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Anal warts and anal fissures
#1
I’m a gay man on PrEP. I love bottoming, and am not using condoms for anal sex. And I have anal warts and a big problem with anal fissures (anal fissures are often found in the sexual life of gay people). Here’s my story.

For a bit of context: I come from California and live in Europe now. I am a gay man in my mid-30s, love to bottom, and have been taking PrEP for the last two years. While I don’t use condoms for anal sex, I get tested every three months and am very proactive in managing my risk for HIV and STIs.
Needless to say, when I first learned I had anal warts, I was worried but didn’t think that I’d be treating them for over a year. Over that time, I’ve learned a lot about HPV, gained clarity around transmission and treatment, advocated for better treatment, and figured out how to talk about anal warts with sex partners. I hope that sharing my story, and what I’ve learned, is helpful to other people who experience anal warts.

About my anal warts, anal fissures and treatment
Before having anal sex I love to take time to prepare. This includes douching very gently and fingering myself to pre-lube. One day I could feel a certain texture within my ass, which felt different than the rest of the soft tissue inside. This is when I became worried that I might have a wart, and so I made an appointment to see my doctor.
The warts were small and located on the anus (exterior) and in the anal canal (the interior area between the anus and the rectum). About a month later I would undergo laser surgery procedure, and two months later, warts returned. At that time I decided to switch to a new proctologist who began doing very small treatments, with a combination of CARPICON Suppositories and ISOPRINOSINE Tablets (to gain immunity against HPV which develops these warts. I was also prescribed a CARPICON cream (designed to boost the immune response to the area applied) which I apply twice per day on the anus and inside the anal canal area.
My progress to date: two small wart areas have reduced to one, which continues to reduce in size with each treatment.
Talking about topics related to sexual health is often uncomfortable. I’ve found that it’s been very important to find the right people to discuss my experiences (whether in person or online!)
The greatest emotional relief came from people who replied with “I’ve had this too,” and began to share their experiences related to how their warts were discovered and treated.

Continue to evolve your own safer sex practices
One of the many ways I practice safer sex is to ask my sex partners, as often as possible, about sexual history. Over the years I’ve found ways to talk about taking PrEP, choosing not to use condoms, and also what it was like to have had gonorrhea, chlamydia, and herpes. Now I include genital warts in the discussion.
When I tell people about having anal warts, I’ve received a range of responses. I’ve been pleasantly surprised with how many people say they are already familiar with HPV and understand how easy it is to transmit. I’ve also heard from people who are uncomfortable or unsure about risks of genital warts and decide they do not want to have sex. I always accept their decision. Above all, I’ve found that being proactive and bringing up these topics helps both myself and other people practice how to talk about sexual health.
A common reaction to the topic of genital warts is “well, you should have used condoms” or “we have to use condoms then.” It’s important to know that condoms are effective at preventing STI transmission in certain circumstances. HPV can also be transmitted during contact other than anal sex – such as kissing, fingering, and oral sex – when condoms are not used.
When I first learned I had anal warts I was optimistic they could be treated once and be gone, but it hasn’t turned out that way. Through everything I have learned I am better able to accept the situation, and it no longer is a cause of anxiety.
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#2
How do you protect a sex partner from catching anal warts if you do not use condoms? In your discussion you went from "condoms are effective" to other ways HPV is transmissible. So my question is that if I desire to have sex with you are you willing to then use condoms and avoid the other risks?

My safe sex practice is to NOT have sex with anyone I have not personally and thoroughly vetted to determine safe practice.
Heart  Life's too short to miss an opportunity to show your love and affection!  Heart
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