In March, after having lived for several months with what I thought was a "skin tag" on my anus, I consulted a doctor and discovered I had a light case of anal warts. My path to discovering and treating HPV was fraught with difficulties and I'd like to talk about some of them here. Rose Afriyie has also written about my experiences in her sex column for the Michigan Daily.
At the time in which I contracted HPV, I was practicing what I call "serial monogamy." This means I, having just gotten out of a long-term relationship, casually dated three men consecutively for about two months at a time. In each case, my partners and I used the fact that we were technically monogamous as an excuse to not use condoms.
In December, before having unprotected sex, the guy I was seeing and I actually discussed how he had had genital warts several years previously. He advised me that most sexually active gay men already have the virus lying dormant in their bloodstreams. True as this may be, it doesn't change the fact that having unprotected sex with this man probably gave me anal warts.
Skip ahead to February. I'm seeing a new guy and I visit University Health Services to get a "full" STI screening. After describing my sex practices to the physician's assistant, he examined my genitals and gave me a blood test, ignoring my rectum entirely. Since I am a (nearly) strict bottom, this represents a significant oversight. While I made a mistake in failing to demand that the PA peek at my nether regions, a rectal examination should have (in a perfect world) been a standard component of the examination in the first place.
After my blood test came back clean, I continued to have unprotected sex with my new partner. It was not until about a month later that I, still irritated by the bump on my rectum, discovered I had HPV. If the PA had looked at my anus at UHS, he would have recognized the bump as a wart and I could have been treated (and started practicing safer sex) earlier.
When I finally visited my family physician, he offered to freeze off the warts through cryosurgery. Having been advised by a friend who is a medical professional that burning off warts (fulguration) is the more effective treatment for HPV, I declined my doctor's offer and instead visited a colon and rectal surgeon where I was able to receive this procedure. I am miffed that my family doctor both discouraged me from pursuing fulguration and advised me that it was unnecessary to use a scope to check for warts further inside my rectum. This seems like shoddy medical advice administered by a doctor that has not been properly educated about gay men's health issues.
Now that I have been treated and can happily insert penises and other (protected) objects into my asshole once again, I have become acutely aware of the need for the biomedical and public health spheres to develop a greater sensitivity to the sexual health needs of gay men in particular and people who practice anal sex in general. This would include the introduction of an HPV vaccine for men, and a more sophisticated discourse about safe sex that does not automatically privilege monogamy as "safer" than other relationship styles.
Honey! Thanks for this wonderful and educationally useful story! It perfectly illustrates the need for mainstream doctors to be clued into the health needs of gay men. I have had one straight doctor here at Michigan's UHS examine my bum before, but generally they ignore my backside without asking much about it. Anywho, thanks very much for speaking out!
Agreed.....the inability and/or unwillingness of many providers (specifically those who are not queer and/or not competent in dealing with the issues of queer patients) to talk to queer men about their asses is appalling.
This post can also easily dovetail into another issue of import to queer men, especially bottoms: anal pap tests and and screening/treatment for anal dysplasia. There is mounting evidence that people who have anally receptive sex (which clearly includes many queer men) should be screened...and that risk increases with history of ano/genital warts and/or being HIV-positive----and yet far too few providers are offering this kind of screening and far too few patients are advocating for it on their own behalf!
Hey Scott!
Thanks so much for posting this -- it takes a lot to do this! I swear to you I thought my dating life would be over when I posted a similar bit here, but it has turned into an amazing opportunity to educate people.
I'm in nursing school and I've noticed two things: 1) the way we handle sexual health is depressing and disappointing -- it was one lecture, and we didn't even do specifics; 2) what we did cover was not homo-inclusive. I went to speak to the professor afterwards -- I work in sexual health, she's a sexual health educator, thought we would be BFF's -- and offered to share my org's sexual health assessment (which is LGBTQ inclusive, IMHO) and her response, "Mine's three times as long and has been developed over 10 years -- what else could yours have?" More importantly, when I came out as a Queer blogger to some of my students/teachers to promote a fundraiser we were doing here in town, the response was: "We don't want to know that about you, Barry, this is a professional school." "What? The blogging part?" "No, the other part."
In short: the whole LGBTQ health care thing is appalling and I honestly think that had it not been for HIV/AIDS, no one would have cared at all. The best they can muster is: "If they're gay, get 'em tested for HIV." Which, you have to admit, is an improvement.
B/Queercincinnati.com