FAQs       

HPV

HPV stands for Human PapillomaVirus and a member of the papillomavirus family, one among seven virus families that are known to cause cancer. There are over 200 strains of HPV10&11. These include warts, pre-cancerous lesions, and cancer. In men, HPV is commonly found in the anal canal, penis, mouth, and throat8. HPV is so common that the CDC (Centers for Disease Control and Prevention) states that nearly all sexually activity adults in the United States have HPV at some point13&14. Most people do not develop symptoms and “clear” the HPV without any intervention14&21. Researchers are very interested in why people living with HIV may take longer to clear HPV.

HPV can be passed through touch, even if there are no signs of HPV infection13. Condoms can assist somewhat in preventing the transmission of HPV for the covered area, however HPV can be spread by any direct skin-to-skin contact13. It is nearly impossible to completely stop the spread of HPV during sex.

Men who have sex with men (MSM) and transpeople have higher rates of HPV infection than heterosexual men4&16. Less than 10% of HIV positive gay MSM DON’T have HPV – the other 90% meanwhile do have HPV. HIV negative gay men have a lower (but still high) rate of HPV – over 60%15. By comparison, less than 20% of HIV-negative men (gay, straight, bi, and trans) who are sexually active have HPV15.

Warts are commonly associated with HPV, but HPV often shows no symptoms to the naked eye12. The strains of HPV that causes anal warts are not the same strain(s) of HPV that causes anal cancer16. Anal warts do not go on to cause anal cancer16. A physician using a high resolution anoscopy examination can detect changes in anal skin cells caused by HPV.

HPV lesions, also referred to as ‘abnormalities’ or ‘precursors’, are areas of abnormal tissue that have the potential of developing into (anal) cancer in the future. It is important to note that these lesions are NOT cancer. Low-grade HPV lesions have a low probability of developing into cancer. High-grade HPV lesions have a higher probability of developing into cancer. Despite the name, only about 1 in 1,000 high-grade lesions actually go on to develop into anal cancer 19.

Low-grade lesions are also referred to as ‘LSIL’ which stands for low-grade intraepithelial lesion(s). Since LSIL has a low probability of developing into cancer, physicians at the ANCRE Clinic generally monitor patients with these lesions rather than treating the lesions.

High-grade lesions are also referred to as ‘HSIL’ which stands for high-grade intraepithelial lesion(s). Since HSIL has a higher probability of developing into cancer in the future, physicians at the ANCRE Clinic generally recommend treatment of these lesions.

The AHHA Study is interested in following patients who have no lesions as well as patients who have LSIL lesions. The study will refer any participants who have HSIL to our general clinic for treatment, as appropriate.

Anal Cancer

Nearly all, greater than 90%, of anal cancers are caused by human papillomavirus (HPV). While there are over 200 strains of HPV10&11, strains 16 and 18 cause a large majority of anal cancer cases17.

The ANCRE Clinic has been researching anal cancer precursors for nearly 30 years. The clinic is interested in understanding how and why anal cancer forms. To address part of this question, the AHHA Study is specifically interested in looking into how the aging process and HIV infection interact in relationship to the development of anal cancer precursors.

In the general population, about 1-2 people per 100,000 will go on to develop anal cancer over the course of their lifetime18. In HIV negative MSM, the risk of development is about 20 times higher (~10-20 people per 100,000)4&16. In HIV positive MSM, the risk of development is as high as 131 people per 100,00022.

Questions About The Study

The AHHA Study is interested in looking at how HIV and the aging process interact in relation to the development of anal cancer precursors. To see how much of this relationship is related to HIV status, the study will be enrolling both HIV- and HIV+ individuals.

Anal cancer precursors can take decades to form8, therefore, they are most frequently found in older individuals.

Yes, your information is always held in the strictest confidence upon joining the study. Precautions are taken to maintain privacy, in line with UCSF, National Institutes of Health (NIH), and HIPAA guidelines.

You will receive an incentive for your time, effort, and travel expenses.

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