Sexually Transmitted Diseases/HPV??

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Question
Glands
Glands  

Shaft
Shaft  
Dear Dr. Behar,

I am 21yo Male, Czech Republic. I have these bumps on my penis and I am not sure if that is a sign of the HPV virus. It does not itch or anything, I do not feel it at all. My girlfriend got HPV from me and she has abnormal cells on her cervix and we are waiting for her doctor'results. I am not sure if my HPV is active or not, is there any way to test whether I are infected or not? and to test which type of HPV I could have?
I have been to a dermatologist, but she only looked at it for about 2s and said that it is nothing to worry about that it's just something to do with the glands and gave my Polysan cream for the night. Can You please tell me your opinion on this?

Answer
Hello James,
The "bumps" shown on the photo appear to be normal variations in the skin, including pearly penile papules on the glans corona (rim of the head).  You may have HPV infection as most adults do, but the photos do not show evidence of HPV or warts.  HPV of course is a microscopic-sized virus not visible to the eye, but infected skin sometimes turns white when vinegar is applied to the skin for 30-60 seconds and then examined with a bright light. There is no good way to detect HPV of the penis unless classic warts are observed. The actual DNA test to detect the serotype of virus requires a cytology (cell sample from something like a Pap smear, which can't be done from the penis), or a biopsy of the skin which is not usually done on the penis either. Infection with HPV probably happened with both you and your partner whenever you had one of your first sexual encounters with someone else. In most people, the immune system usually is able to effectively "fight" off the infection and prevent it from both replicating and spreading to others within a few years of first infection.

The dermatologist was probably right, and that this is nothing to loose sleep about!

Good luck!
--mark  

Sexually Transmitted Diseases

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Mark P. Behar

Expertise

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!

Experience

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.

Organizations
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)

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

Education/Credentials
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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