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If you’re gay and sexually active, there are some unique health issues that should be on your radar. Some health issues, such as STIs, can be universal, and none more so than HPV. Most people will be exposed to human papillomavirus at some point in their life, but what does this mean for sexual health? Are there any long-term effects or risks?

Research shows that men who have anal sex with men (MSM) are more likely to get HPV than women, so the more you know, the better chance you have of avoiding the potentially life-threatening consequences of living with HPV. Knowledge is power, so educate yourself and enjoy a healthier, safer sex life!

It’s more common than you think: HPV is the most prevalent sexually transmitted infection in the U.S. among males and females! A significant portion of gay men become infected with the virus at some point in their life — about 70 percent  — but many never develop any symptoms. Don’t stress. No stigma should be associated with HPV. If you’ve had multiple sexual partners, it’s nearly impossible to determine during which encounter you contracted the virus, as it can lie dormant for years. The good news is that a strong immune system can remove or suppress the virus, often resulting in its having no adverse health effects. However, yearly follow up with an anal pap smear and complete external and internal evaluation is imperative to monitor for changes or symptoms.

If you’re a bottom, you’re more likely to get HPV: Bottoms are at a higher risk of contracting HPV due to the increased localized trauma. The virus feeds off injuries, such as tears that are commonly associated with this sexual preference. Using condoms can help lower the risk of contraction, but unfortunately they are not 100 percent effective, since HPV is also spread via skin-to-skin transmission in the general genital area.

Vaccination is important, but can’t protect you 100 percent: All men age 26 and under should receive the HPV vaccination, Gardasil, which is covered by insurance. If you’re 26+, investment in the vaccine is still highly recommended, due to the multiple strains of the virus affecting the genital area. Even if you are positive for some strains of HPV, the vaccination can protect you from certain additional subtypes, including strains 16 and 18, which are associated with high risk for development of life-threatening anal cancer — so roll up your sleeve!

Pap smears are not just for the ladies! Pap smears are not important only for pre-cancer detection as a result of HPV, but also for compiling a complete sexual history and anal evaluation, ensuring that everything continues to function in the appropriate working order. As sex can include all orifices, it’s important to have oral testing as well during your pap smear consultation. One positive outcome? Pap smears allow you to take the time to meet with your healthcare provider and have a conversation about your sexual health — you can discuss your sexual history, the type of sex you’re having and with whom, and ask questions about things you have been wanting to try. The more your doctor knows, the more they can comprehensively educate and advise, ensuring you have a healthy body and mind when it comes to exploring and enjoying sex. Partners or hookups should also be tested — you’d hate to begin treatment only to become sexual in an active viral environment.

When something doesn’t look right… If external disease (such as the appearance of visible lesions, abnormal skin growths or genital warts) is noted, a complete internal evaluation should be carried out, as eradication needs to be completed. While it may be painful, recovery from eradication surgery is necessary. It is a gradual healing process and it is essential that you heal properly to ensure full functionality. It’s important to see a surgeon who specializes in anal care, treatment and prevention, and many patients feel increased comfort with a doctor who is also gay. It is vital that treatment allows for appropriate sexual function and ideal post-operative cosmetic results, and I feel one must be in the community to truly grasp all of these vital concepts. Think of it like taking your old Porsche 356 for a tune-up — you’d want to be sure to choose a mechanic who not only knows how to fix it, but also is a Porsche driver himself! Post-op follow-up is imperative for a successful outcome, not only for eradication of warts and pre-cancerous lesions, but also for an enjoyable bottoming experience, ensuring that your sex life isn’t negatively affected by the removal of any physical outcomes of the virus. You should see your surgeon every three months in the initial phase to ensure no signs of recurrence, moving to one year for a complete evaluation and annual pap smear.

info: Dr. Evan Goldstein is an out surgeon with Bespoke Surgical who lives in New York, N.Y. His work focuses on the prevention and restoration of the modern man in a concierge-style medical services model. Visit to learn more.