Proctologic management of the HIV-positive patient

With the adoption of mandatory testing for human immunodeficiency virus (HIV) in military personnel, a large number of HIV-positive individuals have been identified. From January 1986 to February 1988, 677 HIV-positive patients were evaluated at Wilford Hall USAF Medical Center. Most of these patients had disease in the Armed Forces Walter Reed stage I or II. Other sexually transmitted diseases were found in 407 patients (more than 60%). Of 163 patients (24%) with treatable anorectal conditions, 44 had nonsexually related anorectal conditions and 119 had anal condylomata. Patients with disease in early Walter Reed stages I and II did well with therapy of their anorectal diseases. We present our methods of evaluation, infection control, treatment, and results.