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Although infections of the genital tract by human papillomavirus (HPV) may be associated with genital warts, they are not clinically obvious in many cases and must be diagnosed by sophisticated laboratory assays. To learn more concerning the prevalence of HPV infection in an inner-city group of women who visited a clinic that treated sexually transmitted diseases (STDs), a study of 116 patients was carried out. The patients were interviewed and underwent gynecological examinations during which specimens were collected. Tests were carried out for several STDs in addition to HPV infection. A comparison of the results of different tests for diagnosing HPV was made. STDs were common among this clinic population: 14 percent of the patients tested positive for gonorrhea; 15 percent were infected with Chlamydia trachomatis (which causes chlamydia); 21 percent had signs of Trichomonas vaginalis (which causes trichomoniasis); and 23 percent had bacterial vaginosis. Between 12 percent and 41 percent of the women were infected with HPV; the results varied according to the diagnostic test used. Evaluation of Pap smears for pathologic changes associated with HPV led to the highest estimation of the prevalence of HPV, while diagnoses based on the presence of warts led to a much lower estimate. Each diagnostic approach has strengths and weaknesses, and almost one-fifth of the specimens could not be evaluated for HPV by all methods. The difficulty in obtaining appropriate specimens hinders the accurate diagnosis of the disease. Diagnosing HPV infection presents an important problem for STD clinics. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research in sexually transmitted diseases (STD) has been primarily directed at biological and clinical aspects. Recently, the more common STDs have become more difficult to control and contain, and new STDs have appeared that are not responsive to the usual therapies. Alternative approaches are required for prevention. Behavior modification as one of these alternatives was shown to be successful in homosexual males in response to the AIDS epidemic. These behavioral changes have also resulted in reduced levels of syphilis and gonorrhea for this population. Changes in sexual habits, earlier onset of sexual activity in women, unplanned pregnancies, and problems of youth make the need for educational and behavioral interventions more urgent. Many of the high risk persons are users of inner city STD clinics and these clinics provide an important point for the dissemination of health and related information. A study group of 116 African-American women, 16 to 43 years old, were selected from those attending an inner city clinic. The patients were consecutively selected, and the usual routine tests were conducted as indicated by patient complaints and symptoms. Each woman was interviewed and questioned regarding sexual behavior, age at first intercourse, number of partners, frequency, pregnancies, sanitary product and douche usage, knowledge of the Pap test, social and smoking habits, and other general and sex related questions. Responses strongly indicated a lack of rudimentary information and the need for both clinical and social education. The STD clinic provides a suitable setting for the delivery of this information. (Consumer Summary produced by Reliance Medical Information, Inc.)