Counseling patients with genital warts

Counseling patients about any sexually transmitted disease (STD) is difficult, for both the physician and the patient, but a diagnosis of genital warts presents particular challenges. For many patients, being told that they have any STD comes as a shock. Although fear is a common reaction, the relationship between human papillomavirus (HPV) and cancer has made the presence of genital warts especially frightening. This fear is heightened by the fact that treatment will not eradicate the underlying HPV infection, and the threat of recurring warts provides a constant reminder that the patient may never be truly cured. Thus a diagnosis of HPV involves many difficult issues, including poorly understood psychological sequelae in the patient, discomfort on the part of the physician, and notification of the patient's partner(s). Finally, issues of communication, lifestyle modification, and long-term management must be addressed.