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About Mark Behar
Expertise
Almost any question or concern about sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), gay men's health issues. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “prescreen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and conseqences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!

Experience
Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answer STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Organizations
Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; Wisconsin Academy of Physician Assistants; American Society of Colposcopy and Cervical Pathology (ASCCP); Board of Directors, National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Publications
Journal of the American Academy of Physician Assistants (JAPA)

Education/Credentials
Physician Assistant Certified, since 1982; Masters in Physician Assistant Studies; Colposcopy Recognition Award, American Society of Colposcopy and Cervical Pathology (ASCCP);

Awards and Honors
Colposcopy Recognition Award (CRA), from the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI

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Sexually Transmitted Diseases - std

Expert: Mark Behar - 10/29/2009

Question
i had indulged in mutual masturbation 6 years back after which i developed swollen scrotum and swollen lymph nodes.i have hyperpigmentation on face too. what it could be? i got tested for hiv and vdrl now and they came back negative. please help me. what test should i take? is there a need for lymph node biopsy? if so , can it reveal the cause?

Answer
Hello Dj,
None of these activities would be sufficient to cause you such a reaction from a sexually transmitted disease. You did not tell me what country you are from, or where you had sex 6 years ago, or whether the symptoms have since resolved. In certain tropical areas, for example, a certain parasite unrelated to sex, may cause such a reactive lymphangitis with lymphedema and swollen lymph nodes.

If you still have swollen glands, than yes, a biopsy may tell you everything is all right or not. However such a biopsy may not tell you what the cause of all this was. Blood tests may be more specific in this regard.

Good luck!
--mark

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