![]() ![]() ![]() In addition, human immunodeficiency virus (HIV) transmission is facilitated by virtually any STI, whether in the presence or absence of ulcerative lesions. When evaluating a patient with an anorectal STI, it is important to remember that coinfection is common and has been reported to be as high as 41% in some high risk populations. Transmission may occur through a variety of sexual practices, such as receptive anal intercourse and oro-anal sexual contact. Common lesions include ulcerations, vegetations, and clinical proctitis. Common complaints of anorectal STIs include anal pain, tenesmus, urgency, purulent drainage, and bleeding. ![]() In one study among men who have sex with men (MSM), routine screening found that 85% of rectal infections with chlamydia or gonorrhea were asymptomatic. Symptoms of STIs are often nonspecific and latent, making diagnoses challenging. Although traditionally associated with homosexual men, anal receptive intercourse is in fact more practiced among heterosexual couples in absolute numbers, showing wide geographical, ethnical and cultural variability. The incidence of anorectal STIs has risen in recent years, a trend primarily attributed to an increase in the practice of anal receptive intercourse. This article reviews STIs of the anus and rectum, examining their epidemiology, presentation, and management.Īnorectal STIs are commonly the result of anal receptive intercourse but may also be due to contiguous spread from a genital infection. Patients with anorectal symptoms or lesions are often referred to colorectal surgeons for complete evaluation or management. Anorectal involvement is common, although the exact prevalence remains unknown due to numerous asymptomatic infections and a lack of accurate epidemiologic data. In the United States (US), the annual incidence reaches approximately 15 million cases. Sexually transmitted infections (STIs) are a substantial health concern, with an estimated worldwide incidence of 333 million cases per year. ![]()
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