Sexually Transmitted Diseases/Odd Raphe or Something Else?


Hi Mark, you do a great job on this site!!

I had a questionable encounter about 3 months ago with a CSW. Since then I have had very bad anxiety about the event. I have though I have had everything from HIV to Herpes. My doctor has run all the nessasary tests, and looked at my penis.scrotum numerous times and said every lump/bump was normal. I continue to "over inspect" my genital area, and have noticed my raphe line looks quite odd. It has always been dark brown, and gets bigger near the base of my penis. I have been streching the skin and looking at it under bright lighting, and i can see a weird texture to it, almost like "warty" or something. It seems to be eveywhere on the dark brown area of my raphe, and varies in the amount of texture. Nothing is raised... if I run my finger over it, or let go of the skin, you can feel or see it. Thearea under the penis seems to be itchy, but only when I think about it...

Does this sound like HPV/Warts or is my level of anxiety so high, that I am driving myself mad? I would go back to the doctor, but he seems almost annoyed with my level of anxiety. When I asked him the last time to look at my penis, he seemed not to relly care.

I know the odds of HPV from one time brief encounter is slightly increased over say HIV, HSV, etc. I know that 3 months later after the standard tests (HIV, Gonnoreah, syph, etc) and no lesions, that i should be in the clear.

Any feedback about the raphe skin texture would be appreciated.

Thanks Mark!

Hello Tim,
Since you know a little about the raphe, you may want to learn more about it by googling it, and looking specifically at to see the vast range of raphi (plural) shown!  Since the raphe is essentially a seam from the anus to the underside of the penis, it's like the seam on your clothing. Usually thicker, sometimes irregular, sometimes with a little redundant tissue. All are perfectly normal variations.

Good luck!

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Mark P. Behar


Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. 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 “pre-screen” 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 consequences 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!


Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered 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.

Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

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

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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