Sexually Transmitted Diseases/Small red rash on penis?


So I had sex for the first time ever last Friday (7 days ago) with my boyfriend, who tested clean for every STD test he took (HIV, HPV, herpes, etc.). The sex was unprotected, and I topped. Since then, I noticed a small, tiny rash on the head of penis (Im uncircumcised), 2 tiny white bumps on the head of my penis, and some discomfort urinating.
I read up on the urinating problem, which I believe to be a UTI because of the E-Coli, but what do you think about the rash? Its more of a soft blood-orange than a red, but I'm still concerned. Should I seek professional help?

Hello Ginger,
When anyone tops during anal sex, there is potential increased risk to the uncirc'd penis exposed to germs inside the rectum, such as E. coli which may cause a urinary infection or prostatitis. The burning sensation may be due to gonorrhea or chlamydia. I cannot say what the white bumps on your penis may have been (without seeing). The rash may be due to friction or a fungal infection.  

You mentioned that your boyfriend had negative tests, but the question is exactly which tests were done?  Was a gonorrhea and chlamydia DNA/NAAT test done on his throat, rectum, and urine (for penis) (3 separate tests!), HIV and syphilis (blood tests)? Herpes tests of a suspected lesion is very sensitive and specific, however in the absence of a particular blistering or ulcerating lesion, only antibody tests (blood) are available, and they aren't easy to interpret since a majority of all people have positive antibody tests to herpes 1 and or herpes 2.

More information is needed!

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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