Ne, two [wart(s)] in his anus. Well, I penetrated him

Ne, two [wart(s)] in his anus. Well, I penetrated him with a condom on, right? I did not know what it was… I figured it was a hemorrhoid. (Transgender sex worker) They are like little water bubbles, I believe they appear in the area of one’s genitals. (Focus group with gay sex workers) In general, information on HPV and GW came from informal sources (e.g. “rumors”). Four participants who reported they had GW had a HMPL-013 site better knowledge of HPV and recognized that their GW were sexually acquired, while among subjects without GW only a few recognized the sexual means of transmission. Many participants expressed worry about the possibility of acquiring GW, while others thought that GW were transmitted by “blood” or “lack of hygiene”: Maybe they don’t have [sex] hygienically… perhaps they are doing it with dirty hands. (Focus group with transgender sex workers) Two men not identifying as ‘gay’ who reported BMS-214662 site having sex with men men considered GW either as a cause or consequence of the immune system’s malfunctioning, and associated the presence of GW with “having AIDS” or “being gay”:The “queers” get them (Interviewer: Why do you think the “queers” get them?) Sometimes their defenses are weak and they get infected. (Man not identifying as ‘gay’ who reported having sex with men) Although some mentioned that GW might produce wounds and bleed, only two people explicitly linked this with the possibility of acquiring HIV: In the long run it can be dangerous [having GW], because… if the warts were to cut open or get caught on a pubic hair… it can get cut open and it can produce more illnesses, since they are infectious. Both of them are linked to one another [HPV and HIV], because warts can tear. (Gay sex worker)Genital wart-related attitudes and experiencesAmong the four interviewees who had GW, fear and uncertainty were the predominant feelings associated with discovering GW on their bodies. Due to GW, these subjects experienced stress and distress, embarrassing situations in their sexual lives, as well as physical discomfort (pain, bleeding, discomfort during bowel movements): [I] felt uncomfortable when I defecated; it hurt when I had sex (…). I felt it was something ugly, for me, I don’t like them, right? And it is something uncomfortable. (Transgender sex worker) [The GW] grow, stick out, and end up bleeding by rubbing against underwear fabric. They hurt a lot. They appeared on my penis… I thought it was something from my prostate, something internal that was bleeding, and I didn’t pay attention to the pain, but the crude reality… I looked at them up close… they were genital warts. (Gay sex worker) Participants with GW avoided disclosing to their sexual partners that they had GW in order to prevent rejection, and feared transmitting their GW to others: (I: Do you normally tell your sex partners about your infection with palilloma?) No. (I: Why not?). Because…I don’t know. I just don’t tell them. (Gay sex worker) [When the GW appeared] … I got very scared and I did not know what to do. I stopped having sex because I was embarrassed and I was afraid of infecting others. (Gay man) One participant stopped having sex when he discovered his GW, and other said he changed his sex role (from passive to active) in order to conceal his anal warts: I liked it when men play with that area [anus] and now they cannot. One [man] made me feel bad, he asked: “What happened to you there?” He was going to rim me, but he lost the desi.Ne, two [wart(s)] in his anus. Well, I penetrated him with a condom on, right? I did not know what it was… I figured it was a hemorrhoid. (Transgender sex worker) They are like little water bubbles, I believe they appear in the area of one’s genitals. (Focus group with gay sex workers) In general, information on HPV and GW came from informal sources (e.g. “rumors”). Four participants who reported they had GW had a better knowledge of HPV and recognized that their GW were sexually acquired, while among subjects without GW only a few recognized the sexual means of transmission. Many participants expressed worry about the possibility of acquiring GW, while others thought that GW were transmitted by “blood” or “lack of hygiene”: Maybe they don’t have [sex] hygienically… perhaps they are doing it with dirty hands. (Focus group with transgender sex workers) Two men not identifying as ‘gay’ who reported having sex with men men considered GW either as a cause or consequence of the immune system’s malfunctioning, and associated the presence of GW with “having AIDS” or “being gay”:The “queers” get them (Interviewer: Why do you think the “queers” get them?) Sometimes their defenses are weak and they get infected. (Man not identifying as ‘gay’ who reported having sex with men) Although some mentioned that GW might produce wounds and bleed, only two people explicitly linked this with the possibility of acquiring HIV: In the long run it can be dangerous [having GW], because… if the warts were to cut open or get caught on a pubic hair… it can get cut open and it can produce more illnesses, since they are infectious. Both of them are linked to one another [HPV and HIV], because warts can tear. (Gay sex worker)Genital wart-related attitudes and experiencesAmong the four interviewees who had GW, fear and uncertainty were the predominant feelings associated with discovering GW on their bodies. Due to GW, these subjects experienced stress and distress, embarrassing situations in their sexual lives, as well as physical discomfort (pain, bleeding, discomfort during bowel movements): [I] felt uncomfortable when I defecated; it hurt when I had sex (…). I felt it was something ugly, for me, I don’t like them, right? And it is something uncomfortable. (Transgender sex worker) [The GW] grow, stick out, and end up bleeding by rubbing against underwear fabric. They hurt a lot. They appeared on my penis… I thought it was something from my prostate, something internal that was bleeding, and I didn’t pay attention to the pain, but the crude reality… I looked at them up close… they were genital warts. (Gay sex worker) Participants with GW avoided disclosing to their sexual partners that they had GW in order to prevent rejection, and feared transmitting their GW to others: (I: Do you normally tell your sex partners about your infection with palilloma?) No. (I: Why not?). Because…I don’t know. I just don’t tell them. (Gay sex worker) [When the GW appeared] … I got very scared and I did not know what to do. I stopped having sex because I was embarrassed and I was afraid of infecting others. (Gay man) One participant stopped having sex when he discovered his GW, and other said he changed his sex role (from passive to active) in order to conceal his anal warts: I liked it when men play with that area [anus] and now they cannot. One [man] made me feel bad, he asked: “What happened to you there?” He was going to rim me, but he lost the desi.

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