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And now another thing

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I go to a military HIV clinic. If they are anything, it is thorough. Last time I saw my Dr. I got anal PAP smear for HPV.  The results of that was a phone call saying that I needed to come in for further tests. Which I did. The test was a biopsy. That went fine but the result of that was not good, high grade squamous intraepithelial cells. So now I have a referral to general surgery to have them removed. I'm sure it will be much more technical but all I can think of is rotor rooter.  :-\

Does anyone have any experience with this kind of procedure? What can I expect? What do I need to watch out for?

If what they found was similar to anal warts, then yes, many of us have had them reomoved. It's uncomfortable (less so than in the "old days" without lasers and such) but you will be well-served by having a lot of fiber and water the days before and after. You will want/need things to "go" smoothly, to say the least.

They offer pain pills sometimes - avoid them if you can. Pain pills tend to constipate, so you are saving yourself a little pain in order to endure an ungodly pain later. Better to bite a washcloth.

I certainly hope that the biopsies of the growths do not necessitate further treatment, but rest assured, you are going through charted territory.

Sorry to hear you have to endure a surgery, but glad you were screened. 

For those following studies, what are the differences between the general public and those who have anal sex and/or HIV poz?  I know one doesn't have to have had anal sex, but it is the greatest factor, right? 

My clinic sent me a email, after they called me with the first set of result, that had a flyer attached that explained some things. Mostly the criteria used for HPV screening along with a little of what to expect. They flyer talked about anal pap smears, what it is, why it's done, and how it's done. It also talked about anal biopsies. It was pretty accurate however, I've progressed beyond the info in that flyer.

According to the flyer, an anal pap smear was recommended for HIV + people who met any one of five things, receptive anal sex, HPV infection, history of anal warts, Anal Dysplasia or an abnormal cervical pap smear. Needless to say I qualified for one of the five before the biopsy and now 3 of 5. joy.

Some of the reading I've done does talk about increase risk fo anal cancer for hiv+gay men. Anal cancer being somewhat rare and more specific to those hiv+ than colon cancer or rectal cancer. Did find this article on The Body. I'm sure there are others.

Hi, I have also been diagnosed with High Grade Anal Intraepithelial lesions (AIN 3).

One thing that bugs me about this topic is AIN is NOT the same thing as anal warts.  They are both caused by HPV but they are NOT the same thing.

I have been treated for this for about two years now.  Treatments can vary.  It really depends on how and what they treat you with.  There are some topical treatments they can use that you apply on your own such as Aldera and 5-FU cream.  Aldera isn't that bad (although some people have a bad reaction to it).  The 5-FU cream was a nightmare for me and I didn't make it through that treatment.

They can also apply acid directly to the cells, this just has a mild burning when they do it but its not that bad.

There is a procedure called Infrared Coagulation.  They zap the cells with some infra red laser thing.  It sounds worse than it is.  It's actually painless and no big deal.

Until they clear you will need to go in for anal paps and a High Resolution Anoscopy on a regular basis (ever 4 months so). Once they clear you will need to go in yearly. 

UCSF has a great website about anal dysplasia that has tons of info about it.

Everyone who is HIV positive should be screened regularly with an anal pap and high resolution Anoscopy regardless if you are gay or not.  The HIV clinic I go to screens everyone.  I guess others don't do it, but since there are no symptoms of AIN (it's not the same thing as warts) you need to be screened regularly.


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