For how long will anal health and hygiene be neglected?
Many countries such as those in Africa who had earlier reported no significant HIV rates in people with same sex behaviour, have reported alarming HIV rates in recent past.
Although ‘anal’ and ‘rectal’ words are used as synonyms, but they aren’t same – and rather refer to different parts biologically. Anal canal is distinct from rectal canal with a unique set of diagnosis. Rectal canal is made up of columnar epithelial cells and anal canal is made up of stratified epithelial cells. Anal canal is also a high pressure environment with about 77 mmHg pressure when sphincters are resting and 180 mmHg pressure when sphincters constrict. In contrast, pressure in human vagina is 0 mmHg in resting phase.
Anal canal is very sensitive to hot, cold, wet, dry, light touch, pin prick, distension, pleasure or pain, however rectal canal is only sensitive to distension, pleasure or pain.
The incidence of adverse events in rectal microbicides studies is quite high with 11% symptoms and signs of anal adverse events in anal canal and 13% in rectal canal. These adverse events include prolapsing haemorrhoids (piles), anal fissure, anal fistula, anal abscess, anal warts, anal or rectal canal cancers, fungal infections, herpes simplex virus (HSV) infection, or sexually transmitted infections (STIs).
The need for right awareness in healthcare providers and their appropriate training is acute as often anal adverse events are misdiagnosed or ill-treated.
The awareness level in people (men and women) who reported to practice receptive anal intercourse was abysmally low. Zero per cent of such respondents had knowledge related to their anal cancer risk, and just half of them knew about HSV. Awareness certainly needs to be upped in people practicing receptive anal sex.
More safety data needed on lubricants used in anal sex
Rectal microbicides are products that could take the form of gels or lubricants – being developed to reduce a person’s risk of HIV or other sexually transmitted infections (STIs) through anal receptive sex.
“What we have seen at this conference is that there is a growing evidence of MSM populations in African nations and HIV rates are alarmingly high in them” said Dr McGowan.
As per published data, not only MSM, there are number of women as well who reported to have anal sex. According to the data from a study in San Francisco, US, very high lubricant use was reported (89%) among those MSM who were practicing anal intercourse, said Dr Shauna Stahlman from Department of Epidemiology, University of California, Los Angeles (UCLA).