[Question #10817] Hiv

19 months ago

I had a high risk hiv exposure 2 weeks ago and have been on pep since then. 3 days after my exposure, me and my family shared a hookah smoking pipe together. I have cracked/chapped lips and bleeding may have been present. I don’t know if anyone in my family had chapped lips or any sores. Assuming that all parties had chapped or a sore on their lip or mouth and bleeding may have been present. What’s the risk of my family getting infected from me. I’m so distraught and ashamed and I don’t know how to tell my family they may have been infected with hiv then again I may have to since it could lead to aids god forbid. I read on this forum that this wasn’t a risk at all but when I search online else where they say it’s a risk? Which one is it? Can you please elaborate and clarify if it is or isn’t?

Additional questions

1. Should I have my family tested for hiv

2. What’s the percentage risk of my family having hiv from this

3. If you were in my shoes would you tell your family they may have been infected? Or should I save myself the embarrassment and shame in addition causing them worry and stress.

4. How soon after a hiv exposure are you able to transmit the virus onto others?

5. Since I’m on pep I won’t be able to tell if I was even infected in the first place or if the pep worked and saved me. Due to this I’m thinking of getting off pep today day (16) to know if I’m infected or not without confidently relying on the pep to know if that saved me or if I was even infected in the first place. Will this work?

Edward W. Hook M.D.

19 months ago

Welcome to our Forum. Thanks for your implied confidence in our Forum. I'll be glad to comment. I think you may have a misunderstanding of how easily HIV is transmitted. There are NO types of direct exposure to untreated HIV infected persons which carry a more than 1% risk for infection and with most sexual encounters the risk is lower- a small faction of 1%. Before I get to your specific questions, let me state that with or without chapped lips, there are no data to even suggest that HIV is transmitted by kissing and/or saliva exchange. Thus sharing a hookah is a no risk event. Further, that you are taking PEP would further reduce any risk which might theoretically be present. I would have no concerns. I'll reinforce this message below:

1. Should I have my family tested for hiv

Nothing you have said suggests any need for testing other family members.

2. What’s the percentage risk of my family having hiv from this

Zero

3. If you were in my shoes would you tell your family they may have been infected? Or should I save myself the embarrassment and shame in addition causing them worry and stress.

I see no medical or scientific reason that you need to inform family members of your exposure and as I said above, they have NOT been exposed.

4. How soon after a hiv exposure are you able to transmit the virus onto others?

For all practical purposed, only persons with positive tests can transmit the virus

If you stopped PEP today, you would still need to wait 4-6 weeks before you could be confident that you were not infected. While I don know about the nature of your exposure, I see no benefit to stopping PEP at this time.

I hope this information and perspective is helpful. EWH

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19 months ago

Doctor I see that you stated “let me state that with or without chapped lips” what if I had a cut and one of my family members had a cut as well on their lips or in their mouth? And if there was blood present. Does that increase the risk? And if so would you have them tested in that instance?

In this article that I will link below it says to get test ASAP. This causes me great concern

https://www.healthtap.com/questions/6690170-can-u-get-hiv-from-sharing-hookah-pipes-eating-utensils-or-kissing-if-hiv-person-has-blood-in-mouth/

I’m so worried i feel like I ruined my family’s entire life.

And my exposure was protected sex with a commercial sex worker

Edward W. Hook M.D.

19 months ago

A cut in your mouth, or your family members mouths would make no difference. Same answer. Same as well for dental problems, gum disease or blood in the mouth. There is no risk and no need for testing. Please don’t worry.

Your exposure was virtually no risk as well. Most CSWs do not have HIV, even most single unprotected exposures do not result in infection, and condoms work. I would have no concerns.

One follow-up remains.

EWH

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Edward W. Hook M.D.

19 months ago

The statement you shared is an overestimate from someone who is not an STI/HIV expert. EWH ---

19 months ago

I just finished pep and im still kind of worried about the exposure I explained above. My question is If i do test negative in 6 weeks does that mean i wasn’t infected at all? I’m confused on how Transmission of hiv works. Please correct me if I’m wrong but in order to be able to transmit the virus you must first Be permanently infected right? So if I do test negative on my test can I assume I wasn’t infectious during the time I was taking pep? And if I was infectious I would have tested positive for HIV since the hiv Did permanently infect me right? What my main worry is that say since I was taking PEP and it prevented (ME) getting permanently infected and I tested negative. What if in that duration of time I was taking pep I somehow transmitted the Virus to somebody else? Is that possible? Or Do I have to be permanently infected in order To be able to Transmit it to someone thus Making my test positive if i was infectious does this sound right?. My understanding is that Pep prevents HIV permanently infecting the body with HIV. So if pep does prevent this does that mean the person taking Pep wasn’t able to even transmit the virus since it didn’t (PERMENTLEY INFECT THEM?) please elaborate and explain to me throughly on how this works. I don’t understand.

19 months ago

If I’m right if I do test negative then it would have been impossible for me to be able to transmit the virus to anybody since it didn’t permanently infect me.

And if I do test positive only then is there a chance I was able to transmit the virus correct?

19 months ago

Please explain this to me throughly doctor I need a through answer to help me better understand this and if my Statements above are correct?

Thank for everything.

Edward W. Hook M.D.

19 months ago

This will be the final response to your questions. You repeat yourself many times. Repetition will not change the answers. There should be no need to return.

I agree with you that you appear to misunderstand how HIV is transmitted. HIV infection is always permanent, i.e. tests become positive and stay positive. Only persons who have HIV can transmit the infection. If your PEP failed and you had become infected, you would have a positive test. If your test is negative 4-6 weeks after completion of pep, you can be confident that you were not infected. At that time you should put any persisting concerns you might have aside and move forward without concern. If you were on PEP and have negative tests, you cannot transmit HIV.

If you test now and are negative, you CANNOT have transmitted HIV to anyone else, in any way. I am confident that if you test now, your test will be negative.

This completes this thread which will now be closed. As I said above, there should be no need to return to the Forum regarding these concerns. EWH

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