What is your approach to anal pap screening among MSM with HIV, and if routinely recommend, starting at what age (assuming access to HRA)?  

I know it needs to be done but we don’t have the time and resources at this time so as an ID doc, I just manage the HIV and recommend an anal pap and send them to their primary care doc who almost never does an anal pap. Hopefully the HPV vaccine will reduce the need and consequences of not g...