Andrew's Anus and the Quest [yes, he's back with Part 7!]

Published: April 26, 2011

For 20 years, Andrew thought of the warts that occasionally sprang up on me as well . . . just warts.

I’m Andrew’s Anus, and I have HPV.

Eventually Andy realized that the human papillomavirus could lead to dysplasia and even anal cancer.

Andy had a good deal of confidence in his HIV providers, but his quest to find better care for me and my HPV uncovered a sad truth about living in the U.S.:

The best anorectal HPV care is available only in a relatively small number of large cities in a minority of states, and the clinics that offer it don’t have the capacity to treat everyone who needs their services.
Getting a high resolution anoscopy (HRA) in just such a clinic had become a priority for Andrew. He’d had three surgeries to remove HPV-related growths and lab testing had twice indicated middle grade dysplasia. Meanwhile, he kept hearing that cancers not historically considered AIDS-related were being observed more frequently in HIV patients. The point was brought home when Andy was diagnosed with a basal cell carcinoma on his left shin. It was treated successfully, and he realized there wasn’t necessarily a direct connection, but all the same . . .

Andy began to email advocates he’d met over the years for advice and referrals. A friend responded with a website that listed providers trained by one of the best anal cancer research centers in the country. The first, most obvious candidatewas inthe larger metropolitan area closest to home. Unfortunately,only PLWHA who were already patients in the local Ryan White clinic could be seen there.

Andy kept looking.

A pozcouple he’d mentored when they were newly diagnosed tried to help. Andy pestered them to find out who their HIV doctor recommended. The doc couldn’t think of anyone in the city doing HRAs, but his nurse did give the name of a reputable specialist in town. Things began to look brighter when Andy called there. “Yes we see lots of HIV positive patients,” the person on the other end of the phone responded. “Yes we do high resolution anoscopies here. Yes we accept that insurance.”

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