Sexually transmitted infections (STIs) have a pronounced negative impact on sexual and reproductive health and are at the top 5 diseases worldwide for which people seek medical care. In adulthood, people are most sexually active and have the highest risk of STIs infection. Generally, the symptoms and signs of STIs are nonspecific or may not be present. Laboratory diagnosis is of utmost importance to verify the diagnosis of STIs. In addition, patient awareness of risk factors and a comprehensive sexual history are crucial for the diagnosis. The first part of the review article analyzes the current epidemiological situation and addresses the sexual behavior of patients at risk for viral STIs. Since the main route of STIs transmission is the sexual route, rectal localization of STIs is more common in people who have anal sex. Therefore, the authors pay special attention to viral STIs with lesions in the perianal area. It has been noted that understanding the clinical and epidemiological features of viral STIs in the perianal area is relevant not only for practicing dermatovenerologists but also for coloproctologists. Unique clinical cases from the authors’ personal practice are presented. Imiquimod is currently an effective topical treatment for anogenital warts approved for use in the perianal area (for self-administration by the patient).