Sexually Transmitted Diseases/Some follow up questions


Hello Again, and thank you again. Some time ago I posted about irritation on my glans. It has largely healed up, it's not red anymore. I also am happy to report that I bucked up, faced my anxieties, and got an HIV test (I am negative!) as of a few days after the last time I asked my question. (I was not super high risk but I wanted to know... for those reading I did the oraquick at home test.. 20 minutes was anxious but relatively quick.)

Anyhow, I wanted to ask a few questions about some things, more out of curiosity than anything else.

If one did have syphilis, how long does it take for sores to appear and go from something minor to major? I've read it's pretty fast, like a matter of a few days to go from minor to totally obvious.

How common are atypical sores that don't look like the "regular" thing?
Would they still "last" the typical time of a few weeks? Or is it one of those things where if you get a sore in an easy to see place, bang, that's it?

Can it look like anything else? My healing spot(s) seems to have a sort of irregular, but almost invisible and almost flat red edge, and under the right light looks ever so slightly different than surrounding tissue. Still not really red, not really raised, not sore, no fluid, etc. not really something that can be felt by finger contact.

Not to play doc but under the right angle of light it almost looks like it could be a minor case of lichen planus or something similar. Other times I feel like I can barely even see it. The only thing I can think is that this is a super duper slowly evolving sore, but.. it is obviously slowly looking better, if I can't really see it without really seriously looking (as compared to before where it was obvious)? Could it be a very minor "leftover" fungal infection I didn't completely eliminate?

To say again, I'm not really worried... I have a med student friend that is getting me a rapid syphilis blood based test kit in a few days after the holidays,(she thinks I'm crazy but knows I have anxiety and is willing to help me rule it out.) If it is indeed that I'm willing to get treated, now that I know that I'm HIV-. But it's probably not, right?

I'd love your advice.

Thank you again for helping us worry-warts :)

Hello Again, Mark,
I believe that your anxiety will continue to fester in spite of any tests that you may have performed, so that even when they come back negative, you may find reasons to believe they were "false negative" or some other reason.  The problem is your anxiety and possible guilt about doing whatever you did, and therefore the cause must be addressed by talking with a therapist.  

Not sure where you may be getting information about syphilis or other STDs, but the best places are from (as the primary medical search engine, rather than, or are good for looking at a wide variety of images, some of which may be relevant, but some which may not be.  If you examine ANY TOPIC closely enough (skin lesions under bright light and magnification, for example, an author, a historical event, a cooking recipe,  a scientific phenomenon, theological rhetoric, etc.), you will find disturbing flaws, most of which may be just variations or differences in interpretation.  That's why medical students studying clinical medicine recognize that all of their hypochondria are explained by the strange new diseases and conditions that they are studying-- a phenomenon known as "medical student's disease."  

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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