Genital Warts

Genital warts are caused by the human papillomavirus (or HPV). There are over 100 types of HPV, at least 10 of which affect the genital region. You can catch these through anal, oral or vaginal sex. In fact, HPV can be spread just from coming into contact with another person's warts. While condoms protect you during cock to asshole contact, warts can still be spread from areas around your genitals. Condoms are still the best way to prevent the spread of warts, other STDs, and HIV.

Genital warts are sneaky. They can hide in your ass (or a woman’s vagina) and can be spread from one person to another even if they're not visible. There is no cure for HPV: once you catch it, you've got it. Sometimes your immune system will clear the virus on its own, like a flu or cold, but since there is no HPV test there is no way to be certain whether or not you've still got it, except for if you keep getting warts. You can have the warts removed by a doctor, but most of the time they will just go away on their own. However, the infection will persist. If you think you might have genital warts, go to a doctor and get examined right away.

What are the symptoms?
Much like humans, warts prefer to live in warm, moist areas. This is why you're more likely to see them in your ass than on your cock. Just because a cock doesn't have warts on it doesn't mean that it can't infect your ass with HPV. Besides, they have a better chance of growing in your ass, anyway. Use condoms! Genital warts appear as soft, fleshy lumps on or around your cock and asshole. They usually will show up 6 weeks to 6 months after you are exposed to them, but the virus can lie dormant for years. The warts are painless, although there may be itching and/or burning around your dick and/or ass. When anal warts get large they can cause bleeding and pain. Sometimes a cluster of warts, especially around your asshole, will look like cauliflower. Gross!

Again, most people that have HPV don't know it. Only about 8% of people actually develop warts as a symptom of the infection. Some 60% of gay/bi men have HPV, and 90% of HIV-Positive men are estimated to have it. The Centers for Disease Control and Prevention (CDC) estimate that there are 5.5 million new infections every year, and that 20 million people in the U.S. already have it.

Testing and treatment
There is a blood test for HPV. Also, docs can do a "hybrid capture," which is an anal swab. The swab is put in a vial and shipped off to a lab where they inspect it for HPV. This procedure is usually performed on women when they get a pap smear, and is not routine for male patients. If you want it you'll probably have to ask for it.

However, gay/bi men who are sexually active, especially all of you hardcore bottoms out there, should get your asses examined at least once a year. Some queer docs will do anal pap smears, which is a scraping of cells. This is by no means standard, and not a lot of docs will know what to do, but if you are frequently the receptive partner in anal sex you should at least ask your doctor about it, or find someone who can give you more information.

There are three types of treatment for genital warts:

  • Topical treatment - a variety of different chemicals, or freezing liquid nitrogen, are applied directly to the warts in order to physically destroy them. Since this is taking place on your cock or ass it is quite painful, how ever most effective
  • Immunotherapy - this gives your own immune system a boost in order to help fight off the infection
  • Surgery - warts are physically cut rather than burned off.

Absolutely do not use over-the-counter wart medication on your dick or ass. The skin in these areas is different than on your hands or feet, and medications can irritate or damage your more delicate areas. Genital warts should only be treated by a doctor or clinician!

No matter what treatment is used, there is a high recurrence rate. You should assume your warts will return, and go back to your doc or clinic as soon as you spot or feel one.

Another new treatment, for external warts only, is imiquimod (brand name Aldara), a topical cream approved by the FDA in 1997. It is available by prescription only, and since it is a cream it will destroy condoms. You apply it at home, three times a week for up to 16 weeks; it slowly causes warts to disappear. It also works on the immune system, bolstering it to help it attack the warts. It can't rid your body of the virus entirely, but by killing off much of the active virus, it may reduce transmission rates. Unfortunately, you can only use it externally, so if you want to have internal anal warts removed you'll have to go with the painful methods for the time being. Imiquimod's use by HIV positive people has not been tested.

How can I prevent the spread of genital warts?
The best way to protect your partners is to not fuck during the time that you have the warts, and always use latex or polyurethane condoms and other barriers afterwards so that they won't catch it. Condoms and dental dams reduce risk.

HIV connection
HIV Positive guys have a higher incidence of HPV, and of precancerous and cancerous lesions. Guys with severely compromised immune systems can even develop warts inside their mouths without even noticing! This is why checkups are very important.

What else should you know?
Human papillomavirus can lead to anal or penile cancer. Yikes! Any gay guy who has a growth or unusual pain in his ass should see his doctor immediately due to increased anal cancer risk in gay men.