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Sexually Transmitted Diseases/concerned about the health of my penis

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age:21
sexual history, ive only been with one person, that ive been with for years now, and she too only has been with one, which is me. which also leads me to believe that there is low chances of this being sti or std but there has been a couple of marks on my uncircumcised penis that i deem questionable that i either have not notice or are new.(maybe im just being paranoid) i have taken antibiotics azithromycin (doctor prescribed) within the last two weeks because i was under a very heavy cold, i was feeling irritation which accrued before i even got sick but im no loger feeling it. my penis has irritated looking red marks specially after intercourse or masturbation but doesnt feel irritated,  and it also seems kind of dry to me, can it be a slight yeast infection occurring? can it be a reaction to condoms? i havent been the healthiest lately as far as my diet? im not to sure if this is the best place for this question but im desperate. i would just like to know if theres something of great concern before having to spend money at a doctors, my insurance isnt very good. is it normal?

Answer
Hello Kenny,
Your dry skin is very typical of insufficient lubrication with an uncircumcised penis during sex or masturbation. You do not show any evidence of an STD. Azithromycin is NEVER appropriate for a "cold" of any kind, since a "cold" is caused by upper respiratory viruses, not bacteria that can even be treated by this antibiotic. The rash you have is NOT caused by an STD, but may come about through use of antibiotics, fungal infections of the penis (usually by yeast), possibly by use of condoms without adequate lubrication. Best lube is silicone based, which is friendly to latex condoms. When showering or bathing, use only plain water on the penis, and avoid soap, which is alkaline. Give yourself several weeks and it should get back to normal.

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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