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World J Gastroenterol. Nov 7, 2014; 20(41): 15262-15268
Published online Nov 7, 2014. doi: 10.3748/wjg.v20.i41.15262
Sexually transmitted infections of the anus and rectum
Roland Assi, Peter W Hashim, Vikram B Reddy, Hulda Einarsdottir, Walter E Longo
Roland Assi, Peter W Hashim, Vikram B Reddy, Hulda Einarsdottir, Walter E Longo, Department of Surgery, Yale University School of Medicine, New Haven, CT 06510, United States
Author contributions: Assi R, Hashim PW, Reddy VB, Einarsdottir H and Longo WE designed the study; Assi R and Hashim PW wrote the manuscript; Reddy VB, Einarsdottir H and Longo WE provided critical revisions.
Correspondence to: Walter E Longo, MD, Professor of Surgery and Obstetrics, Gynecology, and Reproductive Sciences, Department of Surgery, Yale University School of Medicine, 333 Cedar Street -LH 118, New Haven, CT 06510, United States. walter.longo@yale.edu
Telephone: +1-203-7852616 Fax: +1-203-7852615
Received: March 19, 2014
Revised: May 22, 2014
Accepted: June 14, 2014
Published online: November 7, 2014
Processing time: 238 Days and 11 Hours
Abstract

Sexually transmitted infections (STIs) represent a significant public health concern. Several STIs, once thought to be on the verge of extinction, have recently reemerged. This change is thought to be partially related to an increase in STIs of the anus and rectum. Importantly, the global human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) epidemic has contributed to the emergence of particular anorectal lesions that require specialized approaches. In this report, we review common anorectal STIs that are frequently referred to colorectal surgeons in the United States. Epidemiology, clinical presentation, and management are summarized, including the latest treatment recommendations. The particularity of anorectal diseases in HIV/AIDS is addressed, along with recent trends in anal cytology and human papillomavirus vaccination.

Keywords: Sexually transmitted disease; Rectal disease; Sexual behavior; Human papillomavirus; Human immunodeficiency virus; Perianal disease; Highly active antiretroviral therapy; Human papilloma virus vaccines; Anal cytology

Core tip: Anorectal sexually transmitted infections constitute a group of emerging diseases not well recognized by the medical community. An understanding of recent trends in sexual behavior and the epidemiology of sexually transmitted infections is critical to identifying populations at risk. Our scientific review summarizes important characteristics of the most common sexually transmitted infections of the anus and rectum, in addition to the latest recommendations in diagnosis and management. This review also addresses the particularity of anorectal diseases in human immunodeficiency virus and acquired immunodeficiency syndrome and recent trends in anal cytology and human papillomavirus vaccination.