Andrew's Anus and the Quest [yes, he's back with Part 7!]

[Check out the hole series.]

For 20 years, Andrew thought of the warts that occasionally sprang up on me as well . . . just warts.

I’m Andrew’s Anus, and I have HPV.

Eventually Andy realized that the human papillomavirus could lead to dysplasia and even anal cancer.

Andy had a good deal of confidence in his HIV providers, but his quest to find better care for me and my HPV uncovered a sad truth about living in the U.S.: 

The best anorectal HPV care is available only in a relatively small number of large cities in a minority of states, and the clinics that offer it don’t have the capacity to treat everyone who needs their services.

Getting a high resolution anoscopy (HRA) in just such a clinic had become a priority for Andrew. He’d had three surgeries to remove HPV-related growths and lab testing had twice indicated middle grade dysplasia. Meanwhile, he kept hearing that cancers not historically considered AIDS-related were being observed more frequently in HIV patients. The point was brought home when Andy was diagnosed with a basal cell carcinoma on his left shin. It was treated successfully, and he realized there wasn’t necessarily a direct connection, but all the same . . .

Andy began to email advocates he’d met over the years for advice and referrals. A friend responded with a website that listed providers trained by one of the best anal cancer research centers in the country. The first, most obvious candidatewas inthe larger metropolitan area closest to home. Unfortunately,only PLWHA who were already patients in the local Ryan White clinic could be seen there.

Andy kept looking.

A pozcouple he’d mentored when they were newly diagnosed tried to help. Andy pestered them to find out who their HIV doctor recommended. The doc couldn’t think of anyone in the city doing HRAs, but his nurse did give the name of a reputable specialist in town. Things began to look brighter when Andy called there. “Yes we see lots of HIV positive patients,” the person on the other end of the phone responded. “Yes we do high resolution anoscopies here. Yes we accept that insurance.”

The next day Andy got a call from the medical director who apologized that there had been a misunderstanding. The practice did not perform high resolution anoscopies. The doctor was polite and curious; Andy was put in the awkward position of explaining to a big city colorectal surgeon that HRA was considered by many to be a critical tool in preventing anal cancer. “That requires a very expensive piece of equipment,” she quipped. “No, I don’t know of anyone performing HRAs in this area.”

Andy’s frustration began to edge over into anger territory. 

When he attended a town hall meeting organized by a national advocacy organization as part of a regional PLWHA conference, the chair of the U.S. Presidential Advisory Council on HIV/AIDS (PACHA) asked the audience to talk freely about their concerns.

Andy stood up and asked,

“What are you going to do about the massive anorectal neglect that’s occurring in this country?" 

"Rectal microbicide research is a decade behind vaginal research," he continued, "and most people who need access to screening and treatment for anal dysplasia and cancers can’t get it!” The chair agreed the issue was important and said that part of the solution was for people like Andy “to keep advocating.”

Andy picked up a new leadwhen he ran into a mentor at a fall 2009 LGBT health conference. Two researchers who were presenting at the conference were at the table. The four of them were catching up on gossip when Andy off-handedly mentioned how little luck he’d had trying to get an HRA. To his surprise, one of the presenters turned, looked Andy in the eye, and said, “I’ll do that for you.”

Although he’d known that Dr. Langston was a researcher in the field of HIV prevention, it was news to him that he also ran an anal dysplasia clinic.The hospital that housed the clinic was a 600 mile drive from home. Still, there was a chance Andy might earn a scholarship to an upcoming conference there, and he could see Dr. L. then. When that didn’t happen, he set aside the option as too expensive.

Discouraged, Andy dropped his search and the months flew by. Suddenly, he realized it had been nearly a year since his last surgery and resumed his quest in earnest. He looked up the manufacturer of a device used to treat anal dysplasia using infrared coagulation (IRC). Maybe they could help him find a clinic. The sales rep who finally called back suggested one that was eight hours’ drive away – not too promising. He also shared the phone number for a Ryan White grants manager in an adjacent state who’d just bought a unit for a new project. Unfortunately, Andy’s calls there were not returned.

Later that year, at the 2010 Gay Men’s Health Summit, he attended a session on HPV and once again spoke out. Responding to the presenter’s prescription for anal Pap smears, HRA, and treatment, Andy asked whether the speaker realized that most peoplehad no access to these things. Further, did the presenter realize that leading researchers had gone on record saying that providing anal Pap smears was unethical unless a system of follow up screening and care was in place? What were people to do?

One trusted researcher who happened to be in the audience suggested that perhaps a charge of malpractice should be made, but when pressed he admitted that it probably wouldn’t be a practical course of action. Andy recognized the PACHA chair in the audience and approached him with questions. Andy figured a number of HIV clinics already owned the equipment necessary to provide HRAs and were using them for colposcopies to reduce cervical cancer risk in women. Had they been bought with federal funds?

Could that fact somehow be leveraged to apply pressure or attract funding where it was needed?

Tired of investing his energy in what felt like a wild goose chase, Andy decided it was time for action.He was convinced that it was critical for me to have an HRA, to at least establish a baseline, regardless of the cost.When he got home from the conference, he emailed Dr. Langston to ask if his offer was still good, and got an affirmative (and affirming) response.

And cost him it would. Andy thought making a road trip out of the journey could be fun, but when he did the math he nixed the idea.Years of living with HIV had affected his energy level. That would mean extra motel nights. Counting that, the time away, and the gas plus wear and tear on his car, flying came in at about the same cost – almost half of his monthly income.

Andy logged onto a travel website and began making arrangements for his first high resolution anoscopy.


(to be continued... stay tuned)


Read previous installments.


As told to Mark Hubbard

VIDEO: Doctor Ho and Andrew's Anus

via Pittsburgh's Positive OUTLook

Learn more about anal health from a hot doc and a sexy advocate.

Isn't Dr. Ho DREAMY??? Please sir, may we have another pap smear?

And of course, we LOVE our very own Mark Hubbard, the genius behind Andrew's Anus :) Make sure you check out the hole Andrew's Anus series, a first-booty perspective on anal health - there have been six installments so far, and more to come.

Andrew's Anus in the 21st Century [exclusively on LifeLube - Part 6]

[Check out the hole series.]

The human papillomavirus in me laid low and kept quiet for many years. When the big odometer in the sky rolled over from 1999 to 2000, Andrew began to re-think his priorities. He wanted to continue helping folks like himself and decided that meant learning more about the viruses he carried.

Little did we know that before the decade was done, I’d have to go back under the knife.

It was early in the new millennium when Andy first heard someone suggest that HIV positive men needed to get anal Pap smears. He thought that sounded pretty strange, and when he asked local doctors about it the response was dismissive.

“It’s an interesting idea,” one told him, “but what do we do with the information once we have it? There’s no standard to tell us how to proceed.”

When his birthday rolled around, Andy decided to have a Mardi Gras-themed party to celebrate that he was healthy and had made it to his 40th. When he’d gotten his HIV diagnosis at 25, he hadn’t even expected to live to see 30. The cover of the invitation was a picture of a boy sitting on a stoop “flipping off” the world. Inside, Andy invited his friends to come help him “give the virus the finger.”

They decorated his condo complex’s clubhouse in purple, green, and gold and served muffulettas and king cake. The stereo blasted “Lady Marmalade” and “Diamonds are a Girl’s Best Friend” from the Moulin Rouge soundtrack. Andy was single at the time, but one of his straight friends made a pointed remark about the number of his ex-lovers there. “Yes, I’m lucky,” Andy replied, “although it has sometimes taken time, I’ve managed to stay friendly with most of them.”

Speaking of giving the finger, both Andy and his doctor had grown complacent about examining me. 

On the rare occasions that Andy did check, he’d only felt what he assumed were small hemorrhoids. These came and went over the years and he didn’t think he needed to be concerned.

One July day, out of the blue, Andy’s doctor did give him a digital rectal exam (or DRE) and discovered what he called a polyp.Andy wondered if he should be concerned. “I’m not really sure what it is,” the doctor said. He referred Andy to a practice that handled lots of miscellaneous surgeries for local HIV patients.

Dr. Graves mainly treated cancer patients but he was committed to helping the HIV community.In terms of bedside manner he was a dream. He examined me with a simple, clear device called an anoscope, and took the time to explain everything before he did it, while he was doing it, and after he’d done it. Dr. G.said the polyp was likely HPV-related and should be removed with outpatient surgery and sent for testing.

The hospital experience was uneventful in a good way. Andy was in and out without complications. After he woke up, Dr. G came by to tell Andy that things had gone well. “You do have a hemorrhoid,” he told Andy, “and we have a good way of handling those when necessary, but we left it alone.”

When Andy went to Dr. Graves’ office for the follow up visit, Dr. G explained that the pathology did report abnormal cell growth also known as dysplasia. “We think of this in terms of three levels,” he said, “ranging from the mildest to what could be called pre-cancerous.”

“Yours is in the middle range,” he added.“You don’t need to be too concerned, but we do need to keep an eye out for any future developments.”

Andy had begun to go to a few community meetings on HIV/AIDS and gay men’s health. He started to hear HPV and anal dysplasia discussed from an activist point of view. Although his latest experience had for the first time helped him to understand that there could be a connection between HPV and anal cancer, he didn’t really think about it much.

Those concerned included gay men working in big city clinics doing treatment and research in the field. More HPV-related lesions with abnormal or pre-cancerous cells were being seen, they said, and the trend was particularly pronounced in HIV positive gay and bi men. They wondered out loud if a future cancer epidemic was smoldering beneath the surface.

While there wasn’t universal agreement, these researchers and practitioners had observed that when patients were screened regularly and the highest grade lesions removed, anal cancer only rarely occurred and so might be prevented.

Experts said the best method for screening was something called a high resolution anoscopy, or HRA. Andy learned that the procedure was very similar to one called a colposcopy during which women with abnormal Pap smears have their vagina and cervix examined. Trained doctors or nurses use special equipment (a stereoscopic scope and/or a digital camera)along with vinegar and iodine solutions to more reliably identify lesions that need to be biopsied. Andy asked around, and while colposcopies were being provided in local HIV clinics, no one in his region (or even in his state) was providing the rectal version.

Andy had occasionally noticed tiny blood spots on the Charmin after a bowel movement. When the heat and humidity of July returned, it occurred to him that his regular HIV doctor hadn’t asked about or examined me in a year. He hadn’t seen Dr. Graves since just after his last surgery. It was high time Andy scheduled an appointment. I’m sure glad he did.

Dr. G found a new lesion. “It’s a small growth on a hemorrhoid” he said. “I think I can remove it surgically here and now, if that’s alright with you.” For just a moment, Andy flashed back twenty years to his experience with the quack. Dr. Graves had earned his trust, though, and Andy told him, “Sure - let’s take care of it.”

True to form, Dr. G. explained everything and was exceedingly gentle. He used a local anesthetic, and with his nurse’s assistance began the procedure. “I think I need to put just one stitch in here to minimize any bleeding, OK Andy?” he asked. It was, of course. “I think I got it all,” he said afterward, “but from its looks I suspect that it is of a type that might grow back.”

Dr. Graves explained that he would send the tissue out for testing. When Andy next heard from the surgeon, he learned that the results once again showed cells with that middle grade of dysplasia.

Living with HIV for decades had taught Andy that some amount of what others might call denial could be useful. In the early years, everyone had – and rightfully so – been paranoid about any little symptom. Over time they’d learned to distinguish between minor and serious problems and to know when they did and did not need to call the doctor.

It was time for Andy to lift the veil of denial he’d held between himself and me regarding HPV. Fortunately he realized it.

I was at risk for high grade dysplasia or even cancer, and common sense told Andy that the care he was getting for me was just not good enough.

(to be continued... stay tuned)


Read previous installments.


As told to Mark Hubbard

Andrew's Anus - Living with HIV [exclusively on LifeLube - Part 5]

I’m Andrew’s anus, and I have HPV.

Last week I told about how Andy (finally!) got appropriate surgery for my warts and how we learned that it wasn’t the same as a cure.

That was twenty five years ago.

At the time no one dared dream it would be possible to live this long this well with HIV.

For a year or two after the surgery, Dr. Bradley and Andy both kept a sharp eye on me. Occasionally one or the other found a small wart or two in me and each time Dr. B destroyed them with an acid called TCA. Eventually they stopped finding warts and it seemed like I was done with that pesky HPV.

Finding out that he had chronic hepatitis B and HIV put a damper on Andy’s sex life for a while. The shock of the news and the angst that came with suddenly facing mortality had as much to do with that as the viruses. Andy was also really nervous about me. He worried that the surgery might have left me vulnerable and wanted to make sure I had plenty of time to heal.

About six months in, something occurred to Andy. Wouldn’t he feel ridiculous if he moped around for months only to realize he still felt fine?

It seemed sort of twisted to count his chickens before they - what? - died?

 Whether he had two more months or two more years to be healthy and happy Andy was going to focus on living. Eventually his desire came back and then so did his sex life. At the right time and with the right guy, there was a “grand re-opening” for me. The sex felt great and I handled the fucking just fine. I was finally back in the game!

Andy was working for a friend in a small company now. He saw the doctor regularly and when his numbers declined, Dr. Bradley thought it was time for Andy to consider taking the first and only available HIV drug, AZT. His boss was supportive, but Andy was afraid that filing for reimbursement might mean trouble. He worried that there could be an outrageous increase in insurance premiums and they even discussed paying for the expensive medication directly out of the company account.

Dr. B told Andy about a possible alternative. There were openings for a clinical trial that would provide AZT at no cost. He might or might not also get the herpes drug acyclovir – the study would find out if it could help fight HIV. He decided to participate both to help the cause and to avoid the insurance issue.

Andy’s T-cell counts nearly doubled at the beginning of the study, but then went back down in a matter of weeks. Meanwhile, his blood tests showed a problem with his liver and everyone was worried. Treatment was stopped and then restarted at a lower dose.The liver tests got closer to normal then, but not close enough to let him continue in the study.

Together Dr. Bradley and Andy decided that he would stay on the AZT at a reduced dose. Andy was able to postpone buying drugs and filing insurance for quite a while. He still had some AZT from the study and more than once the nurse clandestinely slipped him leftover bottles of pills in brown paper bags. For years, Andy’s liver tests would occasionally climb above normal but they never again spiked like they had that first time.

The end of the 80's had flown by. Several guys from his first support group had passed away. Although he was tired a lot, Andy continued to work and have fun. But the 90's began with two funerals for closer friends and Andy often wondered, “Why am I still here? Am I some kind of exception?”

Andy had dated a number of guys, but one night out dancing he met someone special. Jack was younger and HIV-negative, but the two were in love and it wasn’t long before Jack moved in.They struggled with being over-cautious at first but they eventually got good at using condoms so Jack’s anus and I both got plenty of action.

Unlicensed raves started to spring up around town and some weekends that’s where Andy and Jack partied. They called hotlines for directions to unused warehouse spaces where they drank “smart drinks” instead of cocktails or beer. Young DJs played songs by groups like 808 State and the Future Sound of London and new‘intelligent” lighting machines sprayed vivid color in every direction.

One night, some guy they’d never heard of (Moby!)showed up to perform and when the lights finally came up they were drenched from dancing. The sound of a distant ice cream truck came from the speakers, freezer pops were handed out, and they headed home to collapse into each other’s arms.

Andy’s CD4 counts, as they were now called, slowly declined. Dr. Bradley prescribed a second drug. Once again, Andy lucked into an underground source. “Expanded access” drugs set aside for a now-dead patient were given to him. Dr. Bradley told him there was a chance the Epivir would work against
Andy’s hepatitis B as well. Eventually they added a third similar drug with the hope it too could buy time.

He didn’t know if it was the difference in their ages, the difference in their HIV status, or a fascination with club drugs Andy didn’t share with Jack, but after a few years they grew apart. Andy began to surf online services like CompuServe and AOL and met a few guys that way.

Half way through the decade, Andy’s CD4 counts got down to to dangerous levels. He wasn’t an exception after all. Medically, it seemed like he was just waiting for something bad to happen. Just in the nick of time, stronger drugs became available, and adding one to his regimen stopped his decline. Andy had never given up hope.

And what about me, you ask?

I enjoyed a relatively trouble free decade. Once in a while Andy overdid things, leaving me a little sore, and occasionally I had what he assumed was a minor hemorrhoid issue.

These small problems resolved themselves quickly, though.

In fact, 20 years would pass between the appearance of those last few warts and the time when Andy and I would once again confront the human papillomavirus.

(to be continued... stay tuned)



Read previous installments.


 As told to Mark Hubbard

Andrew's Anus and the Proctologist [a LifeLube exclusive, part 4 in a series]

I’m Andrew’s anus, and getting the care I need has often been a struggle for Andy.

That was especially true in the mid-1980's when I had my first wart outbreak. Although I eventually got the surgery I needed, Andy discovered treatment didn’t mean a cure for my HPV (human papillomavirus.)

Andy figured no one could be worse than the pathetic excuse for a doctor he’d recently encountered. His second prospect seemed more professional - there was even an academic air about him. Andy disclosed that he had two immediate issues –anal warts and a recent positive test for the “AIDS virus.”

“I’m a cardiologist,” the doctor replied. “I’m not sure why they referred you to me as this isn’t my area of expertise. Perhaps it’s because I answered a survey expressing interest in continuing education about AIDS?”

The doctor examined Andy and observed, “You look like a healthy young man to me. Frankly it doesn’t seem possible that you have AIDS. Do you mind if I run a test to verify that you are infected?”

Too anxious to fathom the implications of this, Andy agreed.The blood was drawn and the the required referral for me was provided.

“Well it’s not the worst case of anal warts I’ve ever seen,” the proctologist quipped wryly after examining me.

“What the hell is that supposed to mean?” I wondered. Outpatient surgery was planned and this time it was actually done. Just before he went under, Andy caught a glimpse of his chart. HTLVIII (an early tag for what we now call HIV) was emblazoned in four-inch blood-red letters across the front.

The first week of recovery was hard going, but I hung tough. At his follow-up visit a week later, the proctologist told Andy he was retiring and that he’d refer us to someone else for future care. Almost as an afterthought, he asked Andy if he understood how I got the warts. Caught off guard, Andy waffled and the doctor sternly told him that whoever said my warts were the result of anything but homosexual activity was a liar.

Andy wasn’t aware then that 30% of straight guys have detectable anal HPV, but he did know the doctor’s tone was inappropriate. Still, he had bigger fish to fry and let it go.

Andy still hadn’t found an AIDS doctor.

One night, the most experienced local provider in the area came to talk to his support group. Dr. Bradley was a seasoned and compassionate man who confessed that treating a terminal disease was a big change for him. “I’m used to being able to cure what ails my patients,” he confided, “but I feel powerless against this disease. This is happening to my community and somebody has to try to do something,” he explained.

“Something” in those days consisted of helping new patients understand their T-cell counts, struggling to ward off a bunch of different infections for folks in and out of the hospital, and attempting to help them die with some dignity when the time came.

Andy saw the new proctologist for the recommended follow up, and the doc briefly examined me. He was younger and his office was more modern, but he didn’t show any more compassion. It seemed like he was anxious to close out the case. “Everything looks fine and I don’t see any reason for you to come back,” he advised.

Andy decided to ask Dr. Bradley to be his main healthcare provider. It only took a few minutes in the exam room to know he’d made the right choice. Dr. B. knew as much as anyone in the state about AIDS, yet he’d been humbled by the fortitude of his patients.

A self-described bisexual, Dr. B. had no qualms about sex – straight sex, gay sex, oral sex, or butt sex.

He didn’t pass judgment and he understood the lives of his gay patients.

When Andy mentioned the cardiologist and the confirmatory blood test, Dr. Bradley smiled. “That was nice of him, huh? You do know he’s the CEO of your HMO, don’t you?” Andy hadn’t, of course.

Some months later, Andy was shocked and disappointed when Dr. B, after conscientiously performing a rectal exam, discovered a couple of small warts in me. Andy and I hadn’t really understood. We assumed the surgery had cured me. “No - this is to be expected,” Dr. B. explained. “But don’t worry,” he assured Andy, “if we’re vigilant and treat them when they’re few and small, we may get them under control.”

Eventually, and for a very long time, we did.

(to be continued. read part 5 next tuesday, march 8)

As told to Mark Hubbard

Read previous installments.

Andrew’s Anus and the Quack [a LifeLube exclusive - Part 3 in a series]

Last week I talked about Andy’s foray into urban life and how he found out I had HPV. Things hadn’t worked out on the coast, and as we headed home he wondered if he had AIDS, and I worried about how we were going to deal with my warts.

I’m Andrew’s anus – that last inch and a half or so of his digestive tract connecting his rectum with the outside world.

Andy had a hella hard time finding competent treatment for me then, and I’m sorry to tell you he still does today.

It was 1987 and finding a job with benefits was Andy’s top priority.  Fortunately, his work experience got respect in his home town and in no time he started with a temporary agency. Just when he least expected it, his assignment with a large firm turned into a solid full time job. 

Corporate America had just started smarting from the cost of health insurance.  Because of this, PPOs (preferred provider organizations) were hot, but the newest kid on the block was the HMO, or health maintenance organization. Supposedly designed to promote prevention and cost savings, HMOs strictly limited where employees could get care and contracted providers at a flat “per insured” rate. Andy attended a meeting where it was announced that his company was going that route.

It had been months since the warts on me were diagnosed.

Anxious, he regularly checked me out while soaping up in the shower.

He was worried that those small, rough-surfaced bumps just inside me might grow or multiply. The wait for insurance seemed to last forever. As the weeks passed,the warts did grow and extended a little bit outside of me, horrifying us/both.

Andy thought more and more about AIDS. Had the local guy who’d shared Hepatitis B with him before his big adventure shared something else? Or… could Patrick have? Before leaving the city, he’d come to realize that Patrick had quite an illustrious past. He also recalled how I sometimes bled a little after Patrick fucked me. 

His doctor had recommended against an AIDS test, but Andy finally decided he just had to know. When the health department nurse told him the results were positive, Andy wasn’t surprised. He was referred to the single fledgling support agency in town where services were pretty much limited to hospital visitation and support group meetings which he began to attend.

Andy’s HMO coverage finally kicked in and his first appointment was a nightmare. 

When he told the new doctor about his Hepatitis B, the doc darted out of the exam room like his ass was on fire and grabbed the thermometer that his nurse had used to check Andy’s temperature. “Here,” he said as he stuffed it in Andy’s shirt pocket. “We’ll just let you keep that.”

The phrase universal precautions wasn’t yet common, but even I knew something was very wrong – and so did Andy.

Still, he was desperate to have me treated. When he mentioned the warts, the doctor said, “No problem -we can handle that here and now.” He had Andy lay face down on an exam table, numbed me with injections, and while the nurse held Andy’s cheeks apart the doc came at me with some electrical device. 

“You don’t have any internal warts, do you?” he asked as the odor of burnt flesh and ozone wafted forward. 

Traumatized, and with his own ass now definitely on fire, Andy muttered “I don’t know” but wondered “isn’t it his job to know that?”

The quack sent Andy home with a prescription for Lortab and a wad of gauze in his briefs. I hurt and bled a little for a day or two but slowly began to feel better. When enough time had passed to make it seem less scary, Andy gently probed me to check things out. His heart sunk when he realized the quack had done a half-assed job - I still had warts inside of me.

After participating in the support group for a couple of months, the social worker who ran the AIDS agency asked Andy if he would be willing to serve as a peer facilitator for a new group that was forming. Andy said yes to this first opportunity to help.

Andy still didn’t know where to turn for care. He asked the social worker for the name of an AIDS specialist. “We can’t ethically recommend a doctor,” he said, “but you can call the local academy of medicine for a referral.” Andy did and explained to the person on the phone that he needed someone who knew about AIDS. He and the staffer identified an HMO-approved provider, and Andy took the earliest available appointment.

(to be continued, read part 4 next tuesday, march 1)

As told to Mark Hubbard

Read previous installments.

Andrew’s Anus in the City [a LifeLube exclusive - Part 2 in a series]

Last week I described how Andy discovered sex with me and how he went about discovering his gay self.

I’m Andrew’s anus, and I have HPV.

Eventually, Andy and I discovered that we were shacking up with other viruses as well.

I believe we could all help anuses stay healthier if we’d bring the subject out of dark nether regions and into the light of day.

Most gay guys are fairly informed about HIV, but far too many know far too little about HPV (the human papillomavirus). Experts tell us that most people have been exposed to HPV, which can sometimes cause genital warts or lead to anorectal cancers.

Andy tested HIV positive around two dozen years ago after moving to a big city where he thought his dreams would come true. As it turns out HPV has been inside me for at least that long. No one used the term HPV back then though – instead they talked about anal warts. Andy and I didn’t have a clue.

It was summertime and the Pet Shop Boys’ second big hit “Opportunity” was Andy’s theme song. It was playing at the club when he went out the night before leaving town. Andy was really pumped about his new job working for two up-and-coming gay entrepreneurs. He shook his moneymaker (and me) on the dance floor like there was no tomorrow.

Andy was ecstatic in his new life - for a while. He loved his job, the city was really happening, and he met a hot new beau within a few days of arriving.

The guy was a fish packer (seriously!) and built like a brick shithouse.

Andy worshipped Patrick’s Soloflex body and Patrick really loved “poking” me, as he called it. Andy loved that too, but he had to say no as often as he said yes just to keep from wearing me out.

Patrick didn’t like using condoms. At all. Andy decided “what the hell,” thinking “one more lover won’t make a difference.” Patrick didn’t move in but he slept over nearly every night. Andy almost always woke him up with a back rub the next morning before they both had to go to work. They didn’t talk or think in terms of a relationship or romance, but Patrick was Andy’s only lover. They smoked buds and went to the club every weekend, and had lots of good times.

When the leaves turned it was time for Andy’s third Hepatitis B vaccination. The manager at work referred him to a young gay doctor. Without that stroke of luck, I honestly don’t think I’d have lived to tell this tale. Andy figured the doc would give him the injection and that would be that. Instead Dr. Johnson explained that Andy’s blood should first be tested to check the effect of the two previous shots.

A week later, the doctor called to explain that a third injection would be useless because Andy already had chronic hepatitis B. His previous test had been done “in the window” before antibodies could be detected. Andy was confused but bravely shared this news with Patrick and paid for his hepatitis test. He didn’t know it at the time, but that was the beginning of the end of the relationship.

The sparkle of the city began to dim as Andy saw past its veneer. He sensed a strange dark edge to life there, one he couldn’t quite put his finger on. The shop owners had a reputation for putting the make on their employees and while he stood up for himself, they were generally jerks. The depressed economy painted Andy into a corner. Lots of other guys his age were unemployed and couch hopping and the gay subculture seemed to revolve around crystal meth. Andy didn’t care for it but he knew Patrick and a lot of other guys did.

At his next visit, Dr. Johnson checked Andy (and me) out more thoroughly. He noticed some swollen glands on the back of Andy’s neck and a cluster of warts on me. Both were indications that something might be up with Andy’s immune system.

He hadn’t even known I could get warts, much less that they were caused by a virus that could stick around for decades.

The doctor told Andy the swollen glands were a sign of infection. “It could be a number of things, including the virus that causes AIDS,” he said. Because he had no treatment to offer and because discrimination was nearly certain, Dr. J. didn’t recommend getting a test. Instead he advised Andy to act as if he (and everyone else) was infectious - just in case. His colleague examined me carefully and recommended outpatient surgery to remove the warts.

A week before the scheduled procedure, Andy finally got fed up and told his bosses what they could do with their job. Unfortunately that meant he no longer had insurance and my surgery had to be postponed. Andy tried to find another job, but it seemed only hometown boys were being hired. After a lonely month living on credit cards and wishful thinking, we high-tailed it out of there.

Along the route home Andy stopped to visit friends and have some laughs. On a side trip into the Petrified Forest, his footsteps crunched through a brittle, sparkling layer of snow. He squinted at the low winter sun and watched a long train heading off into the horizon. While deeply inhaling the cold fresh air, a powerful premonition came over Andy – that he was infected and that his life was going to change in a very big way. Somehow the feeling wasn’t centered on illness or death.

“I’m going to help people,” he kept thinking. “Somehow I’m going to help.”

(to be continued, read part 3 next tuesday, february 22)

As told to Mark Hubbard


Read Part 1 of Andrew's Anus.

Introducing... Andrew's Anus [a new LifeLube series - Part 1]

The human papillomavirus, or HPV, has been in the news lately and lots of you have been talking about it, but it’s personal for me.

I’m Andrew’s anus, and I have HPV.

I’m tired of worrying about a couple of pre-cancerous spots in me, and Andy’s downright pissed about the obstacles he’s faced trying to get the right kind of care for me. He says part of the problem is that people aren’t comfortable talking about things like anuses, rectums, and butt sex.

I’m damned determined to change that, so I’m telling my story.

Andy and I have been fuck buddies forever. We discovered we liked having sex about the time he learned to drive. I’ve been with Andy through decades of ups and downs, good times and bad times, lovers and tricks.

Andy’s a likeable dude, sort of the gay-guy-next-door type. He lives between the coasts in a place that’s too big to call a town, but too small to be considered a real city by those who actually live in one. At nearly 50 he gets creative with the clippers to disguise his receding hairline (or just shaves himself bald), is in good shape, and has a sex drive healthy enough for him to enjoy his new found “Daddy” status. Andy stays informed about queer health by keeping in touch with “in the know” friends from across the country.

It wasn’t always that way.

Andy discovered that I could be a source of pleasure a few years after he discovered jacking off. He was still in high school and it was the seventies. Life was fun and easy. Heart, Steve Miller, and the Doobie Brothers were on the radio and just about every convenience store sold “tobacco” pipes and little brown bottles of “room odorizer.” He went to dozens of rock shows where the halls smelled then like the streets of San Francisco do now, if you know what I mean. Lieutenant Matlovich was on the cover of Time magazine above the headline: “’I Am a Homosexual.” Magazines like Playboy, Playgirl, and Penthouse penetrated the male bisexuality barrier with words if not pictures, and were sources of information and “inspiration” for Andy.

Andy knew he was different and rationalized that he was bi, but he kind of hoped he wasn’t gay.

He definitely enjoyed sex with himself. Then he read a Playboy interview with panelists ranging from Deep Throat star Linda Lovelace to gay church pioneer Troy Perry. Linda bragged that she often enjoyed “anal orgasms.” Andy was all for orgasms of any kind so that’s when he and I began to get more intimate.

Andy began to fool around with a neighbor boy or two - no romance or kissing, just dare games and swapping hand jobs. When he found a willing conspirator, they tried giving each other head. Eventually, after a less than successful try or two, I got fucked and Andy found it very exciting and very pleasurable.

Sex education was trendy in the seventies so Andy wasn’t completely clueless. His high school health teacher had students leave their outdated textbooks in their lockers because she used her own more progressive curriculum. The state public health commissioner’s wife came to class and passed around condoms and diaphragms as part of her talk. Andy learned about reproduction and birth control and studied gonorrhea and syphilis, but he doesn’t remember any talk of things like sexually transmitted warts or hepatitis.

Andy chose a small town college for its strong computer systems degree. Like many freshmen he split his time between studying and partying. Surrounded by strapping farm boys that fueled his fantasies, he struggled with his 19-year-old sex drive. Being on his own was great for the most part, but he was frustrated and a little lonely. Late in his freshman year, he took his first male lover but panicked when the guy wanted to get serious.

Over the summer break Andy met some gay friends who took him to his first “alternative” club, where the DJ mixed Dazz Band and Human League with 38 Special and Michael Jackson, and the dance floor smelled like poppers, Polo, and menthol cigarettes. He really wanted a relationship – one like his straight friends enjoyed - but bringing an occasional trick home after a night out would have to do until he found one. When he decided his sexuality was too big and too important to hide, Andy came out.

Meanwhile, herpes made the cover of Time. Andy saw ads in a gay magazine suggesting men use condoms to prevent hepatitis B, but he dismissed the idea as silly. 

He thought not having to worry about pregnancy was one of the few perks of being gay. Only a few years passed before whispers about a new “homosexual” disease arrived. First they were hard to believe; then they were impossible to deny. The guy he’d most recently dated called from the hospital sick with Hepatitis B. Andy’s test came back negative and he started the recommended vaccination series. When he was offered a job in a much larger city, he jumped at the chance for adventure and a clean break.

Andy’s fog of denial about AIDS was lifting. Just that month he’d attended the first ever fundraiser for a local organization created to deal with the illness. Headed for a new job and a new life, Andy decided he’d have a new attitude about condoms and he’d use them every time. As he drove his loaded-down hatchback across America, what he didn’t realize was that a couple of viruses already rode along inside us.

(to be continued, read part 2 next tuesday, february 15)

Read the series.





As told to Mark Hubbard