Genital Warts among Men in Baghdad/ Iraq: Characteristics and Public Health Concerns

Abstract

Introduction: Genital warts “caused by Human Papilloma Virus (HPV)” represent a common public sexually transmitted infection with notable psychosocial and public health considerations. Those infections are considered as important causes for both the genital warts and cervical cancers in the female population, however recent studies have demonstrated their role in the anogenital warts and malignancies in men also. Transmission of those infections can be effectively prevented with vaccination; however it is not yet part of the Essential Programme of Immunization (EPI) in Iraq. Understanding the characteristics of patients with genital warts could offer insights into disease patterns, delays in care (and its possible public health sequences), and the need for probable targeted public health interventions.
Aim: To describe the demographic and clinical characteristics of male patients with genital warts and their possible public health implications.
Methods: A descriptive cross- sectional study conducted on data of male patients attending a dermatology clinic in Baghdad/ Rusafa from Jan.2024 to Jun.2025 and diagnosed clinically with genital warts. Data included age, marital status, number of lesions, the duration of infection, and history of seeking health care. Analysis was performed by SPSS, applying chi-square test with a significance level ≤0.05 for the qualitative values, while means and other statistics were used for quantitative ones.
Results: The study included 47 male patients aged between 22 to 53 years (mean age: 35.9), the age groups 26-35 and 36-45 years accounted for 46.8% and 27.7% respectively. Among all patients, 63.9% were unmarried. Multiple genital wart lesions were present in 59.6% of cases, and 74.5% did not receive or seek a prior health care or treatment. Infection duration was less than six months in 55.3% of patients. There was a significant association between infection duration and both the presence of multiple lesions and a previous history of seeking health care, with a p-value of < 0.001 for both variables.
Conclusions: (1.) About three- quarters of patients were 26-45 years old, about two- thirds of them were not married, and most of them presented with multiple untreated lesions, this is highlighting the need to prioritize this age group in any future public preventive health strategies. (2.) Most patients did not seek a previous health care or treatment, indicating possible delayed diagnosis and limited prior medical intervention which could lead to further public wide transmission for both sexes in the community. (3.) The duration of infection was significantly associated with both the number of lesions and prior health care seeking, in which the longer duration was linked to clinical progression (multiple lesions) and to previous attempts at seeking medical care which appeared to be ineffective in resolving the condition.
Recommendations: (1.) Introduce HPV vaccination into Iraqi EPI (initially could be targeting adolescent females) to reduce the community transmission of HPV and its public health consequences, and to decrease the incidence of genital warts and their complications in both sexes. (2.) Raise public awareness about HPV transmission, symptoms, and preventive strategies, particularly among men in their 20s to 40s, with integration of HPV- related services in routine sexual health care and public health programmes. (3.) Encourage early medical consultation for genital lesions to reduce the duration of untreated infection and the risk of public transmission among both sexes.