Freedomhealth will provide you with some of the best level of medical, sexual health and aesthetic care in the UK. Your care and comfort are our first priority and where we can’t provide that level of care ourselves we will make sure that we refer you on to an appropriate and friendly expert who can.
Freedomhealth caters for men and women who want to be treated quickly and without fuss by reputable doctors in a friendly, non-judgemental environment. Research has shown that many people will very often avoid sharing the complete details about their lifestyle with their usual GP. At Freedomhealth we have re-invented medical services. You’re in control and we’ll provide you with the careful, bespoke medical service you need.
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info@freedomhealth.co.uk www.freedomhealth.co.uk
QUESTION:
Dear Freedomhealth: I’ve read that there’s HPV vaccine for anal cancer in men, but how do you decide if you should get vaccinated and are there any extra implications for people on HAART?
ANSWER:
The Human Papilloma Virus (HPV) is the virus responsible for warts, and is passed on through direct skin to skin contact. Using a condom is mostly effective in preventing infection, but unfortunately not 100% so. There are over 100 different strains of HPV, of which at least 35 primarily infect the genitals, with strains 6 and 11 associated with approximately 90% of genital warts. Most of these are benign in nature. However, strains 16 and 18 are implicated in over 70 % of anal/cervical cancer cases and are also implicated in the increase in mouth cancers in non smokers.
Warts are extremely common and not everyone will be aware that they have them. Some people will have no
visible warts.
A new preventative vaccine, which offers protection against the four most common strains of genital warts, including the two most associated with anal cancer, is now available. The vaccine, Gardasil, is given as a series of three injections over a period of six months. At the moment the vaccine is only licensed for use in women here in the UK, however it is available as a private, off licence, prescription for men. At a recent AIDS conference in Sydney, investigators from the United States presented figures showing that 41% of HIV positive gay men were infected with the two dangerous strains of HPV, supporting their case for vaccination of all HIV positive gay males.
So, how do you decide if you need vaccination? If you are a gay man who has receptive anal sex, it is probably worth having a painless swab test which can tell you whether you have been infected with one of the four strains. If the test comes back as negative, then it would a good idea to get vaccinated, as this should protect you from contracting these strains in the future, and thus significantly reduce the chances of developing pre cancerous changes or anal cancer. Even if you have one of the four strains, but not the others, it is still advisable to get vaccinated, as studies indicate that infection with multiple strains can increase the risk of developing anal cancer.
If you do test positive for one or more of the strains it is really important for you to have an anal PAP smear test. This particularly applies if you are HIV positive, as research suggests that people with HIV, especially those with a low CD4 count, are more at risk of developing anal cancer. A PAP smear is the same test that women have had for many years to screen for cervical cancer and involves a small brush being inserted into the rectum to collect a few cells. This is a relatively painless procedure and the results are available within a week. These will show whether there are any changes in the cells that are pre-cancerous or cancerous. If there are pre-cancerous changes then it is a good idea to have a smear on at least a yearly basis so that any progression can be noted and treated.
It is worth mentioning that the vaccine is not a live vaccine and should therefore be safe in people with HIV. However the effectiveness of the vaccine is likely to be influenced by the CD4 count, so it’s always worth discussing it with your clinic doctor first.
There are many studies showing that in the HAART era the incidence of HIV related cancers are on the increase, mostly due to people living longer lives and therefore developing other problems. With this new vaccination, there should be one less thing to worry about. +
