Clinical Chats: a Podcast for Sexual and Reproductive Health Professionals · Clinical Training Center for Sexual and Reproductive Health

Anal Pathology in Title X Settings

·27 min·1 clip

Excessive hygiene, not undercleaning, is the main driver of many anal complaints.

Clinical Chats opens with a straightforward clinical question about anal pathology in Title X settings. Dr. Tammy Bennett and Dr. Kristen Metcalf-Wilson frame the topic for sexual and reproductive health professionals. They welcome Donathan Baker, a physician assistant whose work centers on anal pathology, HPV, sexual health, biomedical health, HIV prevention, and clinical research on NIH-funded trials. Baker is also preparing to present at the 2025 Virtual National Reproductive Health Conference this August. The discussion is set up as a teaching conversation for clinicians. It begins with basic questions and why clinicians should pay attention to anal pathology. From there, it moves into screening and follow-up decisions. The hosts and guest talk through how abnormal findings lead to further evaluation. High-resolution anoscopy comes up as part of the downstream pathway after abnormal cytology. The discussion also notes that access to this kind of follow-up is uneven across the United States. Some services are concentrated in large urban areas, but the need exists in rural settings, academic centers, private practices, and federally qualified health centers too. Baker points clinicians to UCSF's HRA provider directory as a practical way to locate vetted providers. The exchange also notes that the International Anal Neoplasia Society may be working on similar resources. Training is another major thread. Baker explains that the International Anal Neoplasia Society offers hands-on education, preceptorship opportunities, and newer virtual approaches for clinicians who do not have local experts nearby. The episode compares this work to colposcopy to show why the procedure can be hard to learn well. It also emphasizes that anal high-resolution anoscopy can be even more demanding because of the anatomy involved. The hosts keep returning to the question of what clinicians should do in real practice. The discussion connects recommended guidelines to the way clinicians already think about cervical screening and follow-up. It also reinforces that patients do want to talk about sex, even when clinicians feel uncomfortable bringing it up. The closing material includes the standard educational disclaimer and the reminder that the activity is informational only. The overall tone is serious, practical, and centered on patient care rather than theory.

As heard by us

A focused clinical discussion of anal pathology, follow-up, and referral paths for Title X care.

This episode treats anal pathology as a clinical problem, not a curiosity, and keeps the discussion practical. It stays close to what Title X and sexual and reproductive health clinicians need to know: when to suspect trouble, how to think about follow-up, and how to steer…

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Need a clear clinical map for anal pathology in Title X care?

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