Hello, Welcome to healthcare magic From your description you have whitish fleshy bumps over gluteal cleft which is painful. You have not mentioned since how many days. There are a few possibilities. It could be genital warts or molluscum contagiosum. Genital warts are small warty projections caused by Human papilloma virus. Usually they are not painful but can be painful if it is secondarily infected by bacteria. Molluscum contagiosum is again another viral infection where there are fleshy raised lesions with a central umbilication or depression. They are also painful only when secondarily infected. Herpes usually starts as painful blisters , then they break down to form ulcers. Rarely in HIV patients herpes can become vegetative or warty. I would strongly recommend you to see a dermatologist/ venerologist as they are better in diagnosing such difficult cases than general practitioners and HIV specialists. Hope this helped Take care