[Question #13766] HIV/STD risk from indirect contact in a clinic setting
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23 days ago
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Hi doctor, I would like to ask about a specific potential infection risk scenario.
Before the incident described below, I had undergone a full STD screening, including HIV, and all results were confirmed negative. This testing was completed just prior to the clinic examination described below.
During a visit to an STD clinic, I was lying on an examination bed with my buttocks exposed for a physical penile examination. My hand may have touched the surface of the examination bed. After the exam, I rinsed my hands briefly with water only (no soap). About 5 minutes later, after leaving the clinic, I used the same hand to pick my nose and touched the inside of my nose (nasal mucosa).
About 2 weeks later, I had sex with my wife. Another 2 weeks after that, she developed 7-8 small red spots on her thigh without pain or itching, which caused me concern.
Q1: Does this type of indirect contact (examination bed > hand > nasal mucosa), even if the surface had been contaminated, pose any risk for HIV or other STDs?
Q2: Is there any risk from naked buttocks while lying on an examination bed?
Q3: Do I need HIV or STD testing related to this incident, or should this be considered no exposure?
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H. Hunter Handsfield, MD
23 days ago
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Welcome back. Your previous question suggested you are over-concerned about STDs. This question confirms it: you clearly have some misunderstandings about how STDs might be transmitted and about the reliability of your test results.
Nobody in the world ever caught an STD simply by visiting an STD clinic or being examined there. STDs are not transmitted by contact with surfaces or with contaminated items. Being in an STD clinic was no more risky for catching an STD than sleeping in your own bedroom. As for your wife's symptoms, there is noSTD that would cause "small red spots" on the skin of the thigh or anywhere else.
Q!: Such contact carries absolutely no risk of any STD. And you can be confident the surface was not contaminated anyway.
Q2: No, your naked skin -- of your buttocks or any other body part -- could not be infected in this way.
Q3: You should not be at all concerned and do not need HIV or STD testing.
Why did you have "full STD screening" previously? And why did you visit the STD clinic more recently? I would be happy to comment on whatever STD risks you had previously -- but for sure you were not at risk from simply visiting an STD clinic and being tested there.
Let me know if anything isn't clear.
HHH, MD
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22 days ago
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Thank you again for your clear and reassuring explanation.
My prior testing was done to rule out any possible exposure from events over a year ago, and the recent clinic visit was part of preconception health checks, as my wife and I are now planning for pregnancy. I felt that having a penile examination would be reassuring.
I understand that the specific clinic bed situation I asked about poses no HIV or STD risk and that no testing is needed., even if the bed had somehow been contaminated. I would just like to confirm a few points for my understanding:
1. Would this situation also be considered a totally " no exposure" incident?
2. Does my hand wash procedure matter at all in this scenario? Even if I had not washed my hands, would it still be considered no risk or no exposure?
3. Could you please explain a bit more why such contact carries absolutely no risk of any STD, especially HIV? Is this because HIV becomes non-infectious immediately after exposure to the environment?
4. I've read on this forum that HIV may survive for few days if kept humid or moist. Am I correct in understanding that this refers to laboratory or highly artificial conditions, rather than real life daily situation such as the one I described?
5a. Have there ever been documented cases of HIV or other STDs being transmitted through Nose Picking or hand-to-nasal mucosa contact?
5b. From a transmission standpoint, is this mechanism fundamentally different from sexual exposure?
I appreciate your time and expertise, thank you again!
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H. Hunter Handsfield, MD
22 days ago
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1. Yes, this was a "totally no exposure incident".
2. Hand washing made no difference; you cannot lower a zero risk event to still lower risk!
3. HIV cannot cause infection unless large amounts of virus have direct contact with certain types of cells that are deep inside the body.
4. It does not matter whether HIV survives or how long it survives outside the body. Even if it survives, there is no risk of infection by exposure to blood or body fluids outside the body.
5a. No, there have been ho reported cases of HIV through such kinds of activities.
5b. Yes, fundamentally different; see no. 3.
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21 days ago
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Thank you, Dr Handsfield.
I believe I now clearly understand everything. I just wanted to use this final follow up opportunity to briefly summarise for completeness and understanding for myself, since you mentioned you would be happy to comment on prior risks - I really appreciate that.
My earlier concern was from an event over a year ago, which I understand was low risk (receiving unprotected oral sex, hand to genital contact, breast sex, and protected vaginal sex). For reassurance, I had multiple rounds of comprehensive testing at 3 months, 10 months, and 1 year after the exposure, including HIV AgAb and RNA, syphilis testing (RPR, TPHA), hepatitis A, B and C testing, HSV IgG, and urine STI PCR testing for Chlamydia, Gonorrhea, Mycoplasma/Ureaplasma, and Trichomonas. All results were negative and conclusive, far beyond the window periods, thereby definitively ruling out all infections.
My wife underwent routine health screening last year, which included HIV, syphilis, and hepatitis B testing, all of which were negative.
I also understand that the recent clinic bed situation represents a totally no-exposure incident and therefore there is no need for further testing of course.
Based on these, I understand that I never had any STD, including HIV, and that there has never been any risk of transmission to my wife. We can safely continue our normal sexual life and proceed with plans for pregnancy.
Please let me know if my understanding is correct. Thank you again for your help and patience. I truly appreciate it!
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H. Hunter Handsfield, MD
21 days ago
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All your understandings are exactly right.
That concludes this thread. I'm glad to have helped. Best wishes and stay safe.