Here are some steps that might help reduce the future risk for HPV-related cancers, including anal cancer:
Early Initiation of ART
Starting ART before the CD4+ count falls to low levels helps to reduce damage to the immune system. A stronger immune system should be better able to fend off cancers.
There are two vaccines -- Cervarix and Gardasil -- that provide protection against two strains of HPV that are associated with cancer. One of these vaccines (Gardasil) also provides protection against ano-genital warts. Although the effectiveness of these vaccines was tested in HIV-negative people, researchers at the U.S. National Cancer Institute recently estimated that these vaccines could provide "substantial" protection against HPV-related pre-cancer and cancer particularly in HIV-positive people. Speak to your doctor about coverage for this vaccine in your region.
Tobacco and Other Substances
Reducing exposure to factors associated with cancer (such as tobacco smoke, excessive alcohol and injecting street drugs) is a good step. Another important step is getting help for the mental and emotional health conditions that often underpin some people's susceptibility to addictive behaviours and substance use.
This helps to protect people not only from HIV infection (and for HIV-positive people, new strains of the virus) but also from many sexually transmitted infections. Correct and consistent use of condoms offers some protection from (re)infection with HPV.
Anal cancer screening programs for HIV-positive people may be available in some larger cities. Often such programs are funded as part of research studies and may not be the standard of care. Speak to your doctor about the availability of this screening in your region.
Canadian Cancer Society -- Anal cancer overview
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