Anal Cancer

Bill Weintraub

Anal Cancer


Study: 1 in 3 gay men have incurable STD

Randy Dotinga, / Network

A small study suggests that 38 percent of gay men may be infected with an incurable sexually transmitted disease that is linked to cancer, researchers announced this week.

Experts aren't sure how much risk that gay men face from the disease, genital human papillomavirus (HPV). But HPV has been linked to anal and penile cancers, especially among men infected with HIV.

Federal officials were concerned enough to highlight the new findings during a press conference Tuesday in San Diego at an annual conference on STD issues. Researchers at the Centers for Disease Control and Prevention (CDC) examined the medical records of 83 gay and bisexual men who were surveyed from 1988 to 1994. Of the men, 38 percent were infected by HPV type 16, which has been linked to half of all cervical cancer cases.

"This rate (in gay men) is nearly five times that of heterosexual men and twice that of women," said Dr. Stuart Berman, an official with the CDC's Division of STD Prevention.

Another study examined 349 men -- gay and straight -- who attended an STD clinic in Tucson, Ariz. It wasn't clear when the study was completed.

Nearly 32 percent of the men tested positive for HPV; the rate was lower among those who were sexually monogamous, used condoms or avoided anal intercourse.

HPV often has no symptoms, although it may cause warts in the genital area. Infected people may never know they have it.

Researchers are very interested in possible links between HPV and anal cancer in gay men, said Dr. Hunter H. Handsfield, director of the King County public health department's STD Control Program in Seattle. Some experts suspect that anal cancer is as common in gay men as cervical cancer was in women before screening became common, he said; one study suggested that 35 gay men per 100,000 -- or 1 in 2,900 -- may develop anal cancer each year.

"It's an area of very active research," he said. "A certain amount of emotionality has arisen around it. Some advocates for gay men's health believe that gay men ought to be having annual Pap smears."

The common procedures known as Pap smears detect the presence of pre-cancerous cells in women and can do the same thing for men. Even so, Handsfield said more research needs to be done before anal Pap smears become a routine part of medical examinations for gay men.

Experts consider "bottoms" -- men who are on the receiving end of anal sex -- to be at the highest risk of contracting HPV.

Anal cancer itself is uncommon among the population as a whole and often curable.

Other STD conference news:

-- A small number of drug-resistant cases of gonorrhea are appearing on the West Coast, but doctors are still able to knock out the disease by using alternate antibiotics.

-- Federal officials said the number of cases of gonorrhea in the country remained steady in 2000, while syphilis cases landed at their lowest rate in history. But a decreased emphasis on safer sex may lead to more cases of both diseases among gay men, officials warned.

-- Older lesbians often don't get Pap smears, even though they are susceptible to cervical cancer regardless of whether they've ever had sex with a man, according to Dr. Jeanne Marrazzo, who studies lesbian STDs at the University of Washington at Seattle.

-- About 25 percent of lesbians suffer from bacterial vaginosis, a disease that causes irritation and discharge, Marrazzo reported. It may be sexually transmitted.

-- Fourteen percent of gay men who know what barebacking is acknowledged that they engaged in it during the last two years, according to the first survey to ever look at the phenomenon.

The study, by the CDC, defined barebacking as intentional unprotected anal sex with a man who is not a partner. Of 554 men surveyed, 70 percent knew what barebacking is.

Of those, HIV-positive men were more likely (22 percent) to engage in barebacking than HIV-negative men (10 percent). The barebackers said they don't use condoms because they want better physical stimulation and a heightened emotional connection

Bill Weintraub

Re: Anal Cancer


you know dudes, i posted this story from a few days ago, and so far it seems to have evoked nothing more than a great collective YAWN from you guys

i wonder why?

maybe you just haven't read it closely enough

so we'll take another look

first of all, the study is about "an incurable sexually transmitted disease that is linked to cancer"

what part of that doesn't scare you? -- the incurable, the cancer, the STD?? -- i'd like to know

next: "HPV has been linked to anal and penile cancers"

anybody in here ever seen a penile cancer?

as it happens, i have, cause at the end of his life, my lover's penis was destroyed by a type of cancer called Kaposi's Sarcoma

in his case, the cancer overwhelmed his distal urethra -- what had been his piss slit -- and closed it off, necessitating surgery to prevent death from renal failure

since he was already dying from brain cancer i'm not sure why that was done, but what i do know is that penile cancer is not a walk in the park

next: the "rate in (gay) men is nearly five times that of heterosexual men" but the "rate was lower among those who were sexually monogamous, used condoms, or avoided anal intercourse."

interestingly, this site endorses two of those options -- monogamy and avoiding anal intercourse -- we don't endorse condoms simply because you don't need condoms if you're monogamous and avoid anal intercourse

next: "Experts consider 'bottoms' -- men on the receiving end of anal sex -- to be at the highest risk of contracting HPV."

no surprise there

finally: barebackers "don't use condoms because they want better physical stimulation and a heightened emotional connection"

notice the division of the sentence -- like the rest of gay male life, it parses neatly into tops and bottoms, and in it, the top gets "better physical stimulation"; but the bottom gets "a heightened emotional connection" -- which, after all, is psychological, transient, and imaginary

and apparently worth dying for

David McQuarrie was posting for awhile on under the header "Anal Sex -- It Kills"

i thought that was a little harsh -- but it turns out that David was right

and that's why i don't like it when the do-nothing dudes in here criticize people like me and David for being too strident

we need more stridency

more stridency, and less disease


Mart Finn

Re: Anal Cancer


Barebacking - the Russian roulette psychosis

I have for a long time been at odds with the 'accepted' analysis of the motivations of guys who engage in barebacking. I understand that researchers may have had answers which support their statement re " ... better physical stimulation and heightened emotional connection", when collecting data.

To me this is the obvious rationalisation of guys who engage in a sexual act which they know to be dangerous ... life threatening.

I firmly believe that 'the Russian roulette psychosis' is a more accurate pointer to what motivates guys when presented with the opportunity or the invitation to fuck without protection.

Far more powerful, as Bill says, than 'transient and imaginary' emotions, are psychological traits which lead an individual to make risk and sexual pleasure their erotic imperative. I would also add that it has been recorded that, men who bareback, also have a cavalier sense of "one life" ... 'I'm alive now, and I must do, have what I want ... '

Bill's posting remind us and informs at the same time. Our standard bearers, rightly, are strident, proactive and vocal. They keep us uptodate about what's happening 'at the front'.

The next time a guy asks, or tries to fuck you with out a condom, ask him if he'd let you put a gun to his head and the trigger just once. He'll think your crazy ... but then so is he

Bill Weintraub

Re: Anal Cancer


Hey cockster warrior dude

Thank you for posting.

I agree with you about the russian roulette syndrome, but, as always, i feel we need to look at the cultural context which underwrites the dangerous behavior.

So there are always individuals who will take risks.

But different cultures rate risk in different ways.

For example, if you were a warrior of the Sambia, a people of the New Guinean highlands, you might take outrageous risks when raiding an enemy tribe -- and be respected for it by your peers.

The Spartans, on the other hand, didn't like risk-taking in battle -- they criticized a man who behaved berserkly at the battle of Platea, even though he killed a lot of Persians. To the Spartans, his out-of-control risk-taking showed a lack of self-discipline, and could have endangered the hoplite line.

(And in general, in the Western way of war, which the Greeks invented, a disciplined line and concern for your fellow soldiers are considered more important than individual acts of bravery.)

So the cultural context matters.

Now, safer-sex educators have long known that there are cultural factors underwriting unsafe sex.

Here's a quote from a 1997 study by the SF AIDS Foundation and UCSF's prestigious Center for AIDS Prevention Studies, headed by Tom Coates:

[In the study, it was seen that] "individual formulation of gay male identity and self-worth to a significant degree was based on adherence to specific sexual performance standards and practices within gay male culture. Men in [the study] frequently described anal sex, and particularly anal sex without condoms, as a means to affirm their gay identity, experience intimacy, and feel a broader social and cultural connection."

The key phrase here is "specific sexual performance standards and practices within gay male culture."

My argument with people like Tom Coates is that he won't touch the culture -- he focuses instead on risk-reduction among individuals.

But what i've been saying all along is that the culture is the problem -- that is, if we change those "specific sexual performance standards and practices within gay male culture," the behavior of individuals within the culture will change.

So when guys say they feel a heightened emotional connection in condomless sex, they're responding to cultural messages which exalt and romanticize anal, and tell them that being penetrated is the most intimate male-to-male act.

The reality is that the sensory apparatus in the anus is so deficient (and of course non-existent in the large colon), that the man getting fucked can't tell if his partner is wearing a condom or not -- there's no difference in sensation.

The difference is totally psychological -- it's imaginary, a cultural artifact.

What we are about in the frottage cock2cock dick2dick movement is changing the definition of intimacy. That's what the cockster has done very brilliantly in an essay and short story which I hope to get posted soon on our site -- he's said that cock2cock is lot more intimate than anal.

Which of course it is.

And that is also why I attack anal. It is not enough to make limp-wristed pleas for tolerance with the analists. That won't work, any more than pleas for tolerance worked with White Supremacists.

In both cases, there was a powerful theory underwriting cultural practices -- the theory of White Supremacy underwrote segregation, and the theory of Anal Supremacy underwrites the dominant culture of anal sex.


The way to destroy it is simply by telling the truth: the anus is not a vagina, the bottom's pleasure is "psychological," the act is unequal, degrading, and dangerous.

So anal has to be debunked, and its mystique de-mystified.

And that requires, as the cockster points out, some stridency.

This war cannot be won by rolling over. You roll over for a buttfuck boy, and he'll stick his diseased dick up your butt.

But if you stand up for yourself and your clearly superior way of making love, as Gentle Warrior did in "Having Sex on My Own Terms," and as Brandon and the cockster and Don F and John Renard and Chuck Tarver and David McQ and Stockpeck did with, you'll win, and the buttfuck boy will have the opportunity to learn that there's more to sex between men than penetrating the shit-holes of pseudo-women.


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