First, please take a deep breath and be reassured: negative 6-week
HIV ELISA and TPHA (syphilis) antibody tests are excellent, highly reassuring indicators, and genital lesions like warts or molluscum are completely manageable.
To address your confusion regarding HPV, testing, and your symptoms:
HPV Diagnosis & Testing in Men: Your infectious disease doctor was correct regarding routine screening—there is no approved routine blood, swab, or urine test for HPV in men. In clinical practice, low-risk HPV strains (6 and 11, which cause benign genital warts) are diagnosed purely by clinical visual examination.
"Not Curable" vs. Immune Clearance: While there is no antiviral drug that "kills" the Human Papillomavirus instantly, the human immune system naturally clears or suppresses HPV in over 90% of individuals within 1 to 2 years. Benign warts themselves are easily removed using localized therapies (cryotherapy, electrocautery, or topical prescription creams).
Molluscum vs. HPV: Molluscum Contagiosum is a completely separate viral skin infection caused by a poxvirus. It presents as small, dome-shaped bumps with a central dimple and is easily cured via minor skin procedures.
Internal Burning & Testicular Vein Pain: Genital warts (HPV) and molluscum are strictly skin lesions and do not cause internal urethral burning or testicular vein pain. These internal symptoms point toward a separate, co-occurring issue, such as low-grade urethritis, a urinary tract infection, or pelvic muscle tension.
Next Steps
Consult a Venereologist / Dermatologist for Lesion Removal: Have the penile bumps treated and removed (via cryotherapy, radiofrequency ablation, or prescribed topical agents like Podofilox or Imiquimod). Physical removal reduces local viral load and accelerates immune clearance.
Evaluate Urethral and Testicular Symptoms:
First-Catch Urine PCR / Culture: Screen for non-gonococcal urethritis (such as Chlamydia, Mycoplasma, or Ureaplasma) to identify the cause of the internal burning sensation.
Scrotal Ultrasound (USG Scrotum with Doppler): Rule out varicocele, epididymitis, or mild testicular inflammation to explain the discomfort in the testicular veins.
Consider HPV Vaccination: Discuss receiving the Gardasil-9 vaccine with your doctor. While it does not treat existing lesions, it protects against other high-risk and low-risk HPV strains you have not yet been exposed to.
Health Tips
Do not scratch, squeeze, or attempt to pick at the lesions on your penis. Squeezing molluscum or HPV warts causes autoinoculation, spreading the virus to surrounding healthy skin and increasing the number of bumps.
Use Barrier Protection: Continue using condoms during sexual activity. While condoms do not cover 100% of genital skin, they significantly reduce the transmission risk of skin-to-skin viral infections.
Avoid Unnecessary Strain Isolation: Do not stress over identifying the exact numerical HPV strain. Low-risk strains that cause visible warts are non-cancerous and managed the exact same way regardless of the specific subtype number.