Hello Dr. Handsfield/Hook,

Thinking back, I am very worried about past sexual behavior and hoping you can help me assess my risk of Hep C.

The main sexual act I am nervous about is being fingered while on my period. I may have done this with a man who had eczema on his hands/body so there would have been trace amounts of blood and broken skin on his hands/body. He left a drop of blood on my bed once from one of his eczema wounds.

I don't know if he had Hep C because he never mentioned it.

With the assumption that he had Hep C:

1.) What is the risk of having gotten Hep C if he had trace amounts/maximum of a drop of blood on his hand while fingering me on my period?

2.) Would you be worried if you were me?

Thank you very much in advance for your help, assessment, and understanding.

Irrespective, let me provide some information.

The activities you describe were no risk events.  I say this because hepatitis C is not an STI except for rare occasions when it may be transmitted to persons receiving insertive rectal intercourse.  Even then it is rare.  Second, masturbation is a no risk activity.  This is the case even if you are menstruating at the time and even if your partner has open sores or abrasions on their hands or fingers- by open abrasions I mean scrapes, cuts, or an active eczema rash.  The activity you describe was safe sex even in the unlikely circumstance that your partner did have untreated hepatitis C.  Thus in response to your questions:

I would not be at all worried.  I see no reason for concern and no reason for testing of any sort.

I hope that this information is helpful to you.  EWH

Would you be able to help me understand why this is a no risk event even in the presence of blood to blood contact? I have a bit of trouble wrapping my head around that aspect and the science behind it.

Thank you again for your expertise.

The fact that hepatitis C is the result of numerous scientific studies which have failed to demonstrate heterosexual transmission of the virus.  

We provide up to three responses to each client’s questions.  You have one follow up remaining.  EWH

Thank you again, Dr. Hook. That gives me even more relief.

1.) Please correct me if I am wrong but my understanding now is that this a no risk event even with orgasm because even if the hep c blood got up into the uterus during menstruation, although the hep c blood could technically touch the shedding tissue (endometrium) in the uterus, the uterus itself is not damaged during menstruation so the hep c blood could not get into any arteries, veins, or capillaries (i.e. the bloodstream) to replicate. Can you confirm this understanding is correct?

2.) What if by chance I had a small tear in my vagina that made contact with the drop of Hep C blood? Is that still considered a no/low risk event? How much blood would need to be transferred typically for an infection (e.g. - 1 cc)?

Thank you immensely for taking the time out of your day to assist with my questions/concerns. I do struggle with an anxiety disorder to be transparent. I have been feeling so sick with stress/depression due to this... :(

1.  Correct.  Orgasm would not change the no risk nature of the events you describe.  Even if he had hepatitis C and even if he had blood on his finger, that blood would not have access to your vascular system.  It was a no risk event.

2.  You are, again, getting into "what if" scenarios for what the CDC, the WHO and Dr. Handsfield and I agree is categorically a no risk event.  I urge you to try your best to avoid going down such rabbit holes.  That said, if you had an area of bleeding in your vagina, the direction of blood flow would be out of you, not in--no risk. 

This completes this thread which will be closed shortly.  EWH

Take care. This completes this thread. EWH.