Pap Smear anyone???

[numbersguy82]

Ok so my Doc has decided to give me a Christmas present. I get a Pap Smear in December. Is this normal routine maintence now that I have HIV? None of my friends have ever had them and I'm wondering why she chose to schedule me for one? Is she just milking my insurance for all that it is worth... does she hate me... on the opposite does she enjoy seeing me naked???

Just curious because I haven't heard much about them on here.

[emeraldize]

Hi NG,

You've got a thoughtful doctor, who rather than milking insurance, is looking out for you.

Have you ever had a PAP smear? If not, it's good to have a baseline for two reasons, you are an MSM and you have HIV. With the combo, you are at the highest risk level of developing anal cancer.

Here is one of a host of articles that will give you information and a feeling of confidence that she's doing right by you.

http://www.advocate.com/Health_and_Fitness/Health_and_Treatments/Health_A_to_Z/The_Male_Pap_Smear/

edited to add: If you use this site's Search mode, and just type in pap smear, you'll get a few female-related but mostly male-related threads and posts that you'll also find very helpful.

Best,
Em

[Granny60]

None of the clinics I have been to do pap smears on men, but do women,  but it is recommended in treatment guidelines. I have wondered why this cheap simple test is not more commonly used.  Once established Anal/Colon cancer can be brutal and have met several that were not diagnosed until they had metastasized cancer.

[sharkdiver]

Ok so my Doc has decided to give me a Christmas present. I get a Pap Smear in December. Is this normal routine maintence now that I have HIV? None of my friends have ever had them and I'm wondering why she chose to schedule me for one? Is she just milking my insurance for all that it is worth... does she hate me... on the opposite does she enjoy seeing me naked???

Just curious because I haven't heard much about them on here.

   it's no biggie, it lasts less than a minute. 

[numbersguy82]

Thanks Em-
I honestly thought she was joking until she produced 3 printed pamphlets about male pap smears. I thought why go thru all the trouble to print these up for a gag lol. Thanks for the link. I have checked with all of my friends and none have had them so I was confused. I actually love my doc, and after much research decided she has the best qualifications in my area plus she has a stern yet gentle bedside manner!

[numbersguy82]

Good point Granny better safe than facing something which could have been more treatable having been caught early!!!

Sharkdiver to be honest just the name invokes Fear. It sounds terrible. I know it won't be a big deal, but man could they call it something else? Like Pap screening even??

She told me not to prepare before and to be natural. She traded me a tootsie roll for my promise to skip my weekly vinegar enema for the exam LOL

[WillyWump]

Yeah I've had one. It's not too bad, doesnt hurt, lasts a few seconds. Kind of impersonal, I mean the least she could have done was  give me a reach-around.

-Will

[wolfter]

Thanks for the post.  I had no idea of such a thing.  At first, I was a little excited by the prospect because I have a gorgeous younger gay doctor.  Did I understand correctly that there's a vaccine even if you've had a history of HPV?

[Granny60]

Thanks for the post.  I had no idea of such a thing.  At first, I was a little excited by the prospect because I have a gorgeous younger gay doctor.  Did I understand correctly that there's a vaccine even if you've had a history of HPV?

The vaccine has been approved for men under 26 now mainly because a high percentage of men over that age already have HPV . one brand covers 2 strains,  one covers 4 strains. It may not protect against a strain you already have, but  the vaccines are a good defense against the strains that are commonly associated with cancer.  Personally, I think everyone should get the vaccine. Hubby is still HPV neg at his age and I think he should even be vaccinated just so he doesn't get HPV from a blood transfusion or whatever,  but currently he is outside the recommended guidelines age wise.  On a side note, if you read the product label, you will find they still do not know if the vaccine will provide LONG TERM protection.  You may need a booster years down the road. That is still to be detmined.

[odyssey]

Yeah I've had one. It's not too bad, doesnt hurt, lasts a few seconds. Kind of impersonal, I mean the least she could have done was  give me a reach-around.

-Will

You'd take a reach around from a girl Wumpsters?

[J.R.E.]

I've had it done too.  It's very quick and painless !!


Ray

[tednlou2]

None of the clinics I have been to do pap smears on men, but do women,  but it is recommended in treatment guidelines. I have wondered why this cheap simple test is not more commonly used.  Once established Anal/Colon cancer can be brutal and have met several that were not diagnosed until they had metastasized cancer.

I've wondered why anal pap smears aren't being done more often.  I keep reading so much information about the benefits and need for them.  Is it because most docs still don't know how to do them?  I see others here have gotten them.  It would be a shame to get anal cancer when a test could have caught it.

Are there warning signs that something ain't right down there?  And if you have those signs, is it already fairly progressed by then?

[edfu]

Extremely important info:

http://www.thebody.com/content/confs/croi2009/art50604.html

[Miss Philicia]

Definitely read edfu's link, I've read it previously (and perhaps referenced it in other threads) and in my opinion the explanation of why more attention isn't paid to this matter is that many HIV doctors probably don't know where to go after the PAP smear comes back -- an HIV specialist can do a PAP smear easily, it's just sticking a large Q-tip up your ass, but when/if it comes back showing an irregular cell structure many don't know how to read it, or where to send you for further monitoring because this is an area that's been evolving over the past several year in terms on anal dysplasia (what HPV can develop into and become a larger concern).

As stated, the PAP smear is only the first small step. I had my first one seven years ago, but my HIV doctor at the time was pro-active with the issue and able to immediately refer me to someone specializing in ano/rectal disorders that did high-resolution anoscopy, and I had one place up my pooter treated with laser surgery.  After moving to Philadelphia I informed my current HIV specialist of my previous treatment and he referred me to someone locally for monitoring.  I had a more recent PAP smear done and it came back as showing that whatever was currently going back there was OK, but they'll still continue to monitor it but in a less invasive manner.

Oddly the handful of doctors that I've dealt with all know each other professionally, though they've been in two different cities.  Seemingly it's a smallish circle of doctors dealing with this, and even in my LTS local support group I get blank stares when I raise this issue.

[Miss Philicia]

ps: edfu, as I know you comment on this issue a lot, would you mind relating what you've had done with it in the couple of locations you have recently lived in?

[jay195]

I have had a PAP done every year without fail since I was 25 years old and now I am 58.

                Jay xx

[bocker3]

Because I've had a few bouts with anal warts, I see a colon-rectal specialist each year.  He's not a big fan of pap smears, but does the anoscopy each time I visit. 

Mike

[Assurbanipal]

I checked on getting a pap smear with my GP last time I was there and he said he had never done one and that I should talk iit over with my ID doc.  He actually has a practice subspecialty of geriatrics and I've only ever seen 2 younger patients (and I'm in my 50's).

He's given Gardasil twice.

On to the ID doc in Dec.

[edfu]

I have had a PAP done every year without fail since I was 25 years old and now I am 58.

Ms. Jay, I believe the Pap test you're referring to is the cervical Pap test, which is universal practice.  The Pap test we're talking about here is an anal Pap test, which is not yet accepted as standard medical practice (sadly).  The purpose of the latter test is similar to the former:  to find out if there are any cell abnormalities caused by the human papilloma virus, but the ultimate objective is different--to take appropriate steps to prevent full-blown anal cancer as opposed to cervical cancer.  HPV causes both cervical and anal cancer.

The shocking statistic is that there now are more anal cancers annually diagnosed in HIV-positive gay men than there were annual cervical cancers when the cervical Pap test became fully accepted protocol.  The destruction of low-grade and high-grade lesions, which may develop to full-blown cancer, is analogous and is the ultimate follow-up to Pap tests that indicate cell abnormalities.   One of the many current problems is that there is now no accepted protocol for what to do about anal cell abnormalities confirmed by biopsy after the anal Pap test indicates there are potential problems.  There is only an accepted protocol for treating full-blown anal cancer:  chemotherapy and radiation.    

[edfu]

ps: edfu, as I know you comment on this issue a lot, would you mind relating what you've had done with it in the couple of locations you have recently lived in?

Deja vu, Miss P.  You've asked me about this before.  I related my experiences in NYC in this thread from 2007.  See my post #21, dated 6/11/07:

http://forums.poz.com/index.php?topic=12942.msg162034#msg162034

When I get the strength, I will relate what happened after I moved to Connecticut in Jan. 2009, but I am at the moment too upset.  Sorry. 

[Miss Philicia]

Deja vu, Miss P.  You've asked me about this before.  I related my experiences in NYC in this thread from 2007.  See my post #21, dated 6/11/07:

http://forums.poz.com/index.php?topic=12942.msg162034#msg162034

When I get the strength, I will relate what happened after I moved to Connecticut in Jan. 2009, but I am at the moment too upset.  Sorry. 

Sorry something has upset you -- hope whatever it is goes away.  Yeah, I was really meaning more after you moved as to how easy it was to locate someone there that would continue what you'd had done previously.

[edfu]

Sorry something has upset you -- hope whatever it is goes away.  Yeah, I was really meaning more after you moved as to how easy it was to locate someone there that would continue what you'd had done previously.

OK, in brief:  I tried for a year and a half to find someone who would administer an anal Pap smear or a high-resolution anoscopy.   The HIV hospital-affiliated clinic looked at me like I was insane.  Every doctor and administrator told me each time I asked, every three months when I went for my labs, that they would have to get back to me.  They never did.  The ASO also told me they had never heard of this issue and doubted that they could use their Ryan White funds for this, as they did not believe it was HIV-related.  I'm pleased to say that I finally convinced them of the latter by forwarding Internet links.  When I originally asked them if they paid for cervical Pap tests for their female clients, they said yes (!). 

After phoning around myself to no avail, I finally thought to check the Gay and Lesbian Medical Association (GLMA) website and found a reasonably located GP but had to have someone make an intervention so that I could see him.   He did indeed administer anal Pap tests, and I failed mine.  He told me that he had tried for three years to set up an established protocol with my HIV clinic for dealing with this issue but had failed.   Then the next shocking revelation:  He insisted that there was only one colorectal guy in the whole state of Conn. who performed high-resolution anoscopies, including the Yale-New Haven medical establishment.  This guy performed HRA's only in a hospital surgical setting, with general anesthesia.  When I pointed out to him that HRA's were commonly done in NYC doctors' offices, he snidely suggested that I then go to NYC to have it done.

I will leave it at that for now.  I apologize again.

[Miss Philicia]

That sounds like a disheartening ordeal to say the least.

[Grasshopper]

HPV is not only causing anal cancer in men, but possibly also throat cancer.

read more: http://abcnews.go.com/Health/ReproductiveHealth/hpv-oral-cancers-rise-oral-sex-popular-spread/story?id=11916068

[jay195]

Edfu, thanks for the info. I didn't know guys could get pap smears done.

[Jeff G]

My clinic does pap smears on me every year . I had mine done last week . 

[Miss Philicia]

My clinic does pap smears on me every year . I had mine done last week .  

And where do they send you if/when it shows irregular cell structure and needs high grade anoscopy to detect anal dysplasia?

http://www.ncbi.nlm.nih.gov/pubmed/15156490

[Jeff G]

And where do they send you if/when it shows irregular cell structure and needs high grade anoscopy to detect anal dysplasia?

Good question . That hasn't happend so I don't know . I would assume a research hospital such a UAB where I'm seen would have on in use ? .

[Miss Philicia]

Good question . That hasn't happend so I don't know . I would assume a research hospital such a UAB where I'm seen would have on in use ? .

so your PAP smears show no irregular cell structures I take it?

[Jeff G]

so your PAP smears show no irregular cell structures I take it?

That's correct , it has always shown no problems detected . I looked at the link you provided , thought provoking 

[next2u]

my doc ain't hip to it either but i believe we anal sex lovers need em. ill be seeing my id in two weeks or so and will request one.

best,
d

[AaronbytheC]

Well I got one today and it wasn't bad at all.   
 
My doc sent me to a doctor who specializes in stuff like this.  He was super knowledgeable, cute and gay!  He made the who experience relaxed, funny and enjoyable.   

After the Q-tip test he stuck a small camera thing up there and took a look.   
He says to me "it looks good from here"  I had to just laugh...  and say well thank you! 

He recommends that they be done annually for gay men.