Note:Hello there Dr HHH or Dr Hook… I wanted to know when is the results definitive for the following and I wouldn’t have to go back to be retested… HIV 4th or 5th generation antibody antigen test? Chlamydia and gonorrhea, syphilis, herpes simplex virus 2 genital… ??
On July 28th and August 6th I was with two different women and I was tested last on September 27th everything was negative.. but for the past month I have been having some pimple like looking things on my upper leg right next to my testicles on the inner leg nothing really on the actual penis or scrotum maybe just on the ridge of the scrotum… There is these red dots like pimples I send photos to my doctor John Obert Hong and he said they were genital pimples and he recommended using acne soap down there because it could be warm sweaty and restricting with clothing that’s what his response was to me after looking at my photos of them.. they do not hurt at all there’s no pain no nothing but when they do come to a head that is like a beige looking almost whitish pus like a pimple so I really think that’s not herpes genital and my doctor said it wasn’t either… But I do push out the pus with a q-tip and then they turn red and heal up I also tried putting calamine lotion on them to dry them out and also I took another herpes genital blood test on November 29th and it came back negative and like I said the last thing I did was July 28th and August 6th so that would be really definitive correct? But then on December 9th I was with another woman and all we did was kiss and she gave me unprotected oral sex and then again a couple days ago on December 18th I was with a different woman and she gave me unprotected oral sex and we had intercourse and I had a condom on the whole time… She did stroke me and had some vaginal fluid on her hand as well I don’t know if that makes any difference when I was about to ejaculate without a condom? But all the stuff I just told you was what has been going on since this year but my main thing was what do you think about those pimple like bumps and do you agree with my doctor that there is genital pimples? And I would love to know the definitive weeks were the results are 100% accurate and I will not have to get retested I am now in a committed relationship and want to put that all in the past so if you could tell me how many weeks for each test is 100% definitive I appreciate it thank you…

We don't examine lesion photos, so I can't directly attempt to diagnose the problem. However, the location you describe argues strongly against any STD as the cause, and both your detailed description and your doctor's opinion strongly support that these are indeed just pimples (or folliculitis) and not herpes. If un-manipulated lesions are smooth topped and pink, and especially if they have a dimple in the center, molluscum contagiosum would be possible. It's a minor viral infection, often transmitted sexually -- you can google it for photos. However, the internal core of MC lesions is a hard white pearl, not liquid pus. So pimples sound right.

As for the sexual exposures you describe, they are very low risk and I see no need for any STD or HIV testing at all. But if you would like to be tested for reassurance, a urine gonorrhea/chlamydia test would be valid any time from about 4-5 days after the last exposure. HIV testing with the antigen-antibody (AgAb) test is nearly conclusive (98-99%) at 4 weeks and definitely (100%) at 6 weeks. A conclusive syphilis blood test also requires testing at 6 weeks. However, both these blood tests are optional:  the chance of either syphilis or HIV is virtually zero from the events described.

The herpes blood tests aren't conclusive until 12 weeks after exposure or onset of symptoms, and even then they miss some infections. The HSV blood tests just aren't all that accurate for several reasons, and I don't recommend testing at all. And for sure no other testing is necessary:  don't be tempted by online "comprehensive" STD testing panels, which are expensive and include several tests you do not need.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

With persistent or newly developing "pimples" for a month, molluscum seems likely. The location is typical as well (usually groin, upper thighs, or pubic area). Stop manipulating them:  if new ones appear, do not poke, squeeze, or try to remove pus. Then see a doctor in person (ideally a dermatologist) so s/he can evaluate un-manipulated bumps. Also stop putting calamine, cortisone, or anything else on them. As suggested above, also consider googling molluscum contagiosum and seeing if the photos look like your "pimples".

And my doctor told me to just leave them alone pretty much like everything you told me... Can I wait on going to the dermatologist to see if they go away on their own within the next month and if they don't after a month I will make an appointment and yes I've been manipulating them to get the pus out so we'll see what happens when I just leave them alone totally for one month.... Even if I didn't go to the dermatologist would that eventually go away even if it was say next summer or is the dermatologist going to give me some type of prescription of some sort? Thank you for your time and your help have a Merry Christmas... 

You really shouldn't wait all those weeks. If it's MC, you could develop many more and treatment might be more difficult. (Did you do the google search for photos that I recommended?) Better to see someone sooner rather than later. Among other things, if it's MC, the doc might treat the currently active ones in the office and prescribe treatment for any that appear thereafter. This is far smarter than perhaps waiting till you have many lesions that all need treatment at once.

Also, if MC is confirmed, you should inform both your recent partners so they can be on the lookout for lesions, and get promptly treated if necessary. Also no sex with them (or anyone else) until this is all sorted out.

That completes the two follow-up comments and replies normally included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.