1

  6. STD Clinic Surveillance – Proportion of STD Clinic Visits Related to Genital Warts (N=14,670), Aug 2006 – July 2008* n=3,019 n=2,634 n=3,812 n=627 4.1% n=313 n=4,265 *Preliminary data, MN: 11/07 – 08/08

  7. How can SSuN data be used to monitor impact of HPV vaccine? • Monitor burden of disease in STD clinics • Genital wart visits accounted for an average of 4% (range 1.8 – 11.0%) of STD clinic visits in 2006-8 • Stratified by sex • How will this change over time? • How many of these patients required treatment in clinic? • How much time does a visit for genital warts take and how much does it cost? • Modeling to estimate potential impact of HPV vaccine • Monitor characteristics of patients with warts • 2/3rds of patients with genital warts in 2006-8 were under 29 years of age • Over half of genital wart visits were follow-up visits in 2006-8 • How will this change over time? • Describe the HPV vaccine status of STD clinic patients? • __% of eligible women attending STD clinics had been vaccinated

  8. What specific measures should be used to monitor the impact of the HPV vaccine? Possible measure: # women with dx and/or tx of GW # women seen in STD clinic • Did the patient population change? • Changes in clinic demographics • Changes in volume of GW diagnoses • Did clinic volume change? • Changes in clinic volume • All visits vs. provider only? • Subset by visit type

  9. What are some other possible questions of interest? • GW and other STD coinfection • Should STD screening be recommended at all GW visits? • GW treatment choices • Are there great differences by site? • Driven by provider or by clinic? • GW and neoplasia • Should biopsy be recc’d in MSM/HIV+?

  10. Questions & Comments?

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