According to a medical study by experts in cancer and epidemiology, of the 620,000 homosexual and bisexual men in the United States living with HIV in 2014, 100,000 of them were not even aware of their infection. The study showed that they are also 100 times more likely to have anal cancer than HIV-negative men who exclusively have sex with women. The researchers contend that anal cancer is “the next big crisis.”
The researchers noted that the introduction of anti-retroviral therapy for those infected with HIV greatly reduced the incidence of deaths related to AIDS while improving survival rates. But the introduction of the therapy did apparently change risk behaviors. The authors of the study, which was published last month in the journal Cancer, wrote: “However, this improvement in survival led to an increase in the lifetime risk of developing anal cancer, especially among HIV-positive gay and bisexual men.”
The researchers noted that anal cancer is caused by chronic or persistent human papillomavirus (HPV) infection. Such an infection can lead to anal precancer and, if not adequately treated, may lead to full-blown anal cancer. The human papillomavirus can also lead to cervical, vaginal, vulvar, oropharyngeal, penile, and rectal cancers. HPV is found among approximately one-third of men in the general population.
While HPV may clear naturally, under some circumstances it may persist and then progress into anal cancer if undetected and untreated. According to the American Cancer Society, there will be 8,200 new anal cancer cases this year. Without a national screening protocol, the authors of the study estimate that more than 50 percent of these people will be diagnosed at stage III or IV anal cancer, when five-year survival is less than 40 percent.
“This creates a major public health concern,” they wrote.
The authors of the study suggest that even though HPV vaccination is not currently recommended for persons aged 27 or older, they believe that their findings confirm that vaccination of those persons already diagnosed with anal precancer may experience a reduced risk of a recurrence of precancer after treatment, which typically involves surgical treatment.
A similar study in Clinical Infectious Diseases in 2009 showed that the incidence of anal cancer was increasing in a population of women in Hawaii. The infected women tended to be young, white, less-educated, low-income, and with a history of receptive anal sex, and multiple sexual partners. Non-penetrative sex and use of fingers and sex toys also may have contributed to transmission of HPV, or the virus could have been shed from cervical secretions, the report said. According to one of the authors of that study, Dr. Brenda Hernandez, it is possible that some of the participants in the study were less than candid about how they contracted the infection.
Participants in the study were twice as likely to contract the high-risk strains of the HPV virus associated with cervical and other cancers than the low-risk variations of the virus, the report showed.
Despite studies such as those referenced above, various websites and publications directed at minors advocate anal sex for women and girls. For example, Teen Vogue writer Gigi Engle penned an article titled “Anal Sex: What you need to know.” The editor of Teen Vogue is a young homosexual man, Phillip Picardi. In response to parents concerned about the article, he wrote defiant tweets. He wrote, “Generation Z will be our queerest and most fearless generation yet.” He tweeted a photo of himself kissing another man while displaying a painted, uplifted middle finger. He added, “In conclusion, here's my only reply I'll be giving to any of the messages.”
Martin Barillas is a former US diplomat and the editor of Spero News.