39. Can't you just cut them off? Meeting the educational and emotional needs of the patient with anal HPV/dysplasia

Abstract

HPV infection among sexually active people is ubiquitous. Concern regarding the consequences of cervical HPV infection is not significant in most asymptomatic women who present for annual GYN screening. However, men and women who are referred for diagnosis of an HPV condition presenting as condylomata or an incidental finding of colonoscopy or following haemorrhoidectomy often present with highly emotional concerns and questions. Primary care providers frequently lack basic information with which to appropriately address issues such as:

Will I ever get rid of these warts?

Will I always be contagious?

Did I get these from my current partner?

Does this mean my current partner was unfaithful to me?

Do I have to tell future partners?

Am I going to die?

I feel unlovable! Sometimes I think about just giving in and dying of cancer.

My PCP told me they were haemorrhoids!

Can’t you just cut them off??

Why didn’t anyone recommend anal screening after my treatment for cervical cancer?

My husband was treated for anal cancer. Should I be checked?

I asked my PCP and oncologists what caused my anal cancer. They said they didn’t know. Now I read online that it’s caused by an STD?!

Responding to these concerns, promoting a hopeful attitude, and supporting a fragile self-esteem are important aspects of an anal dysplasia practice. This presentation will provide some practical approaches to anal HPV education and counselling.