My exposure was:

- i had sex with african sex worker in Saudi Arabia. I dont know what is the rate of HIV in Saudi Arabia. We did some foreplay, fingering with a cut under the nails for a long time deep inside, felt the cervix, there was a bad odor in her vagina, my finger stinked for awhile. sat on me and started rubbing her vagina with my penis and scrotum to help her orgasm she said but she didn’t  then she gave me a condom and we had sex for roughly 3 minutes and finished. I dont know if the condom broke or not during the sex because i left in hurry, i didnt check the condom, i took it and gave it to her with a tissue, then she quickly checked the condom and throw it in the garbage. I was anxious . I developed some strange feeling in my penis, discomfort 2-3 days after.i. Maybe due to the first time using a condom but not sure or maybe due to before the sex i washed my genitals with a shampoo and also when I came back home after the sex. Her vaginal odor was bad. 

My fingers hurt, the flesh under the nail is cut when i squeeze it, blood comes out. 

- i did alot of fingering with many sex workers because i didnt have a condom and they didnt but i know fingering is not a risk. 

What is the risk of hiv and std from the encounter i had from the forplay to the sex. I have no idea of the rate of std and hiv in Saudi arabia. I have job that requires me to be health free  and new girlfriend, i dont want to give anything to her. 

- i read somewhere the less the duration of sex, less likely you will get infected with hiv. 

- frequent urination, pain after ejaculation for awhile, discomfort in penis and the whole pelvic area, pressure when urinating, lower abdominal and back pain. 

- what and how many lymph nodes swells due to HIV? 

- im just anxious about std or hiv from too many fingering deep for awhile and this exposure from the foreplay, rubbing and sex. 

The exposure you describe was very low risk.  I'll provide specifics below but as a generalization, this was a virtually no risk encounter.  Here are the reasons why:

1.  STIs, including HIV are relatively uncommon in Saudi Arabia, even among commercial sex workers.

2.  There is NO risk for STI from masturbation of a partner, even for a prolonged period and even with a cut on your finger.

3.  There is no risk of STI from frottage ("...rubbing her vagina with my penis and scrotum...")

4.  You used a condom for the penetrative vaginal sex.  You can be confident that the condom did its job if it was worn throughout the encounter and did not visibly break.  When condoms fail, they break wide open, they do not "leak".  If the condom appeared intact it was.

5.  Even if the condom had failed (again, there is no indication it did),and even if your partner had an STI (again, no indication she did), most single exposures do not lead to infection

6.  Finally, you mentioned the brevity of your encounter.  While there are no studies to indicate how the duration of exposure effects the risk for infection, it is logical to assume that shorter encounters are less risk.

Considering all of the above, I would not be worried.  

Regarding your symptoms, the symptoms you describe are not those of any STI.  Urinary frequency is a sign of anxiety, not STI.  Same is true for pelvic pressure sensations and abdominal discomfort.  

Please don't worry.  I realize that in SA testing may be difficult to get.  I do not feel strongly that from a medical perspective it is important to test.

I hope this information is helpful.  EWH

- You said very low risk’ and virually no risk, im confused.

- No the condom didn’t break wide open as i would have 100% know it. Am i protected from HIV and STD (beside skin to skin)?

- No risk from fingering even when you did it with multiple CSW with cuts, i thought cuts with fresh blood raises a risk how come? Most of the time after the act my fingers gets sore, im afraid it hurts because something went in.

- what about the frottage risk, it was kind of hard rubbing, is not the vaginal fluids contain STI

- i want to ask you about the lymph nodes, do they stay swollen or goes back to normal size, due to HIV and how big they become. I know symptoms are not useful to diagnose HIV but i want to know this information. 

-Doctor from your expertise, Can i be confident and move on from too many deep fingering, protected sex and rubbing for 3-4 minutes and not be worried. Is testing necessary. I only had 1 protected sex and with hard rubbing and too many fingering.

The condom would have protected you against STIs, including HIV.

The idea that cuts and scrapes on the fingers that get contaminated with genital secretions is a risk for HIV is a myth.  So is the idea that contact with a partners genital secretions during frottage, even vigorous frottage.

We get many questions about swollen lymph nodes.  When examined by a trained clinician, most people have lymph nodes that can be felt. The presence of lymph nodes is not a reliable indication of HIV and in persons with HIV can be quite variable.

Prostatitis is almost never caused by STIs.  In over 40 years of sexual health focused practice, I have never seen a case.

I encourage you to move forward.  From what you say, I see no need for testing.  EWH

1- i have fingered deep to the point of orgasm too many CSW with cuts and scrapes and sometimes tiny blood comes out and then it stings. Vaginal fluids won’t be able to enter the fresh small cut in my fingers. Isn’t that a risk, what kind of cut that makes it a risk and how big is the risk. Because im in habit (bad habit) of fingering alot and CSW gives me a handjob like mutual masterbuation but for me i go deeper in their vagina. 

2- protected sex: how or why do people say that they had protected sex and still got infected with STI or HIV, are they lying or did the condom break without them noticing but how they wont notice if it only break catastrophically wide open? Should i ignore the symptoms that comes out of protected sex?

3- this is the first time i do frottage, it was kind of vigorous, what if the CSW when she on top rubbing did put my penis in, would i feel the difference in sensation or that is impossible to happen to manage to put my penis inside her vagina during rubbing without me feeling it, because this is the first time i do sex so i have no idea the difference in sensation. 

- you told me its uncommon in saudi arabia std and hiv and im scared about hiv the most, but how uncommon is uncommon.

4- last, i know you answered that before, im sorry for that again, you are telling me with your respected expertise that i dont have HIV or STD from one act of relatively short protected vaginal sex, frottage and multiple fingering deep inside with cuts and scrapes and the blood that came out under my nails after cutting them too short all the time because everytime i cut my fingers too short so that i dont hurt the womens. 

- should i stop worrying for good and move on with my life and career. Should i stop thinking about the too many fingering and protected sex frottage. Sorry for the excessive 

1.  As I said above, there is a widespread misconception that contamination of cuts or scrapes with genital secretions during masturbation (fingering or hand jobs) represents a risk for acquisition of HIV. There are no scientific to support this idea. It is worth pointing out that in such situations, the lesions heal quickly and that when they are bleeding, the blood is moving out of the body while for HIV to cause infection infected material must go into the body. Finally, part of the perception regarding scrapes and wounds relates to the fact that for diseases which caused open wounds, such as syphilis or herpes, white blood cells which are cells attacked to start HIV infection are often located in the base of the infected lesion as part of the way the body fights infection. These sorts of lesions associated with herpes and syphilis , do increase the risk for HIV.

2. My advice is to ignore symptoms that occur. If your sexual encounters are condom protected, the condom is worn throughout the encounter, and it does not obviously break.

3.  In 2020 there were only 12,000 people in Saudi Arabia who were known to be infected with HIV. The prevalence of infection is substantially less than 1/10 of one percent of the adult population.

4.  Your summary is correct, I would encourage you to put your worries aside and move forward without concern.

As you know, this is my third and final response to your questions. The thread will be closed now. Take care. Please don’t worry. EWH.