The Federal Drug Administration approved Gardasil for use in women in 2006 and for males in 2009 (courtesy Creative Commons)

Every year 1,500 men get human papillomavirus-associated anal cancer.  21-year-old Tim Donaldson* said he hoped he wasn’t next.

Donaldson, a senior at the University of Southern California, was diagnosed in April with anal condyloma, most commonly known as anal warts. His surgery was scheduled during finals and he remembered the difficult and painful recovery process well.

“I had to take a final standing up and I had to tell my teacher something like ‘I injured my tailbone,’” Donaldson recalled. “I’ve never felt like I had to explain anything to anyone, but it was still awkward.”

According to the Center for Disease Control, 1 percent of sexually active men in the United States have genital warts at any time.

Before Donaldson was properly diagnosed, he was treated for hemorrhoids. After he finished running the Los Angeles Marathon, Donaldson experienced discomfort and noticed some discharge from the area. He assumed it was hemorrhoids and when they didn’t go away after using a topical cream, he went to a gastroenterologist. His doctor prescribed him a stronger ointment but the warts got bigger and itchier. The pain became unbearable.

Donaldson soon found out he had precancerous anal warts caused by HPV and they would have to be surgically removed.

“There are three stages of precancerous growth and then it can turn into cancer,” Donaldson said.

After the surgery a biopsy revealed that some of the warts were stage 2 and 3 growths.

“My doctor told me that it’s a big jump between stage 3 and cancer, but it’s something I need to be monitored for every year,” Donaldson explained.

There is a possibility that Donaldson could’ve prevented the sexually transmitted disease by getting the HPV vaccination, Gardasil.

The Federal Drug Administration approved Gardasil for use in women in 2006 and for males in 2009. The vaccine protects males against HPV types that cause 90 percent of genital warts and most anal cancers. Now available for boys and men ages 9 to 26, the vaccine is given over a few months in a series of three shots.

According to the CDC, approximately 20 million Americans are currently infected with HPV and another 6 million become newly infected each year.

“It had been on my to-do list for a very long time and I just never knew where to get it,” Donaldson said.

The American Academy of Pediatrics added the HPV vaccination for males to the recommended immunization list in February. However, it remains harder for men to get Gardasil over their female counterparts.

“We recommend it, but we aren’t giving it too often,” said Dr. Christine Curtis, a pediatrician in Manhattan Beach, about Gardasil for males. “Most insurance companies aren’t paying for it yet and it’s $500 for a series of three.”

All insurance companies cover the vaccination for women.

“The insurance companies drag their feet as long as they can, so they don’t have to pay for it,” Curtis said.

Roughly 50 percent of sexually active men and women get HPV at some point in their life, though it is not always physically manifested.

“Almost everybody gets exposed but most people’s bodies fight it off and it doesn’t invade,” Curtis said.

Currently no tests exist to detect HPV in men. The virus is passed on through skin-to-skin contact with the genital areas. HPV can also be passed on during oral sex.

Men who have sex with other men are roughly 17 times more likely to develop anal cancer than men who only have sex with women, according to the CDC. Condoms may lower a person’s chance of passing on genital warts but HPV can infect areas that are not covered by a condom.

Donaldson became sexually active two years ago and has only been intimate with other men. He has had unprotected sex several times. When asked if contracting HPV changed his sexual behavior, Donaldson was brutally honest.

“It should have, but I’ve had unprotected sex one more time since it has happened,” Donaldson admitted. “In the moment, sometimes you don’t think about it but after you’ve had sex you are like, ‘Oh, that’s really bad.’”

Donaldson’s doctor told him to tell every future sexual partner that he has HPV, but Donaldson is worried about people’s reactions.

“I feel like if I tell people they more than likely would freak out because they don’t know about it,” Donaldson said.

He stressed that the acceptance and education surrounding HIV and AIDS among the gay community is lacking around HPV.

“People don’t understand what HPV actually does and how painful it can be,” Donaldson said. “I feel like people are pretty open about being a survivor of HIV and someone needs to start a movement that is very visible about the prevention of HPV.”

Donaldson said he doesn’t think that the HPV vaccination should be mandated because the government shouldn’t be able to force someone to put something in his or her body. However, he said he believes that more research should be made available and the vaccination should be recommended a lot more.

“HIV tests are free, but the Gardasil shot isn’t,” Donaldson said. “If we live in a country where we can advertise Viagra and Cialis, you need to be able to advertise the other side of the coin, too.”

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*Subject’s name has been changed to protect his privacy, but all other facts and information are true.