[Question #11734] Hiv bitting

12 months ago

Hello doctors.

I am a 38 year old male from European country and i am really worried about an hiv transmission.

Before some hours ago i had an intimate incidence with a 30 year old woman from Colombia of unknown hiv status. We were at a club and while we were dancing, suddenly she bit me on the chest a bit hard but over my T-shirt (meaning i was wearing clothes). I felt discomfort and pain and some kind of stinginess. I have no visible blood but afterwards i notice a very small puncture in the bitten area. We also did kiss with lips closed.

I am terrified that i might be in danger of contracting HIV from this event since she is from a country with high rates of hiv and her life is a bit promiscuous. Can you please tell me if am i at risk of hiv transmission? Do i need Pep?

Edward W. Hook M.D.

12 months ago

Welcome to our Forum. Thanks for your questions. I'll be glad to comment. The activities you describe did not put you at risk for HIV. I say this for many reasons:

1. You do not know that this woman has HIV. Statistically it is unlikely that she does. Rates of HIV in Columbia are not particularly high

2. If she did, while HIV could theoretically be transmitted through a bite, reports of this are so rare that it is difficult to calculate how often a full bite which drew blood would lead to HIV infection.

3. The bite did not break the skin. Without more of a puncture, there is virtually no risk

4. The bite occurred through your shirt. HIV and other infections are not transmitted through cloth.

5. There is no risk for HIV from closed mouth kissing.

You certainly do not need PEP for this event. In fact there is little or no medical necessity for testing other than to reassure yourself. Please don't worry. EWH

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12 months ago

Dr Hook thank you for your reply.

I have just been informed that she did an hiv test before four months and it was negative. She says she does frequent check ups every six months if we can rely on what she says its true.

I believe that wearing my tshirt was some short of protective barrier for the contamination. Although afterwards while using my macro camera from my cellphone i noticed that the puncture, had tiny blood trace (probably superficial?). I applied rubbing alcohol and did not sting or anything.

Now since there is a slight possibility of transmission would you consider that i should get tested? Excuse me if i repeat myself but i am thinking the worst case scenario. Should you think that there is no chance of any risk at all?

Edward W. Hook M.D.

12 months ago

Thanks for the additional information. Most people do tell the truth.

If you had to look that hard to see where she bit you, this was not a meaningful puncture.

As I said above, based on my knowledge and experience, I would classify this as a no risk event. Testing is always a personal decision however. If you choose to test, I am confident that you will prove that you were not infected. EWH

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12 months ago

I know that testing is a personal choice and for reassurance but i am a bit confused. Some last questions

1. Since you found no risk of transmission why you said above “..there is little or no medical necessity for testing”? I mean little necessity could be perhaps there is a some danger?

2. I know that her hiv status could be different in these last four months since she is promiscuous, so considering that she has hiv and my skin has a tiny puncture with some trace of redness/blood could this change your perspective? Excuse me for insisting but i am thinking to take any action to prevent myself from contracting hiv than testing later to find maybe some terrifying results.

3. If you were in my place would you test yourself and continue to have unprotected sex with your wife?

I hope you understand my fear. Thank you for your effort and advise

Edward W. Hook M.D.

12 months ago

Final responses, after which the thread will be closed without further responses. There should be no reason to return.

1. Since you found no risk of transmission why you said above “..there is little or no medical necessity for testing”? I mean little necessity could be perhaps there is a some danger?

Many of our clients wish to have the additional reassurance that a negative test provides despite our reassurances. This is the reason for the statement you have questioned. If you test, I am confident your test will be negative. Given the anxiety you have displayed on this thread, remember that testing with a 4th generation, combination HIV antigen/antibody test will not be conclusive until 42 days (6 weeks) after your experience. PCR testing is more expensive but would be conclusive any time more than 11 days after your experience.

This is a hypothetical, "what if" questions which in no way changes my assessment.

3. If you were in my place would you test yourself and continue to have unprotected sex with your wife?

In your place I would not test and would not hesitate at all to have unprotected sex with my wife.

Again, this was a no risk activity. This answer is not going to change with further "what if", hypothetical, or attempting to read between the lines for hidden messages.

This completes this thread. EWH

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