This review aimed to look at the available literature about knowledge, attitudes and behaviours of women infected with GWs in different countries, in order to understand the impact of the disease. Certainly, healthcare priorities are different in developing and developed countries.

From the literature review it has been found that there is a wide range of reported levels of knowledge about HPV internationally. This project demonstrated significant gaps in knowledge among many women worldwide about genital and HPV infection which varies according to ethnicity, socio-economic and other demographic characteristics (Mays et al, 2000, Cuschieri et al, 2006).

Australian women in the literature seemed to be well informed about genital infection and HPV and this can possibly be attributed to the broad educational campaign about HPV vaccination (Pitts et al, 2010). Australia was the first country in April 2007 to introduce the free quadrivalent Gardasil HPV vaccine in its campaign which covers the commonest wart-causing sub-types (6,11) as well as the commonest oncogenic subtypes (16,18) for all women aged 12-26 years and younger (Donovan et al, 2010). Recently, Australia reported a rapid decline in new cases of GWs by 25% among women and 5% in heterosexual men in 2008 (Fairley et al, 2009).

The articles that I examined concluded that HPV diagnosis carried emotional reactions, and socio-psychological impacts like fear, worry, detachment and guilt, because of the cosmetic and physical disfigurement to the affected lady's genital area. Thus it is essential to address psychological needs (Hillemanns et al, 2008, Escalas et al, 2009, Dediol et al, 2009, Mortensen and Larsen, 2010, Daley et al, 2010).

It is hard to talk about sexuality openly in any community as its considered a private thing. This may make it harder to develop prevention messages which can be disseminated to the general public.

Educational intervention which may be utilised is new technology like the internet where everyone can reach out and find the information they need in private, and people tend by nature like to read about sexuality and sexual issues. Also considering the use of social networks, mobile texts, and anonymous telephone hotlines as ways of increased awareness may be useful. (DeJong et al, 2007).

Implications for policy and implementations
Adopt the ABC rule, "Abstinence (from extramarital sex), Being faithful (to spouses), Condoms (for sexually active with infected partner)", as a general rule for cultural norms.

Empower women's confidence about their rights, with a confidential approach, for her potential in making things better for society.

It seems that an almost universal finding in the literature explored for this project is the lack of knowledge about HPV among women of different ethnic and demographic backgrounds. This suggests that there is a strong case for increasing educational awareness about the infection and the possible treatment interventions, including men (GWs carrier) who seemed to be less aware compared with women, about genital and HPV infection.

Health care and service providers in the community must be educated and should be sensitive towards patients' needs and should avoid adopting a paternalistic and coercive approach in giving services and counselling in culturally sensitive ways, in order to encourage the patient to seek advice when it is needed.

Addressing psychological factors such as embarrassment and stigma, and the importance of confidentiality is a vital issue in such patients. Further communication between HPV and, or STDs patients, and clinicians needs to be improved to better understand and ensure medical care and treatment at the start.

To date, most studies on attitudes toward HPV vaccination have been conducted mostly in the western countries, thus it is a challenge to conduct in the developing countries and compare results with western cultures about women'a different ethnicity thoughts. Attitudes will be influenced by many factors such as culture, religion and diverse people'a perceptions, which can be an obstacle for running vaccination programs.

The best rule is prevention rather than cure whereby that would involve improving public health measures, such as health promotion and education, partner identification, condom use, promotion of safe sex, screening, and effective public education to slow down STDs and HPV spread.
Additionally, if only people could behave, we could say goodbye for good to every STD.