Sexually Transmitted Diseases/Genital warts?


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I am a 23 year old female from South Africa. My boyfriend and I have been having sex without a condom for about 5 months now. I've had thrush before and last month I started experiencing thrush like symptoms, the burning and the itching. So I decided to take a look and I notice some bumps on my down below area. I had not had sex for about a week before I started noticing them. I went to my health care provider on campus to ask what it was and he said it is genital warts. We searched my boyfriend's penis for warts and found nothing. So I'm confused about it being genital warts because we've had skin to skin contact and he has nothing. 2 days ago I applied vinegar and the whole area turned white with minor burning. So I'm not sure what to make of it. Please advise. Thank you.

Hello Dudu,
Two issues: 1) Thrush; 2) Warts.

Thrush is an infection by certain fungi, usually in the mouth/throat, or in the vulvovagina, where it is usually called candidal vaginitis. A microscopic examination of a swab of the area can easily detect the presence of fungi. If it recurs frequently, than you should be checked for diabetes, which is a frequent precursor to yeast vaginitis.

The white bumpy area does look like HPV induced warts. Your boyfriend may be infected with the invisible HPV, and NOT have evidence of clinical warts. Or, they have NOT YET appeared, as everyone's immune system deals with HPV differently. Consult a knowledgeable health care provider or gynecologist for treatment and management of the warts.  A Pap smear is also required (if you haven't had one in the last year) to rule out cervical HPV and other abnormalities.  

Good luck!

Sexually Transmitted Diseases

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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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