A problem below stairs...

I’ve had warts since I was a child – they run in my family. At one point, around the age of 12, I had small warts on most of my fingers. Although I never sought treatment, after a year they suddenly disappeared within the space of a week.

My first bout of genital warts was similarly uneventful. I came home from my first year at university with a self-diagnosis of piles – an unbearable itch in my back passage, and pain and blood after using the toilet. I came away from the GP with an instruction to visit a ‘treatment centre’ 20 miles away. After being quizzed about my sexual history, an examination revealed the presence of an anal fissure and a single anal wart. The wart was quickly dispatched with a blast of liquid nitrogen.

Eight years later, a couple of years after my HIV diagnosis, the warts on my fingers, plus a few tiny ones on my chin, had returned and been removed with a quick nitrogen zap. When a subsequent examination revealed the presence of a few warts around my back passage, I assumed that a few icy blasts would see them off.

I diligently followed my doctor’s advice to pop into the clinic a couple of times a week to have the warts sprayed. I was encouraged by the nurses’ reassurances that the warts were small and would soon be gone – especially as my viral load had plummeted from over 120,000 to below 50 copies/ml within a month of starting therapy.

As my bi-weekly visits started to stretch over weeks, then months, a trip back to my doctor revealed that the three months of cryotherapy had achieved nothing, probably on account of my sluggish CD4 count response – rather than climbing obediently, it had continued to fall before hovering around 130 for most of my first year on therapy.

In the two-month wait to be seen by a surgeon, the warts, no longer being kept in check by their regular cold shower or by imiquimod cream, grew to grotesque proportions. One grew inside my anal canal and prolapsed every time I used the toilet, eventually becoming more than 5cm in length and unbelievably painful. I felt disgusting and my sex drive evaporated.

I pinned my hopes on the operation. However, nothing (and no one) had prepared me for how painful this would turn out to be. After three days in hospital on intravenous antibiotics, there followed eight weeks of a degree of pain I had never imagined. I became terrified of using the toilet, necking laxatives and painkillers in handfuls and teetering on the edge of depression.

To top this off, the warts returned, even stronger, within a month of the surgery. On a return to see the surgeon, he nonchalantly informed me he “would have to repeat the procedure". Gritting my teeth through another three-month delay on a waiting list, the warts became larger than ever: I could barely walk for hours after using the toilet, and I was in tears most days.

Luckily, the second operation was far less traumatic than the first. I was up and ready to leave within hours of coming round, and felt better within days. I only had moderate pain for around a week.

In the two months since the procedure, there is no sign of a recurrence, although the few small warts that couldn’t be excised are now enjoying their weekly nitrogen fix. Despite a diagnosis of grade I anal intraepithelial neoplasia (AIN), which is now being monitored in a clinical trial, my mood is climbing almost as quickly as my CD4 count. I’m back on my bike, and finally, after over a year, I’m no longer scared of the toilet.

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My hero!

By Philip

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Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.