[Question #13827] Risk at the STD clinic

4 days ago

Good day Doctors,

On Friday, I went to the clinic for my three monthly PrEP review (which I take daily).

Whilst doing my urine and swab samples in the clinic toilet, I noticed my thumb had a small cut on it and it was bleeding, that wasn’t there prior to me entering the bathroom.

I can only assume I cut this on the door handle as I was closing the door, or the faucet of the tap.

I cannot confidently say how long it had been since someone used the bathroom before me, but it was maybe minutes (I didn’t see anybody go in and out of there whilst I was filling out my forms).

If I cut my finger on the door handle or tap, that was previously used by someone with HIV and it had secretions/blood on it before, is there a risk of HIV?

Is prep systemic? Would this provide me with protection in this scenario? Is it even warranted in this scenario?

I have a regular partner whom I love dearly and I want to continue sex with them without worry.

Looking forward to your thoughts.

Edward W. Hook M.D.

4 days ago

Welcome to our forum. Thanks for your questions. I’ll be glad to come. The bottom of line is that having experienced a cut while after the PrEPTh clinic is a no risk event. Let me explain why.

1. Few people in the STD clinic have HIV. If they have HIV they likely go to a dedicated HIV Clinic. Persons taken PrEP typically don’t have HIV either.

2. Most importantly, your PrEP is systemic and would protect from infection if you were somehow experienced a cut from a surface contaminated with HIV infected blood.

I see no reason for concern or for testing. EWH

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4 days ago

Thanks, Doctor! That's super helpful.

Although I know people with confirmed HIV attend specific clinics, what concerned me is what if there was someone there who was not diagnosed yet?

I'm curious to know if the rule of no risk in the environment applies here? I'v frequented a few other posts whereby you and Dr Handsfield have stated that coming into contact with fluid/blood in the environment poses no risk even without the PrEP at play – does this apply to this scenario given I cut my hand on an inanimate object at the clinic?

Also, just for peace on mind, I want to confirm that it's safe for me to resume sex with my partner without worry?

Edward W. Hook M.D.

4 days ago

I understand your concern but, as I said most people attending STD clinics don’t have untreated HIV, effectively treated HIV is non-infectious, and irrespective, your PrEP virtually eliminates any risk of infection if exposed. Further, as you point out, environmental exposures of this sort virtually never lead to infection as explained in the prior threads you reviewed.

Please don’t worry. One follow up remaining. EWH

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4 days ago

Thanks, Doctor! So, to sum up:

PrEP fully protects me regardless of type of exposure and is systemic?

This situation is a no risk situation, even without the PrEP?

This situation does not fall into the category of needle stick injuries?

I can safely continue sex with partner without worry regarding this scenario?

I do not need to test for this situation?

Edward W. Hook M.D.

4 days ago

Each of the summary statements you make are correct.

Please don’t worry. EWH

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4 days ago

Thank you doctor! Both you and Dr Handsfield continue to be incredibly helpful when it comes to sexual health queries.

Enjoy the rest of your day