Sexually transmitted anal diseases

Sexually transmitted diseases (stds) of the anus are caused by a range of approximately 30 viruses or microbes. The possibility of a relative infection should be seriously taken into consideration in gay men and those who have anal intercourse. These diseases are often in HIV-positive men and at the same time they facilitate the HIV-infection. Infections without symptoms are very common after the anal intercourse. An asymptomatic infection by HPV is very common in gay men and reaches a percentage of approximately 70% and 90% on those who are HIV-positive.

 Inflammation of the anus

The most common manifestation of an std is the anal inflammation (proctitis). The proctitis is manifested by:

  • pain in the anus
  • constipation and a feeling of an incomplete defecation
  • liquid discharge (purulent or bloody)
  • tenesmus (continuous tendency to defecate).

The most common cause of a proctitis in gay men is gonococcus (30%), chlamydia (19%), herpes (16%) and syphilis (2%). In a significant percentage, the infectious cause is not found. If proctocolitis  appears (when the infection spreads to the intestine), then the symptoms are:

  • diarrhea
  • bloody stool
  • pain in the low abdomen
  • Sense of incomplete evacuation.

The most frequent causes of proctocolitis are Shigella, Campylobacter, Salmonella, CMV and amoeba. The infection often comes from the area of the mouth.

Besides the above infections which are responsible for causing proctitis, HPV (one of the most serious infections), molluscum contagiosum, and Haemophilus ducreyiis are also included in sexually transmitted diseases. Moreover, HIV infection and Hepatitis (A and B) are very common on those who prefer anal sex.

Preventive actions

Men and women who have anal sex, will need a yearly testing for HIV, hepatitis B, syphilis, chlamydia, and gonococcus.

In case of multiple or unknown partners or when there is use of substances or drugs, these tests should be done more frequently. Furthermore, the patient has to be checked regularly with anal cytology or even better with high resolution anoscopy for possible anal dysplasia and warts caused by HPV (usually per three years or per year if an HIV infection exists). Of course, all the necessary precautions during the anal intercourse should be taken.

The vaccination for HPV virus is considered to be essential for gay men, so it must be completed before the age of 26 years.

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