Pap Smears? Yes, Gay Men Need To Get Them, Too.

Returning home from one of routine yearly physical exams, I looked at my roommate and asked him, "Did Dr. Carl do that to you, too?"


Feeling a little violated, my roommate and I talked about anal pap smears.  I remember making fun of the phrase pap smear with the girls.  It was an unpleasant procedure they have had done to them before when visiting the OB/GYN.

Dr. Carl was a little ahead of his time when he "smeared the paps" of most of the gay men in the greater Portland area.  Although pap smears are a very common part of OB/GYN practices, growing research points toward a benefit of gay and bi men having them as well.


What is an anal Pap smear?
An anal Pap smear or Pap test is when a health care provider collects cells from the wall of the anal canal and sends them to a lab to be examined for abnormal cell growth that could indicate cancer. Anal cancer develops slowly, beginning with minor cell changes, so it can be caught early, which greatly increases chances of survival.

Why would I need one? 
The main reason to get an anal Pap test is to determine if the human papillomavirus (HPV), a widespread sexually transmitted infection, has sparked anal cancer, pre-cancerous cell growth, or lesions on the tissue of the anus that make you more vulnerable to HIV and other STIs. Unlike HIV, which is transmitted through bodily fluids, HPV is spread through skin-to-skin contact, so using condoms is only partially successful in preventing transmission. HPV may be symptomless. Factors that increase the risk of anal cancer include multiple sex partners or use of drugs, alcohol, or tobacco. Being HIV-positive increases the risk of HPV infection and vice versa. According to the Cancer Network, 95 percent of HIV-positive men who have sex with men already have anal HPV, as do approximately 65 percent of HIV-negative gay and bisexual men. (Note: There is now a vaccine for HPV available.)

Who needs to get an anal Pap?
Standards aren’t yet well established, unfortunately, which probably means your general practitioner isn’t going to recommend you get one unless you specifically ask for it. 

But there’s a growing number of physicians arguing Pap tests should be part of routine screenings for anyone who has anal sex. As with HIV, the receptive partners are at the greatest risk, but anal cancer is a rising cause of illness and death among all men who have sex with men, especially those who are HIV-positive. If a woman is having anal sex, she should also be getting a regular anal Pap. 

How often do I need an anal Pap?
Again, standards haven’t been well established. But the recommendation is that all who practice anal sex, especially those who are living with HIV or HPV, be tested every one to three years. –


I had told Dr. Carl that there wasn't that much activity back there, but he recommended the exam.  It wasn't painful, per se, but a little discomfort was fine to put both our minds at ease.  Luckily both my roommate and I checked out fine.

Have you had an anal pap smear?

Has your doctor ever recommended one?

Will you ask your doctor about an anal pap smear during your next appointment?


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