ANAL PAP SMEARS FOR ALL BOYS

I am embarrassed to post our video, here. Because the audio sucks. But I just don’t have time to do retakes. It seems like everything we do is a one night stand. BamBam, thank you, man. It’s shoot it once, record it once, and then, we have to run. I love it when people tell me that the boys should be reading more books.

Bubba, we’re lucky to put our panty hose on one leg at a time.

Any week before a clinic visit, the anxiety level in the house rises to a force-five-hurricane long before the warning from the National Weather Service.

The boys hate the clinic.

I hate the clinic.

The boys hate the people at the clinic.

I hate the people at the clinic more than they do.

Every day I get up, and like a lot of other people, I look at what has arrived.

This morning, a public health email annouced that the boys need anal examinations.

Why.

Boys who share their sexual history have been found to have a significantly higher risk for developing anal cancer, over thirty-five times greater than the general population.

HIV-positive boys are estimated to be eighty times more likely to get it. Although anal cancer accounts for less than 5 percent of all digestive and intestinal tract cancers, the rates have increased 160 percent over a thirty- year period.

Gay African-American men have the sharpest increase and the lowest survival rates. Interestingly, anal cancer in gay men is as common as cervical cancer was in women before the use of the Pap smear, the test that screens for precancerous lesions on the cervix.

Both types of cancer are caused by the human papillomavirus (HPV), which also causes anal and genital warts. HPV is one of the most common STDs in the world. Fortunately, anal cancer is highly preventable and treatable if caught in time.

Ask any pediatrition if he has had his boys vaccinated for HPV. They will roll their eyes, and say no. I guarantee it.

Here’s the answer you will get: My boys aren’t gay and they aren’t the issue.

Like you know that, Dr. Bones.

Any number of your boys could be gay, and your decisions are very much the issue.

There are more then one hundred different subtypes of HPV, and some are the source of common warts as seen on the hands and feet. HPV affects approximately 65 percent of HIV-negative gay men, and nearly 95 percent of HIV-positive gay men carry HPV in their anal canals.

Most do not even know they have it. Subtypes 6 and 11 cause 90 percent of genital warts, while subtypes 16 and 18 are far more dangerous because of their precancerous potential.

The lining of the anal canal, once infected with HPV, can reproduce uncontrollably if left untreated. In most cases, the immune system clears the infection naturally, but in a small number of cases, usually over many years, HPV can cause changes in the cells of the anus and rectum that can lead to cancer.

According to the Public Health rhetoric, the Pap smear is something that should be offered to all gay men and boys. In March 2007, the New York State Department of Health AIDS Institute, in collaboration with the Johns Hopkins Division of Infectious Diseases, issued a recommendation concerning anal Pap smear.

Clinicians should perform anal Pap tests at baseline and annually in the following populations:

1. Men who have sex with men.

2. Any patient with a history of anal or genital warts.

Clinicians could ostensibly refer patients with abnormal anal Pap test findings for high- resolution anoscopy and/or examination with biopsy. Like cervical cancer, invasive squamous cell cancers of the anal canal are associated with certain types of HPV infection, most notably, HPV-16 and HPV- 18.

Although this is a new practice that may not be routinely available, thank god for small favors, screening for cellular dysplasia is recommended, particularly in persons at high risk for infection with papilloma viruses.

There are various ways to treat genital and anal warts depending on the size and location.

Topical medications, like podofilox, which burns warts, can also burn the surrounding skin, so it is recommended that patients apply Vaseline or zinc oxide around the wart to protect healthy skin.

Imiquimod, which goes by the brand name Aldara, another topical cream, is also directly applied to the wart, and acts to diminish it as well, but is reserved for only minor warts.

Cryotherapy with liquid nitrogen freezes warts and is done in a doctor’s office; likewise, electrodesiccation, in which warts are burned off with an electric cautery, is another treatment. Other treatment options includetopical use of trichloroacetic acid or bichloroacetic acid and interferon injections.

Recent studies show that infrared coagulation is a safe procedure performed under local anesthesia on patients with discrete high-grade squamous lesions. The device uses a beam of far- infrared light.

The anal Pap smear is a simple test that is performed by your doctor in his office.

The boys think it’s right up there in the funland categories of anal fun as they would put in the funbag as Six Flags Over Georgia.

Can we charge them for doing sex work on us.

No.

The PAP involves swabbing the anus with a Dacron swab, which looks like a long Q-Tip. The swab is then smeared on slides and sent to the pathologist.

This test is so important because there are many different types of HPV. The most common are types 6, 11, 16, and 18. Certain subtypes, specifically 16 and 18, are considered precancerous.

If you are precancerous, you may as well slam the veins, child, with dope, and fucking die because according to Public Health, you’re going to die, any which way from Sunday no matter what because YOU DID NOT DO whatever the fuck they said you should do.

As a patient, you should report any cauliflower-like lesions that develop on your skin because HPV can show up on your penis, anus, and even your tongue.

It’s a problem when you begin to grow actual cauliflowers on the tip of your nose, and cherry tomotoes for eyes.

In 2006, Merck & Co delivered the first vaccine for HPV called Gardasil. It is a quadrivalent vaccine, which means it works on HPV subtypes 6, 11, 16, and 18, and it is given in three separate injections over six months.

Currently, the vaccine is indicated only for women, but the majority of gay health- care providers are urging their gay male patients to consider this vaccine, especially those men who are HIV positive or have a history of HPV.

At this time the vaccine is not covered by insurance — imagine that — and would have to be paid for out of pocket. Presently, Merck is studying this vaccine in 4,000 young men, including those who engage in sex with other men, and the National Institutes of Health (NIH) is evaluating the response to Merck’s vaccine in preteen HIV- positive boys and girls.

All of this is the status quo argument for doing what the fuck ever Public Health tells you — from their lofty pinnacle, on high, or some other strange drugs — so you do not have to die a painful death and everyone can see your asshole.

And pictures of the inside of your asshole.

Just fuck me.

I’m not going to do it. I am not going to have the boys imposed upon with these tortures. Enough is enough.

We’re not going to do it because we have done enough.

I’m serving the tennis ball back into their court, and I am walking off into the sunset.

Call me whatever you want. I don’t give a fuck. I am making the decision here that it would be best for us to to fucking die versus being tortured like we are objectified experiments for Public Health to play nut-nut who has the nut on the chess board

Over my dead fucking body, bitch. Eat me. Death is preferable to this.

This is supposed to be a safe house. Not the house of Dr. Frankenstein or Dr. Mengele.

Public Health can kiss my ass. Make boys who have been raped an exception.

Problem solved.