During a seven-month start up period 150 HIV-positive men were evaluated. Their median age was 47 years (range 24 to 83 years), their median HIV viral load was <75 copies/mL (range <75–228,000 copies/mL), and their median CD4+ cell counts was 454 cells/UL (range 7–1663 cells/uL). One hundred and twenty-two patients (81%) were Caucasian, 12 (8%) were African American, three (2%) were Asian, nine (6%) were Hispanic, and for four (3%) race was not identified. Fifty (33%) had a normal PAP and normal exam/biopsy, five (3%) had an abnormal exam but either declined biopsy or had a health care condition that precluded biopsy, 48 (32%) had low-grade anal intraepithelial neoplasia (AIN), and 47 (31%) had high-grade AIN. One patient with high grade AIN was referred for surgical treatment and was noted to have micro-invasive SCCA. No patient experienced significant post-procedural complications (i.e. bleeding, pain, or infection). Patient tolerance and acceptance of the procedure was good and the majority of those who underwent screening have been compliant with follow up exams.