A 33 year old HIV positive man presents with lower abdominal discomfort, alternating diarrhea and constipation, rectal bleeding with a mucopurulent discharge, and tenesmus for 2 weeks.

He engages in regular anal intercourse with his male partner.

He is currently on highly active antiretroviral therapy (HAART). His CD4 count is 1158 cells/mm3, while the HIV viral load is <50 copies/mL.