Sexual Health


Over the last 20 years OIC has developed specialized preventative medical care tailored to our patient’s needs. It ensures you receive state of the art screening and treatments. While Human Papilloma Virus (HPV) is common in sexually active adults, screening is not. HPV can lead to cancer if untreated. Early detection and treatment can reduce this risk so we screen everyone at risk as a preventative measure.

Preventative HPV Medical Care

Anal dysplasia is most commonly linked to HPV which is considered the most common sexually-transmitted infection. Roughly 80% of people who have had one or two lifetime sex partners and 100% of people who have had five lifetime sex partners have had HPV infection. Thus, HPV is extremely prevalent, particularly in young, sexually active populations. This original infection may resolve itself or may persist for life.
Anal dysplasia is an abnormal condition which occurs when the mucosal lining of the anal canal undergoes abnormal changes. During this condition, lesions or visible pattern of clustered abnormal cells appear. These cells may then progress from low-grade lesions to high-grade lesions.

Symptoms may include genital and or anal warts in and around the anus. In some patient’s abnormalities in the lining of that anal region can occur without the presence of warts and any other symptoms.

Anal cancer, like cervical cancer, is a member of a broader group of anogenital cancers known to be associated with sexually transmitted viral HPV infection. Anal cancer is rare in the general population but it is significantly more common in the HIV infected population.

Unfortunately, the risk for anal cancer is reported to be increasing dramatically in HIV-positive males and females, despite the introduction of highly active antiretroviral therapy in the mid-1990s. This may be because people are living longer and some may continue to get newly exposed to other HPV viral strains.

Anal Dysplasia Screening

An anal Pap smear is a very simple procedure performed by your medical provider as part of a routine physical evaluation. The purpose of the Anal Pap smear is to screen for abnormal cells and if detected, refer for HRA for further evaluation. It is recommended that HIV positive patients, patients with history of genital or anal warts, previous anal dysplasia, and women with abnormal cervical Pap smears or solid organ transplant recipients have this procedure done once a year.

The procedure takes only 30 seconds. Your provider will insert a moist Q-tip into your anus and remove it slowly in a circular motion. The procedure is essentially painless, and rarely associated with minor discomfort. It does not require special bowel cleansing. The sample is then sent to the laboratory where it is read by a pathologist. Results are available in approximately three weeks. Your provider will discuss your results with you.

Anal Dysplasia Treatment

Anal Dysplasia can be treated successfully with very close follow up and monitoring. Individuals with low-grade lesions will generally have repeat HRA in 6 to 12 months. Individuals with high-grade lesions will have repeat HRA every 3-6 months. This will continue until there is no further evidence of high- grade dysplasia.

Human Papilloma Virus (HPV)

HPV is a virus transmitted through contact with the skin and mucosal membranes found in the mouth, throat, vagina, cervix, anus and penis. There are over 100 HPV strains that can affect the human body. The vast majority of these viruses affect the skin and cause benign warts. About 40 HPV types are sexually transmitted and about 16 of those strains cause lesions that can progress to dysplasia and cancer. A person can be infected with multiple HPV strains simultaneously.

HPVs can be classified into high-risk and low-risk groups according to the likelihood that an infection by the HPV type can lead to a cancer. Most sexually active people will be infected with at least one type of HPV at some point in their lives. Having just one sex or oral sex partner can expose you to HPV. Although the immune system generally clears an HPV infection within several months to a few years, some infected people may not resolve the infection. The virus can remain in the skin layer and gradually alter cells so that they become abnormal and cancerous usually after a period of years or decades after the initial infection.

Men and women infected with HPV can unknowingly spread the virus as the infection may present no symptoms and infected individuals may not realize that they carry it. Though a condom may help reduce transmission, HPV is spread via skin-to-skin contact through the moist layer of skin and can therefore be passed onto a partner even when a condom is used. Nevertheless, safe sex practices including the use of condoms should still be utilized as a method to reduce the likelihood of transmission.

Genital and Anal Warts

High Resolution Anoscopy, or HRA, is a procedure that allows for examination and evaluation of the anal canal.
Using a small thin round tube called an anoscope, the anal canal is examined with a high-resolution magnifying instrument called a colposcope.

Anogenital Warts

Anogenital warts are small, skin-colored or pink growths that form on the vulva (the lips of the vagina), vagina, penis, or anus. They are caused by HPV. Anogenital warts are often called just “genital warts” or “anal warts”.

The types of HPV that cause most forms of genital warts are not usually dangerous. But other types of HPV can lead to cancer of the cervix (a part inside the woman’s body), throat, penis, or anus. Most people with genital warts have no symptoms (other than the warts). But some people have itching, burning, or tenderness.