Open Access Research article

Human papillomavirus-related psychosocial impact of patients with genital warts in China: a hospital-based cross-sectional study

Shu-Zhen Qi1, Shao-Ming Wang2, Ju-Fang Shi2, Qian-Qiu Wang13, Xiang-Sheng Chen13, Li-Jun Sun4, An Liu4, Nanci Zhang5, Ning Jiang13, Priya Siva26, Xiu-Lian Xu1 and You-Lin Qiao2*

Author Affiliations

1 Institute of Dermatology, Chinese Academy of Medical Sciences, Peking Union Medical College, Nanjing, China

2 Cancer Institute/Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China

3 National Center for STD Control, China CDC, Nanjing, China

4 Beijing You An Hospital, Capital Medical University, Beijing, China

5 University of California, Los Angeles, USA

6 Vanderbilt University School of Medicine, Nashville, Tennessee, USA

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BMC Public Health 2014, 14:739  doi:10.1186/1471-2458-14-739

Published: 21 July 2014



Genital warts (GW) are the most common sexually transmitted infections. To date, few studies using a human papillomavirus (HPV)-specific questionnaire have focused on the impact of quality of life (QoL) among patients with GW in developing countries. The origins of GW related psychosocial burdens and variations between genders were poorly characterized as well.


A hospital-based survey was conducted in Beijing and Nanjing of China in 2008. Eligible patients aged 18–65 who had a diagnosis of GW within 3 months were recruited. Demographic information, HPV knowledge, and assessment of psychosocial burden were collected by the HPV Impact Profile (HIP). The HIP examined 7 specific psychosocial domains by 29 items: (1) worries and concerns, (2) emotional impact, (3) sexual impact, (4) self-image, (5) partner and transmission, (6) interactions with physicians, and (7) control/life impact. HIP scores are reversely relates to the subjects’ QoL, by which a higher score indicating a heavier psychosocial burden.


Patients with GW experienced heavier psychosocial burdens than those of the general population, and females experienced heavier burdens than males (male vs. female: 49.20 vs.51.38, P < 0.001). “Self Image” and “Sexual Impact” were the two domains that affected patients the most, with mean HIP scores of 63.09 and 61.64, respectively. Women suffered heavier psychosocial burdens than men in the domain of “Worries and Concerns” (female vs. male: 54.57 vs. 42.62, P < 0.001), but lower psychosocial burdens in the domains of “Sexual Impact” (female vs. male: 59.16 vs. 65.26, P < 0.001) and “Interactions with Doctors” (female vs. male: 34.40 vs. 41.97, P < 0.001). Patients from Nanjing suffered a higher psychosocial burden than those of Beijing, especially in domains of “Emotional Impact”, “Sexual Impact”, “Partner and Transmission”, and “Interactions with Doctors”.


Patients with GW suffered heavy psychological burden, and self-image and sexual-related concern were the primary cause of burdens. It’s important to change the current biomedical model to bio-psycho-social model, and establish psychosocial support systems. The distinctions of origins of psychosocial burden between genders identified will be informative for prevention of GW and control efforts in China and other similar settings.

Genital warts (GW); Psychosocial burden; Quality of Life (QoL); Human papillomavirus Impact Profile (HIP)