Sexually Transmitted Diseases/What is this, possible anal warts?


View 1
View 1  

View 2
View 2  
Hello, my name is Blake, I'm a 23 year old male. I live in Oklahoma City, Ok. I'm a gay, sexually active person who enjoys anal sex, and  was diagnosed with HIV about a year ago. But that isn't why I've type this question today.

I've had what looks like whitish tinges in my anus, that look somewhat like cauliflower. I've had this since before I got diagnosed. So far, none of my partners have mentioned seeing something like this when we have sex, but I"m still concerned. These do not cause me pain. I'm concerned they could be anal warts. I think the whiteness is only present near the opening.

Hello Blake,
Your assessment is correct.  These do appear to be anal warts. Note, that the virus responsible for anal warts-- human papillomavirus-- had many different strains, and some of these are highly associated with the development of anal cancers.   Progression from a nuisance wart to a precancerous and eventually cancerous condition, can occur over 5-20 years without treatment, and unfortunately HIV infection, even if under good control with antivirals (so that you would be "virus undetectable) is no guarantee that HPV won't progress. As long as these warts are growing, they are shedding virus, which has already infected the penises of your partners.  Note, that even if they wear condoms, the part of the penis that is uncovered (closest to the base including the scrotum, which isn't usually covered by condoms) is usually infected, and they may develop warts there too.

Treatment is designed to freeze or otherwise treat the warts by a specialist who will know what to do.  Sometimes, a specialized test known as High Resolution Anoscopy (somewhat like a colposcopy for women with abnormal Pap smears), as well as an anal cytology (anal Pap smear) may also be needed.

Good luck, and do let your regular doctor know and not be dismissive of your condition.


Sexually Transmitted Diseases

All Answers

Answers by Expert:

Ask Experts


Mark P. Behar


Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “pre-screen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and consequences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!


Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

©2017 All rights reserved.

[an error occurred while processing this directive]