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Questions and Answers about Anal Pap Smears

The Pap smear, developed by Greek doctor Georgios Papanikolaou almost 70 years ago is a quick painless test in which cells of the female cervix are examined for abnormalities. Prior to routine pap smear testing in women, cervical cancer was the number one cancer killer in women worldwide. Over the last decade, physicians have come to recognize that the same test may be used for the early detection of anal cancer, an illness which is on the rise worldwide, especially in the gay and lesbian community. The disease is easily treatable when found early and is preventable. This is intended to dispel some myths about anal pap smears and help you decide if pap smear testing is right for you.

My partner was vaccinated for HPV. Should I get an Anal Pap Smear? 

Yes. The vaccine helps protect against the acquisition of low risk subtypes that cause the majority of genital warts and the high risk subtypes that cause the majority of anal cancers. Unfortunately, if either you or your partner has had exposure to the high risk subtypes at any time in the past, the vaccine will not destroy it.

Yes. HPV can be spread through skin-toskin contact and is easy to pass even in the absence of penetration

I’ve never had unprotected anal sex. Should I get a Pap Smear? 

Yes. Condoms help, but do not prevent infection. HPV can lie at the base of the penis, scrotum and thighs where condoms offer no protection.

I had warts treated 20 years ago and haven’t seen any since. Should I consider getting a pap smear? 

Yes. All we know for sure is that you have had Human Papilloma Virus (HPV) infection in the past. Like many viruses, HPV can lay asleep for decades waiting for the chance to wake up and reinfect.

I’m HIV negative. Should I get a Pap Smear? 

Yes. Unfortunately, a number of other high-risk populations have been identified including HIV negative men who have sex with men (MSM), women who have sex with women, people who engage in unprotected intercourse with multiple partners, transplant recipients, women with a history of abnormal cervical pap smears, and IV drug users.

I’m HIV positive, but my viral load is undetectable and Tcells are doing great. Should I get a Pap Smear?

Yes. Unfortunately, while the rates of many cancers have gone down with the HAART-era, anal cancer is on the rise and no correlation to CD4 counts or viral loads has been observed.

I have been vaccinated.  Should I get a Pap Smear? 

Yes. As mentioned above, if you were exposed to the high risk types prior to vaccination, the vaccine can’t protect you. Although we have tests to check which subtypes you may have, they are not currently approved for routinely in men.

I haven’t had sex in years. Should I get a Pap Smear?

Yes. HPV can ‘sleep’ in you for decades and there is some evidence that the longer you have been exposed, the higher risk you have. This is even more important now that many people with HIV are living almost normal life spans with their disease.

I had a full battery of STD tests recently and all came back negative.  Should I get a Pap Smear? 

Yes. At this time, the DNA tests for HPV are somewhat imprecise and not always offered in a routine STD screening program. Up to 70% of HIV negative MSMs and close to 100% of HIV+ MSMs will test positive for at least one subtype of HPV even if they have never seen a genital wart in their lives.

I’m a virgin. Should I get a Pap Smear? 

Yes. Penetration is NOT required to be exposed to HPV, so unless you have never been intimate with anybody EVER, you may be at risk.

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