[Question #10109] Risk via Urethral Swab?

25 months ago

After I tested negative for HIV (see Question #10069), I decided to do a range of other tests (including a HPV swab test) to make sure I caught no other STDs. The STD clinic does not have its own bathroom, and I had to collect the samples at a semi-public bathroom shared by other tenants in the building. There's only one stall in there and it's tiny. It's not too clean, and possibly somebody just stayed there for STD sample collection before I entered there. I took the long cotton-tipped plastic stick out from the test kit, rubbed it around my skin, and then inserted it into my urethra (following the test instructions). It hurt a bit, then I got immediately worried because I wasn't sure if the stick touched anything in that narrow stall. If the stick came into contact with fluid or blood on the wall/toilet/door when I was turning around or moving my arm, do I have any HIV risk? I know HIV cannot be transmitted by touching surfaces, but I am alarmed because I directly inserted the stick right into the urethra and rotated it (so it definitely touched the membrane inside.)

H. Hunter Handsfield, MD

25 months ago

Welcome back, but I'm sorry to see these sorts of concerns. They are unfounded.

It seems exceedingly unlikely the swab contacted any surface in the bathroom before you collected your specimen, and probably the business end did not contact your hands or fingers. How could that happen without you being aware of it?? Even if this happened, it is very unlikely the surfaces or your hands were contaminated with a previous patient's genital or other body fluids or blood. And even if these things happened, it is probably impossible enough virus or bacteria would contaminate the swab to infect you.

For sure there is no risk of HIV or any other STD on account of these events.

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

HHH, MD

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25 months ago

Thank you, Dr Handsfield. I guess I am having some serious kind of HIV anxiety, that's why I feel stressed out by any risk (even just perceived risk) of infection. Please bear with me.

A follow-up question: I actually also paid for other health check-up services (as a package), one of those involves chest scanning and I had to do it at another building. I was taken to a small room to get changed, and in the middle of it, I looked down and was surprised to see an open box full of used syringes on the floor near my feet and right next to where I put down my backpack. There was also a short but open trash can with used medical gloves. The staff told me they use that room for many purposes including blood draw. I didn't have time to check around carefully, but there was definitely blood in that syringe box. My shirt/pants/backpack could have contacted the box or anything that had spilled out from it, as I didn't notice the box or the can in the beginning.

Based on what I have read on this site and others, HIV loses its ability to infect as soon as it leaves the human body. This is true even if the blood is still fresh and wet, right?

Also, I understand that the virus has to get into my bloodstream in order to infect me. As long as I wasn't stabbed by any syringe or touch any blood with a bleeding wound, then I should be fine? (Even if my clothes somehow got contaminated and I put them on right back?)

Sorry for my anxiety. I am trying to keep it at bay and need your professional judgement to help.

H. Hunter Handsfield, MD

25 months ago

These concerns are equally unfounded as the your worries about the urethral swab. You describe nothing that suggests risk for HIV infection. There has never been an HIV infection known to have resulted from contact with the virus or contaminated blood or other body substances in the environment. Sure, maybe some of the syringes contained HIV infected blood. If so, it doesn't matter.

It is not true that HIV loses infectivity "as soon as it leaves the body". It requires air exposure and drying of fluids; blood inside a syringe or needle might have infectious virus for hours or days. And of course HIV infection does not require direct introduction into the bloodstream (sex doesn't involve that). But that doesn't mean there is risk from superficial exposure of the skin, even with open cuts, to the virus-- which also is one of those theoretical risks that has never been known to happen. It is an anxiety-driven error to focus on the biological reasons why risk might be present. If such exposures have never been known to cause HIV infection, the biological reasons don't matter.

This forum is not responsible for addressing users' anxieties except by providing reasoned, science based facts and advice. Beyond that, anxiety management is up to the user. The fears expressed here, and to some extent in your previous discussion with Dr. Hook, suggest an underlying psychological issue -- perhaps anxiety itself. If these thoughts and worries continue, you should consider professional counseling. I suggest it from compassion, not criticism.

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25 months ago

Thank you for correcting my misunderstanding and my wrong interpretation of facts. I appreciate your reasonable explanation and advice. Yes, anxiety is a problem I have to pay attention to and manage better. The presence of blood and unknown fluids tend to trigger anxiety in me. I only recently tested negative after a long period of worrying, so I am still kind of being over-sensitive.

Now that I think back rationally, the urethral swab should not have posed risk as I first thought it might.

As for the box of bloody syringes in the changing room, the risk should be minimal because I don't think I realistically got poked by any of those. I suppose if I did get poked, I would have at least noticed it or felt pain? Besides, if blood or fluid contacts my exposed skin or wound, I should have felt it (or observed it when I checked myself)? So, to conclude, there had been certainly no risk at all (whether the HIV virus, if any, is alive or not in those syringes), and I can move on?

H. Hunter Handsfield, MD

25 months ago

I'm glad you understand the urethral swab issue. As for the syringes in the room, all I can say is that we are STD/HIV experts. You ask me to judge the possibility you had an Injury from a needle that you didn't notice. I can't comment professionally, but as a rational, thinking human being, I don't understand how that could happen. Going back to my professional opinion, it would be little or no risk for HIV even if it happened.

That concludes this thread. I hope this and the previous discussion help you move on without such worries in the future.

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