Recent epidemiologic analyses suggest that the majority of HIV cases in sub-Saharan Africa may be due to non-sterile health care practices. The present paper reviews the anthropological, proctologic, and infectious disease literature, and argues that both homosexuality and heterosexual anal intercourse are more prevalent in Africa than has traditionally been believed. The authors hypothesize that perhaps the majority of HIV transmission not accounted for by iatrogenic exposure could be accounted for by unsuspected and unreported penile—anal intercourse. This default assumption is reinforced by time-honoured denial of penile—anal practices in Africa. Recent reassessment of epidemiologic evidence indicates that a substantial amount, if not the preponderance, of HIV transmission in sub-Saharan Africa is of iatrogenic origin 1,2. In this communication, we review evidence from several sources to support our contention that the majority of HIV transmission not accounted for by iatrogenic exposure could be accounted for by unsuspected and unreported homosexual and heterosexual penile—anal practices.
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A year-old male presented to us with the history of purulent discharge from scrotum since 5 months ago, with increased amount of discharge during sexual intercourse. Magnetic resonance imaging showed a fistula tract ending at the root of the penis. However, intraoperatively it was found to be communicating with the anal canal. Fistula in ano rarely presents with an external opening in the scrotum. We could not find any published literature in this regard.
The value of high-resolution anoscopy in the diagnosis of anal cancer precursor lesions in hiv-positive patients. CONTEXT: Anal cancer, although a still rare disease, is being observed in ascending rates among some population segments known to be at risk for the development of the disease. Human papillomavirus HPV infection, immunodepression and anal intercourse are some factors associated with the development of the malignancy. Its similarities to cervical cancer have led to many studies aiming to establish guidelines for detecting and treating precursor lesions of anal cancer, with the goal of prevention.