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Sexually Transmitted Diseases/Correlation with ASCUS pap & Hpv results


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Hello I'm 25 and recently went to get a pap & got some abnormal results as the title suggest. I just want to know if this bumps attached should be of concern or are in correlation to my results. I'm a little freaked out.

Hello Amanda,
ASCUS (atypical squamous cells of undetermined significance) is a cellular abnormality of cervical or anal cells that hasn't progressed to more "severely" abnormal cellular "precancers" or "dysplasias" such as LSIL or HSIL (low or high grade squamous intraepithelial lesion).  When examined by pathologists microscopically, there are specific cellular changes (certain nuclear changes, ratio of size of nucleus to remaining cytoplasm of the cells, etc.) that you may have to dredge up from your high school or college biology classes!  In any event, the photo does not show ANYTHING abnormal.  As ASCUS is a cervical (or anal) cellular abnormality, it usually does NOT express itself with visible abnormalities, like a white patch or bump on the cervix or in the anus.  

The photo shows the normal opening of the vagina and vulva, not the cervix.  It is possible for VULVAR, VAGINAL, Penile, Anal, and Cervical abnormalities that are subjected to the same cellular tests (the Pap), and histology (from small pieces of tissue taken by a biopsy) to examine more in depth analysis of the tissues. These terms are adjusted for the deep tissue (histology): Vulvar Intraepithelial Lesion, Vaginal Intraepithelial Lesion, Penile Intraepithelial Lesion, Anal Intraepithelial Lesion, Cervical Intraepithelial Lesion: VIN, VAIN, PIN, AIN.  They are further categorized with a "1", "2", or "3" reflecting mild, moderate or severe levels of abnormality.  

ASCUS may progress (get worse) or regress (get better) over the course of many years. So it is important to have regular gyn exams and Pap smears.

Good luck!

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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

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