The HIV Link To Anal Cancer Your Doctor May Not Have Told You About. Here’s What To know…
As an HIV-positive man, Daniel Garza was used to doctors making assumptions about his lifestyle. He just never expected those assumptions to mask a cancer diagnosis. Speaking to PRIDE, the LA-based actor and comedian shared his experience with stage two anal cancer, a diagnosis that came 15 years after he was diagnosed with HIV in 2000. He now warns that the stigma surrounding gay sex almost stopped his cancer from being found.
“I knew something was wrong.”
Garza’s symptoms were initially dismissed by medical staff. “My symptoms were initially assumed to be associated with foods I ate as part of my Latino heritage and with my lifestyle being a gay man,” Garza told PRIDE. He knew something was wrong and had to keep pushing for answers. After a difficult treatment involving 38 rounds of radiation and two weeks of chemotherapy, Garza began using his platform to warn others about the risk factors and the importance of advocating for your own health.
The HIV and HPV connection.
For two decades as an HIV advocate, Garza says no doctor ever told him that living with HIV increased his risk of anal cancer. “I wish I had known this sooner,” he said. “People living with HIV are 25 to 35 times more likely to develop anal cancer than people not living with HIV.”
This risk is closely tied to the Human Papillomavirus (HPV). Dr. Naomi Sutton, who works in the HIV and sexual health space, explained to PRIDE that around 90 percent of anal cancer cases are linked to HPV. While most people clear the virus on their own, an immune system managing HIV may have more difficulty doing so. This can allow high-risk HPV types to cause abnormal cell changes that may develop into cancer.
The risk is higher for men who have sex with men.
The statistics are stark. According to Health Equity Matters, men who have sex with men are 20 times more likely than heterosexual men to develop anal cancer. For HIV-positive gay men, that risk increases to 100 times more likely.
This medical gap is often widened by bias. “Doctors are people, too, and can have biases around gay identity and gay sex,” said Andrew Spieldenner, executive director of MPact Global Action for Gay Men’s Health and Rights. He told PRIDE that doctors can dismiss symptoms like bleeding or pain as being related to sexual activity rather than a more serious issue. “It is up to us to advocate for our needs, including finding another medical provider if we have to.”
How to advocate for yourself at the clinic…
Since most anal cancer is related to HPV, testing often starts with an anal swab to check for abnormal cells. A doctor may also perform a Digital Rectal Exam (DRE). If you have symptoms like persistent bleeding, itching, pain, discharge, or small lumps, it is important to press for more. Dr. Sutton notes that further tests, such as an anoscopy (which uses a magnifying instrument) or a biopsy, may be necessary. Early detection of precancerous changes, known as Anal Intraepithelial Neoplasia (AIN), is the main goal.
It’s awkward, but it’s necessary.
Garza, who now works with Cheeky Charity on anal cancer education, uses his background in comedy to break the stigma. He wants to save others from what he went through. “As a cancer survivor with an ostomy bag, my life has changed forever, and I don’t want that for you,” he says. “Be uncomfortable for just a little bit so you can live a better life.”
