I recently returned from the 18th Conference on Retroviruses and Opportunistic Infections or what is more commonly referred to as CROI. Considered by most HIV clinicians to be the most important HIV meeting of its kind, CROI gathers physicians, scientists and healthcare providers from around the world.
One of the most interesting symposiums addressed the growing number of cases of anal cancer. Over 5,000 cases of anal cancer are diagnosed annually. A little more than half are among women. Anal cancer develops from the human papilloma virus (HPV), the same organism implicated in cervical cancer. HPV is transmitted via contact through receptive intercourse, which begs the question: If more than half the cases of anal cancer are among women, then how much anal sex do women engage in?
Very little has been reported about anal cancer rates. Part of the issue is the stigma attached to this sex act. Farrah Fawcett supposedly died from complications related to anal cancer. Upon her death I read many articles that said she died from colon cancer.
Further analysis of the date showed that HIV positive men who have sex with men (MSM) had high-grade anal lesions 2- 3 times more than HIV negative MSM’s. High grade lesions can go onto become cancerous.
Gardasil is an FDA approved vaccine used for the prevention of HPV serotypes 6, 11, 16 and 18. The latter two are potentially cancerous. Initially approved only for women, the indication now includes men. Unfortunately, Gardasil is not always covered by insurance. Given in 3 separate injections over 6 months, Gardasil can cost over $300 for the entire series.
It’s important to discuss your sexual practices with your doctor. The consensus at CROI is that Gardasil should be offered to all women and MSM’s, especially those with a history of HPV.