AboutMark Behar Expertise Almost any question or concern about sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), gay men's health issues.
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 “prescreen” 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 conseqences 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; answer 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 Distinguished Fellow, American Academy of Physician Assistants; Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.;
Wisconsin Academy of Physician Assistants;
Florida Academy of Physician Assistants;
American Society of Colposcopy and Cervical Pathology (ASCCP)
Publications Journal of the American Academy of Physician Assistants (JAPA)
Education/Credentials Physician Assistant Certified, since 1982;
Masters in Physician Assistant Studies;
Colposcopy Recognition Award, American Society of Colposcopy and Cervical Pathology (ASCCP);
Awards and Honors Colposcopy Recognition Award (CRA), from the American Association of Colposcopy and Cervical Pathology
Past/Present Clients Brady East STD Clinic, Milwaukee, WI
Expert: Mark Behar Date: 6/27/2007 Subject: Herpes, Staff infection, or Hickey?
Question About a month and a half ago I noticed a mark on my arm on my bicep when I was getting ready to shower. At first I thought it was a hickey from my girlfriend (She tends to bite) and ignored it.
But as time went by it didn't seem to get any better. Perhaps it was just because I was looking at it every day, so it didn't seem to be healing... but my girlfriend said that it was smaller and didn't look as bad.
It's been well over a month now and the mark is still there but noticeably smaller. It's red with pinkish speckling around it. I work at a health club swimming pool and asked the head life guard what he thought it was. His first thought was Staff Infection due to the environment I'm working in and the way it looked, but he said it couldn't be staff because after a month and a half it should look a lot worse and be spreading and I should feel ill.
A friend of mine said it looks like I have a herpes on my arm. Or that it was some sort of infection.
I've never had an STD or anything, so I don't know what one looks like.
I don't feel ill, but I'm normally a fast healer and bruises don't last long on me, so I don't think it's just a hickey.
I'd be happy to take a picture of it and send it to you if you'd like.
The head life guard told my to just put some NeoSporin on it and give it a few days.
I don't have health insurance and can't really afford to go to the hospital to get this checked out.
Any help you can offer will be greatly appreciated.
Thanks for your time.
MOT
Answer Hi MOT,
It does NOT sound like herpes or another STD, a staph infection, or a hickey. It may have been a bruise that is healing slowly, but gee, it is sort of tough to figure it out without seeing it. Any other symptoms?? Itch, pain, numbness, sensitive to touch, red, flakey, sharp or diffuse borders, elevated, multiple colors, scaby, pus, etc.
You are welcome to send some digital snapshots; if you do, let me see all of you (i.e., a general skin view, to see if skin is dry, hairy, light or dark pigmented, scaley, etc.) , your arm where the rash is, and the rash in closeup straight up and a side view (to see if there is any elevation or texture)-- 4 views. I cannot say whether this will help, but maybe, it will look like something obvious to me. Send to: mpbehar@wisc.edu
The only other option is to try an over-the-counter cortisone cream, but I would rather know what I am treating before I actually try to put something on it.
