HPV: What Gay Men Need to Know About the Virus, the Vaccine, and the Screening Tests That Could Save Your Ass (Literally)

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At Tom of P-Town Health, we like to keep it real—and when it comes to sexually transmitted infections, few are as common and misunderstood as HPV. Human Papillomavirus (HPV) is the most common STI in the U.S., and while most people associate it with cervical cancer in women, let’s be crystal clear: HPV is also a major health concern for gay and bisexual men.

So buckle up—we’re about to break down what you need to know about HPV, cancer risk, the vaccine, and why screening (yes, even "down there" and "back there") matters more than ever.

What the Hell Is HPV, Anyway?

HPV isn’t one virus—it’s a family of over 100 different strains. Some cause benign skin warts, some cause genital warts, and some are the high-risk types that can lead to cancer. You can get HPV from oral, anal, or genital contact—and condoms only reduce, not eliminate, the risk because HPV spreads from skin-to-skin contact, not just fluids.

Why Gay Men Should Care (Like, Really Care)

The high-risk strains of HPV are linked to:

  • Anal cancer
    Rates in men who have sex with men (MSM), especially those living with HIV, are up to 100 times higher than in the general population.

  • Penile cancer
    Rare but nasty—and mostly preventable.

  • Oropharyngeal (throat/mouth) cancer
    HPV is now the most common cause of head and neck cancers in men in the U.S., thanks to oral sex transmission.

Let that sink in: HPV can give you cancer in your butt, your junk, and your throat. Still think it’s just a “chick thing”?

The HPV Vaccine: Your Best Shot at Prevention

The Gardasil 9 vaccine protects against the nine most dangerous HPV strains—both high-risk cancer-causing types and those that cause genital warts.

✔️ Pros of the Vaccine

  • Prevents over 90% of anal and genital warts.

  • Protects against most HPV-related cancers.

  • Safe, effective, and FDA-approved up to age 45.

  • Reduces transmission to future partners.

⚠️ Cons (but minor ones)

  • Mild side effects like arm soreness, fatigue, or low-grade fever.

  • Not retroactive—it can’t cure existing HPV.

  • Insurance may not cover it for those over 26 unless medically indicated (but we can help you fight for it).

Bottom line: If you haven’t had it, it’s not too late. Talk to us.

What About Anal Pap Smears and HPV Testing?

Just like cervical Pap smears catch precancerous cells in women, anal Pap testing can catch abnormal cells in the rectum before they become cancer. This is especially important for:

  • Men living with HIV

  • Men over age 35

  • Anyone with a history of genital warts or receptive anal sex

HPV testing (often done with the Pap) can also help identify high-risk strains early.

👉 Our stance at Tom of P-Town Health:
We recommend annual anal Pap and HPV co-testing for all gay men, especially those living with HIV. If you’re HIV-negative but sexually active, it’s worth talking to us or your established health care provider  about whether screening makes sense for you.

Coming Soon: Oral HPV Screening

New oral HPV tests are starting to emerge, particularly aimed at detecting high-risk types linked to throat cancer. These are still in their early days, but if you’ve had multiple oral sex partners (and let’s face it, who hasn’t?), screening may eventually become standard—especially for MSM.

We’re keeping an eye on the research and are happy to talk about whether early testing makes sense for you.

Final Takeaway: HPV Is a Big Deal—But It’s Manageable

HPV isn’t just a nuisance—it’s a potentially cancer-causing virus that disproportionately affects gay men. But with vaccination, screening, and regular check-ins with a provider who gets you, it’s something we can absolutely manage.

If you’re due for your HPV vaccine, want to talk about anal Pap testing, or are curious about oral HPV screening, slide into our texts or book an appointment. At Tom of P-Town Health, your health—and your ass—is in good hands.

🏳️‍🌈 Tom of P-Town Health

Concierge care for gay men and the people who love us.
📍 Provincetown & Beyond (Telehealth + House Calls)
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🧬 Because medicine should never be one-size-fits-straight.

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