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treating anal fissures is important because theres a higher risk of hiv infection if youre exposed to hiv during anal sex. Anal fissures arent something that we talk about much in the gay community, said pierre-cédric crouch, np, the nursing director of the sexual health clinic magnet at san francisco aids foundation. Anal fissures are seen more often with certain medical conditions, such as anal cancer leukemia stds and hiv complications from other conditions, like crohns or ulcerative colitis. anal fissures may cause sharp pain and small amounts of bright red blood with bowel movements. Other causes of fissures are anal cancer, crohns disease, leukemia as well as many infectious diseases including tuberculosis, viral infections (cytomegalovirus or herpes), syphilis, gonorrhea, chlamydia , chancroid (hemophilus ducreyi), and human immunodeficiency virus (hiv). The chance of having an anal fissure decreases as people get older. People who have had fissures in the past are more likely to have them in the future. Fissures are quite common in the general population, but are often confused with other causes of pain and bleeding, such as hemorrhoids. Anal fissures can occur at any age and have equal gender distribution. Most (85-90) fissures occur in the posterior (back) midline of the anus with about 10-15 occurring in the anterior (front) midline. Hiv-associated ulcers must be distinguished from idiopathic anal fissures in hiv-positive patients and from other sexually transmitted diseases that cause anogenital ulcers as the treatments differ. Keywords hiv-associated ulcer, differential diagnosis, treatment. Anal fissure (fissures) is a very painful condition caused by trauma to the anus and anal canal, which then cuts or tears the anus and anal canal tissue. These tears can be caused by straining to have a bowel movement, hard stools, and chronic episodes of diarrhea. Symptoms include rectal bleeding, anal itching, and painful bowel movements.
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