Methodology An online survey, titled Let's Talk About Sexual Health Warts and All, was fielded from February 25 March 28, 2016 by HealthyWomen, in partnership with PharmaDerm, a division of Fougera Pharmaceuticals Inc., a wholly-owned subsidiary of Sandoz Inc. The survey sought to uncover the disconnect in current conversations between health care providers and patients as it pertains to sexual health, particularly sexually transmitted disease (STDs), including genital warts. A total of 1,041 individuals participated in the survey, solicited via HealthyWomen.org (which receives more than 108,000 unique monthly visitors), and the Facebook and Twitter channels of HealthyWomen (which have nearly 38,000 combined likes/followers). The respondent pool was comprised of 873 patients/consumers (83.9 percent) and 168 health care providers (16.1 percent). Of the 1,041 respondents, 973 were female (93.5 percent) and 68 were male (6.5 percent). The response rate for each individual survey question varied; full survey results can be found below. P-VRG-1338834; 12/2016
Health Care Professional Questionnaire
Let s Talk About Sexual Health Warts and All: HCP Survey Qualifier questions 1. Sex Male Female 2. Age Younger than 18 years old (disqualification) 18-24 years old 25-34 years old 35-49 years old 50 years old or older 3. Are you a health care professional? Yes (route to HCP survey) No (route to Patient survey) HCP Demographic questions 1. What is your specialty? Family practitioner OB/GYN Urologist Internist Dermatologist Nurse practitioner Registered nurse Physician assistant Other: [fill in the blank] 2. Approximately how many patients do you diagnose with genital warts (which includes external genital and perianal warts) each year? 10 or fewer 11-30 31-74 75 or more HCP Survey Questions 3. When do you discuss genital warts with your patients? I cover the basics of genital warts with all patients. I discuss genital warts during counseling for the human papillomavirus (HPV) vaccine.
I discuss genital warts when I diagnose it. I discuss genital warts when patients bring it up. 4. To what degree do you involve patients in genital warts treatment decisions? I provide an overview of the best options and give a recommendation, which my patients usually follow. I provide an overview of the best options and encourage patients to do their own research before we agree on a regimen. I provide an overview of the best options, but patients usually come in with an idea of what they want to do. 5. Do you generally prefer to prescribe a provider-administered or patientapplied treatment? Provider-administered [go to question #6 and skip #7 and #8] Patient-applied [go to question #7 and skip #6 and #8] Combination [go to question #8 and skip #6 and #7] 6. Why do you prefer provider-administered treatments? (check all that apply) I believe they are more effective. I believe they are safer. I can be sure the process is completed properly and better control the outcome. I find patients are more comfortable with/want this option. o Why? [fill in the blank] These treatments work immediately. Other: [fill in the blank] 7. Why do you prefer patient-applied treatments? (check all that apply) I believe they are more effective. I believe they are safer. Patient-applied treatments are less invasive and painful. These treatments reduce the likelihood of genital warts recurrence. I find that patients are more comfortable with/want this option. o Why? [fill in the blank] Other: [fill in the blank] 8. Why do you prefer a combination of provider-administered and patient-applied treatments? (check all that apply) I believe this is the most effective regimen. This regimen offers both short and long-term efficacy. I find that patients are more comfortable with this option. o Why? [fill in the blank] Other: [fill in the blank]
9. What kind of treatment do you think your patients prefer (assuming equal efficacy)? A provider-administered treatment that physically removes the warts o Why? [fill in the blank] A prescription pharmaceutical applied by the patient that treats the warts more gradually o Why? [fill in the blank] 10. How would you compare genital warts to other STDs in terms of seriousness? [chart] Chlamydia is (more serious, less serious, the same, why [fill in the blank]) Syphilis is (more serious, less serious, the same, why [fill in the blank]) Herpes is (more serious, less serious, the same, why [fill in the blank]) Gonorrhea is (more serious, less serious, the same, why [fill in the blank]) 11. How would you compare genital warts to other STDs in terms of treatability? [chart] Chlamydia is (more treatable, less treatable, the same) Syphilis is (more treatable, less treatable, the same) Herpes is (more treatable, less treatable, the same) Gonorrhea is (more treatable, less treatable, the same) 12. What would you think is the biggest barrier to proper genital warts diagnosis/treatment? Patients are resistant to seeking medical help. Patients are embarrassed to discuss symptoms. Patients are resistant to discussing sexual history. Patients are resistant to discussing symptoms. Patients are not aware of genital warts severity. Patients have a hard time being compliant/keeping up with at-home treatments. Patients are averse to in-office treatments that seem invasive or severe. 13. What do you think is the number one reason patients don t want to talk about STDs, including genital and warts, with their doctors? Embarrassment Belief they will resolve on their own Denial Other: [fill in the blank]
14. What have you found to be the best way to raise the topic of STDs with your patients? Giving them literature to read at home Asking them specific questions about their sexual history and potential symptoms Discussing it after a physical exam or diagnostic tests I find it s best if I let them bring it up Other: [fill in the blank] 15. What, in your opinion, do patients need to know about genital warts? (check all that apply) Treating genital warts can reduce the risk of transmission. If not treated, genital warts can grow in size and number. Preventative measures, such as condoms, may not work to prevent transmission. Genital warts can be associated with painful symptoms. Between 20 percent and 30 percent of genital warts outbreaks will go away without treatment. Genital warts can be more likely to occur due to various factors, including smoking, HIV infection and a compromised immune system. Treatments are available to suit patients individual needs. All of the above
Patient/Consumer Questionnaire
Let s Talk About Sexual Health Warts and All: Consumer Survey Qualifier questions 1. Sex Male Female 2. Age Younger than 18 years old (disqualification) 18-24 years old 25-34 years old 35-49 years old 50 years old or older 3. Are you a health care professional? Yes (route to HCP survey) No (route to patient survey) Consumer Survey Questions 1. Which health care provider are you most likely to talk to regarding your sexual health? Family practitioner OB/GYN Urologist Internist Dermatologist Nurse practitioner Registered nurse Physician assistant Other: [fill in the blank] 2. Do you or anyone you know currently have genital or perianal warts (commonly referred to as genital warts), or have you or anyone you know been diagnosed with genital warts in the past? (check all that apply) Yes, I have genital warts. Yes, I have had genital warts previously, but have not experienced a recurrence. Yes, I know someone who has genital warts. Yes, I know someone who has had genital warts previously, but that person has not experienced a recurrence. No, I have never had genital warts. No, I don t know anyone who has ever had genital warts.
3. Which conditions do you ask to be screened for at your annual exam? (check all that apply) HIV Cervical cancer (Pap and/or HPV tests) Chlamydia Syphilis Gonorrhea I do not ask to be screened for any of the above conditions Other: [fill in the blank] 4. Which conditions does your health care provider suggest you should be screened for at your annual exam? HIV Cervical cancer (Pap and/or HPV tests) Chlamydia Syphilis Gonorrhea My health care provider does not suggest I be screened for any STDs Other: [fill in the blank] 5. Do you discuss STDs with your partner when you begin a new sexual relationship? Yes, I bring up STDs as soon as I start seeing someone new. Yes, I bring up STDs when the relationship starts to become sexual. Yes, but I wait for my partner to bring it up when he or she is comfortable. No, I do not discuss STDs with my partners. 6. How would you describe your knowledge of genital warts? Very knowledgeable because of my personal experience(s) Very knowledgeable because of a friend s experience(s) Very knowledgeable because of conversations with my health care provider Somewhat knowledgeable because of articles I ve read online or in other places Not very knowledgeable 7. Which of these statements do you think apply to genital warts? (check all that apply) About 1 million cases of genital warts are diagnosed each year. Genital warts are more common in women than men. Genital warts is a common, easily contracted sexually transmitted disease. Genital warts can be so small that you sometimes can t see them. If untreated, genital warts can go away without medical treatment. If untreated, genital warts can grow in both size and number. Genital warts can be painful. Health care providers can treat genital warts in their offices.
Genital warts can be treated at home with prescription topical ointments and creams. Once you treat genital warts, you can get them again. Genital warts are caused by the human papillomavirus (HPV). The HPV vaccine may protect against genital warts. Genital warts are contagious and can be spread to sexual partners. 8. Which of these genital warts symptoms are you aware of? (check all that apply) Small, flesh-colored growths in your genital area Several warts clustered together Itching or discomfort in your genital area Abnormal vaginal discharge Bleeding with intercourse 9. If you needed to treat genital warts, would you rather do it yourself at home or see your health care professional for treatment? Do an at-home treatment by myself [go to question #10] See a health care professional for treatment [go to question #11] A combination of at-home and in-office treatments [go to question #10 and then question #11] 10. Why would you want to do an at-home treatment for genital warts? (check all that apply) I d be embarrassed to have a health care professional treat me. I d prefer to avoid office visits if alternative options are available. If I treat myself at home, I can monitor progress without having to make repeated trips to see my health care professional. I think an at-home treatment will be cheaper than seeing a doctor. 11. Why would you see a health care professional for genital warts treatment? (check all that apply) Being professionally treated ensures it will work. I think that seeing a doctor for treatment is the fastest route to a cure. I d be too nervous to perform the treatment myself. 12. How truthful are you with your health care professional about your sexual history? Very truthful; how else will he/she know what s going on? Somewhat truthful; if I have a specific question or problem I ll bring it up during my appointment, but he/she doesn t need to know everything. Not very truthful; I don t like sharing that type of information. Not truthful at all; as a health care professional, shouldn t he/she be able to diagnose anything after an exam?
13. How do you want your health care professional to bring up/discuss genital warts with you? I bring up any questions or topics I want to discuss during appointments. I want my health care professional to provide me with information about genital warts (and all STDs), including risk factors and symptoms, during my annual exam. I want my health care professional to ask about genital warts only if I exhibit signs or symptoms during a physical exam. Other [fill in the blank] 14. How did you feel or how would you feel if you received a genital warts diagnosis? (check all that apply) Embarrassed; how am I supposed to tell sexual partners about my diagnosis? Ashamed; I should have taken more precautions. Scared; where can I turn for information? What can I do next? Devastated; I would be more upset than ever before. Relieved; I d rather know so I can receive treatment sooner than later so I can move on. 15. In addition to the health implications, what would most upset you about receiving a genital warts diagnosis? (Rate in order, 1=least upsetting, 5=most upsetting) The treatment Disclosing my diagnosis to my sexual partner and/or past partners The embarrassment or stigma of having an STD The worry over it coming back in the future, even if I treat it now The cost of managing my condition 16. How did (or would) receiving a genital warts diagnosis change your life? (check all that apply) It would drastically change my life. I don t know if I would ever feel comfortable in my skin again, and I think my relationship with my sexual partner would be strained. It would change somewhat. I would reevaluate how I protect myself from STDs, but I would be able to move on. It would not change my life. I would continue to live my life as always. Other: [fill in the blank]
Full Survey Results