[Question #13602] HIV worry?

8 days ago

Dr Handsfield / Dr Hook

I would be grateful if you are able to offer any reassurance.

I have started a new relationship with a female (I am Male) and we are based in MENA (she is half Lebanese half English, I am English). We have not engaged in any sexual intercourse or oral sex as yet, but it is a matter of time before it will likely happen.

I have had somewhat of a phobia of HIV ever since I found out that my ex-GF had been cheating on me and the person she was seeing was HIV positive.

I have two events where I would appreciate your expertise:

1. I noticed a 2 inch long scab on my arm a few days ago. I picked at it and ended up peeling it off entirely, which caused it to bleed. I wiped away the blood with my finger before applying a tissue.

I did so without washing my hands when I returned to my apartment. I had been touching door handles at my work, in my apartment block and on the Metro beforehand.

2. My current GF and I have only engaged in long episodes of deep / French kissing.

I do have a habit of biting my lip when I sleep and sometimes bite skin off or my lips can be dry.

Am I at any risk for HIV regarding the above or worrying for nothing? (and would you recommend testing at all if I was one of your patients?)

Thank you in advance.

Kristian

H. Hunter Handsfield, MD

8 days ago

Greetings. Welcome to the forum, and happy Thanksgiving (if you're in the US).

Your questions se.em to reflect your phobia about HIV. That you were sexually exposed to the partner of an HIV infected person really should not be especially alarming, assuming your partner herself tested negative. Probably you got tested at that time too, right? If not, it would have made sense if only for purposes of reassurance.

Question 1: In the 40+ years of the known worldwide HIV/AIDS epidemic, nobody has ever been reported to have been infected by contact with a contaminated environment. Even if the door handles or other objects you touched were contaminated with HIV infected blood or body fluids, you were not at risk at all.

Question 2: Almost certainly your prospective new sex partner does not have HIV. But even if she does, the virus is not transmitted by kissing. Whether or not one's lips are "dry", irritated, or even have open wounds, there was no risk.

From a medical or risk standpoint you do not need to be tested for HIV. However, in view of your phobia, you and your probably should discuss being tested together before you begin to have sex together. This advice does not mean I believe either of you has HIV: I definitely do not. But reassurance alone is a valid reason for testing, and it seems likely that you will continue to worry about until and unless you and she have been tested. While you're at it, you might also consider testing for other common STIs, especially gonorrhea, chlamydia and syphilis.

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

HHH, MD

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8 days ago

Thank you for your reply, Dr Handsfield. Especially on Thanksgiving!

My last episode of sexual intercourse and oral sex was a year ago (with my ex-GF). Once I found out about her cheating 3 months after we split, I was tested with a 4th generation (Negative). At the same time, I also had a blood test for Syphilis and Hep B/C (all Negative). I also got my three doses of the Hep B vaccine earlier this year.

Further, only 2 months ago I had my medical for my visa renewal and the HIV result was negative.

I have read your comments on this forum and on Healthtap, where you state that an adult will never be at risk of HIV unless they (1) have unprotected vaginal / anal sex; (2) share needles; and (3) are exposed to huge amounts of blood (i.e treating a gunshot victim) or blood transfusion.

I wanted to get the opinion of yourself / Dr Hook as I understand that nobody has ever turned out to be HIV positive based on your advice. I have seen many Doctors (including on Healthtap) advise testing following deep kissing and touching wounds / open scabs (not sure if the advice is outdated or simply them being overly conservative).

So in summary: move on with my life without any concern whatsoever?

Thank you for your help.

Kristian

8 days ago

Apologies Dr.

I should have added that we have discussed sexual partners and agreed to each be tested in the near future if/when the time comes (even though my blood tests are very recent and I have not had sex since).

My follow up questions relate to the deep kissing and the touching of the bleeding scratch that I peeled off (and the perhaps ‘conservative’ advice that I saw on Healthtap from others):

i.e can I move on with my life with zero concern of HIV whatsoever if touching a bleeding scratch with my finger and deep kissing were my only events?

I appreciate that this will be my last post. Thank you for your services.

Kristian

H. Hunter Handsfield, MD

8 days ago

All your statements of understanding our previous replies are exactly right: you have been at very low risk of HIV and the test result you report show you definitely are not infected. In answer to your specific question about Dr. Hook's and my experience, the answer is no: neither of us ever has had a patient (or heard of one) who tested positive in the circumstances you describe. In addition, in the 21 years of this forum and our preceding one, with thousands of questions from persons worried about HIV after an exposure, nobody has yet reported they eventually tested positive. You definitely will not be the first. Many physicians and others indeed take conservative stances or simply agree with theoretical risks even when the actual known risks are zero or close to it. I'm glad to hear you and your prospective partner plan to be tested before you have sex. The additional questions you ask are the same as above, in different words -- and the answers are the same. Yes you "can move on with [your] life with zero concern of HIV..." following the scratching event described.---
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