Genital warts in females information. Informing adolescents and young adults about HPV and the risks associated with infection is an important consideration for the pre- vention of further increases in the incidence rates for HPV and genital warts. Aggressive health edu- cation strategies such as classes, magazine articles and internet information need to be employed to remedy this situation. There is no simple method of preventing infec- tion with HPV other than abstinence from sexual intercourse, an approach that has been shown to be relatively ineffective. HPV can be present in cells throughout the genital tract1, and is transmitted by skin-to-skin contact. Barrier methods of birth con- trol, which do reduce transmission, do not elimi- nate the possibility of infection1. A recent survey reported that approximately one-third of women attempt to prevent transmission of their genital warts by condom usage25. However, there is a risk of transmission from lesions that are not shielded by a condom25. It is still unknown at which stage patients with genital warts are infectious, and 1. Baer HS, Allen S, Braun L. Knowledge of human papillomavirus infection among young adult men and women: implications for health education and research. J Community Health 2000;25:67–78 2. Beutner KR, Wiley DJ, Douglas JM, et al. Genital warts and their treatment. Clin Infect Dis 1999; 28(Suppl 1):S37–56 3. Cates W. Estimates of the incidence and prevalence of sexually transmitted diseases in the United States. American Social Health Association Panel. Sex Transm Dis 1999;26(Suppl 4):S2–7 4. Cheah PL, Looi LM. Biology and pathological associations of the human papillomaviruses: a review. Malays J Pathol 1998;20:1–10 5. Jablonska S, Majewski S. Human papillomavirus infection in women. Special aspects of infectious diseases in women. Clin Dermatol 1997;15:67–79 6. Koutsky LA, Galloway DA, Holmes KK. Epidemi- ology of genital human papillomavirus infection. Epidemiol Rev 1988;10:122–63 7. Chuang TY, Perry HO, Kurland LT, Ilstrup DM. Condyloma acuminatum in Rochester, Minn, 1950–1978. II. Anaplasias and unfavorable out- comes. Arch Dermatol 1984;120:476–83 8. Schoultz DA, Koutsky LA, Galloway DA. Epide- miology and modes of transmission. In Gross G, REFERENCES Gall whether the elimination of the wart itself influ- ences infectivity2. Prevention of cervical cancer relies primarily on the detection of intraepithelial disease through Pap smear screening1, as opposed to the prevention of initial infection with HPV. The prospect of testing for HPV DNA in conjunction with Pap smears is currently under consideration32. CONCLUSIONS The increasing incidence of HPV infection and genital warts highlights the need for an effective strategy in the management of this disease. Even though many different treatment modalities exist, none of these have actually been proven to ‘cure’ the disease. New therapies such as imiquimod are improving therapeutic outcomes, but increasing public knowledge about prevention and trans- mission of HPV and genital warts is fundamental in the fight against these conditions. von Krogh G, eds. Human Papillomavirus Infections in Dermatovenereology. Boca Raton, FL: CRC Press, 1997:83–97 9. Simms I, Fairley CK. Epidemiology of genital warts in England and Wales: 1971 to 1994. Genitourin Med 1997;73:365–7 10. Hughes GI, Simms I, Rogers PA, et al. New cases seen at genitourinary medicine clinics: England 1997. Commun Dis Rep CDR 1998;8(Suppl):S1–11 11. Habel LA, Van Den Eeden SK, Sherman KJ, et al. Risk factors for incident and recurrent condy- lomata acuminata among women. A popula- tion-based study. Sex Transm Dis 1998;25:285–92 12. Franco EL. Epidemiology of anogenital warts and cancer. Obstet Gynecol Clin North Am 1996;23: 597–623 13. Feldman JG, Chirgwin K, Dehovitz JA, Minkoff H. The association of smoking and risk of condyloma acuminatum in women. Obstet Gynecol 1997;89:346–50 14. Munk C, Svare EI, Poll P, et al. History of genital warts in 10 838 women 20 to 29 years of age from the general population. Risk factors and association with Papanicolaou smear history. Sex Transm Dis 1997;24:567–72 INFECTIOUS DISEASES IN OBSTETRICS AND GYNECOLOGY 153