If someone told you that you’ve been referred for an HRA, and you’re wondering, “What exactly is going on back there?” — you’re not alone.
At Central Outreach, we believe sexual health care should be accessible and affirming. So here’s everything you need to know about HRA, answered with care and clarity.
What Is HRA?
HRA stands for High Resolution Anoscopy. It’s a specialized exam where we take a very close look at the anal canal using a magnifying microscope. We’re looking for any abnormal cells that could turn into cancer if left untreated.
Think of it as a Pap smear — but for your booty.
Why Was I Referred for This?
You were referred because you're in a higher-risk group for developing anal dysplasia or anal cancer. That doesn’t mean anything is wrong right now, but it’s a good idea to screen for early changes, so we can take care of them before they become serious.
Where Is It Done?
We perform HRA exams right in our offices at:
- Pittsburgh
- Cleveland
- Erie
- Washington (PA)
No hospital visits, no complicated scheduling.
Do I Need to Prep for It?
There’s no fasting or major prep required. Just avoid the following for at least 24 hours before your appointment:
- Anal sex
- Lube or anal creams
- Douching
Basically, give your booty some time off.
Do I Need to Stop Eating or Taking Medications?
Nope. Eat, drink, and take your medications like normal. There’s no need to change your daily routine before your HRA.
What Happens During the Exam?
Here’s what to expect:
- You’ll undress from the waist down (you can keep your shirt and socks on).
- Your clinician will help you get into position and explain everything.
- A plastic scope, about 15mm wide, is gently inserted into the anal canal.
- A microscope is used to closely examine the tissue.
- We’ll apply vinegar and iodine to help identify any abnormal areas. (???)
- If needed, we’ll take a small biopsy — and yes, numbing gel is used to make it more comfortable.
What If Treatment Is Needed?
If we find any precancerous areas, you may return for an HRA treatment visit. The procedure is similar to the exam, but this time we’ll use a tool that delivers electrical energy (electrocautery) to treat the abnormal cells.
To minimize discomfort, we use lidocaine injections to numb the area before treatment begins.
Is It Painful?
Most people experience mild discomfort or pressure, but nothing extreme. We use numbing gel and take every measure to keep you as comfortable as possible.
What Should I Avoid Afterward?
For 1–2 days, avoid:
- Anal sex
- Inserting fingers, toys, or anything else into the anus
Give your body time to heal before jumping back into play.
I Already Had HRA — Why Do I Need Another?
Unfortunately, being at increased risk for anal cancer means that even if your last HRA was clear, new abnormal cells can still develop over time. Regular monitoring helps us catch changes early and treat them effectively.
Will I Need More Than One Treatment?
It’s possible. Every person is different. Your provider will talk you through what they find and whether additional treatments are necessary.
Is This Covered by Insurance?
Yes, we bill your insurance for both the exam and any treatment. A few things to know:
- Biopsy samples are sent to Quest Diagnostics, which may send you a separate bill or copay.
- If you need help covering costs or you’re uninsured, our Case Management Team is here to support you. Just email billing@centraloutreach.com.
Still Have Questions?
You can always reach out to your HRA provider directly at hra-providers@centraloutreach.com. No question is too small or too personal.
There’s nothing weird, shameful, or embarrassing about getting your butt checked — especially when it could save your life. Central Outreach offers care that’s informed, inclusive, and rooted in respect. This is queer health care done right.
