[Question #142] HIV Pobia, any need for testing?

37 months ago
 Hi, so part of me totally understands that this is an irrational fear. I'm hoping that some solid information will put my fears to rest and I can move on. 

 11 weeks ago I was elbowed in the face while playing basketball. I don't remember my lip bleeding very much, if it did it was very little. I just know my lip was swollen for the rest of the day with a little red spot on the inside of my lip. It wasn't actively bleeding. Later on that day I was deep kissing with someone who had recently had some dental work done. There was  no taste or sign of blood.    Ever sense my mind has been participating in these "what if" questions. I took and oraquick oral swab test at 11 weeks which came back negative.   

 In your response could you please address how much blood would actually have to be present and how large of a wound would I have had to have had in my mouth for this to have been any kind of risk at all?    Also whether or not I should trust my 11 week  Oraquick  results versus their 12 week recommendations? 

 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
Welcome to the forum. I'll try to help.

The part of you that understands the irrational nature of your fear is correct. I'm not entirely certain whether your concern is the kiss with the injured lip, or that you might have acquired HIV from the injury itself. I'll assume it's the kiss -- probably you understand there is no possibility that an elbow hitting your lip could not have transmitted HIV.

Perhaps the most "solid information" that will help put your fears to rest is that to my knowledge, there has never been a case of HIV known to be acquired through kissing. And if you think through the billions of kisses that must have occurred between HIV infected and uninfected persons, including billions in which the "exposed" person had a recent oral cut, injury, inflamed gums, etc, you will realize that any risk is simply too low worry about. To that extraordinarily low risk, we can add the improbability that your kissing partner had HIV, assuming not at obvious risk (gay man, injection drug user, etc) -- and even with those risks, probably wasn't infected. Finally, your negative test. The oral fluids test is considered 100% reliable at 12 weeks, and 11 weeks is close enough. Even if we assume it is "only" 99% reliable, when combined with the certainty you couldn't have been infected anyway, it is 100% for all practical purposes.

How much blood blood exposure would be required to be infected? The exact amount isn't known, but it's a lot. Oral exposure to blood or infected fluids is inherently low risk; even swallowing a spoonful of HIV infected blood probably would usually not lead to infection. The low risk of all oral exposures is an important reason why oral sex is extremely low risk, far lower than vaginal or anal sex, and why kissing is not a risk. Among other things, saliva inactivates the virus.

So the bottom line is that you don't need any further testing. Assuming no exposures since the kissing event, you can go forward with 100% confidence you don't have HIV.

I hope this has helped. Best wishes--  HHH, MD


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H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
As you probably understand, there is a typo in my opening paragraph. Delete "not".

HHH, MD


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37 months ago
 My biggest concern was that she may have had bleeding gums from recent dental work and I had the sore on the inside of my mouth  from having my lip busted earlier that day.    I'm sure you understand all of the misinformation that is out there. Especially when one start searching the Internet. 
37 months ago
Thanks for letting me know that there was no risk and to trust my results.  Take care
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
You have it right. Indeed the internet can be daunting for anxious persons. Perhaps you are familiar with the statistician Nate Silver (www.fivethirtyeight.com). Here is a quote from his book, The Signal and the Noise: "...[consider] what might happen if you put a hypochondriac in a dark room with an internet connection. The more time that you give him, the more information he has at his disposal, the more ridiculous the self-diagnosis he'll come up with: before long he'll be mistaking a common cold for the bubonic plague."

In other words, it isn't just misinformation on the web, although there is plenty of that. It's also that anxious persons tend to be drawn to information that heightens their fears and often don't "see" the reassuring parts. And even with seemingly valid information, there is a strong bias in support of atypical health risks. Plenty of people will post their stories about getting HIV through apparently atypical risks, like kissing or oral sex, but the billions of people who kissed or had oral sex with infected partners don't post those experiences.

Best wishes and stay safe.


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37 months ago
The OCD part of me has to ask...

Oraquick after 12 weeks or 90 days?

Im really trying to accept the reassuring facts.  As you can see it's easier for me to fear than it is to let go of the "what if?".    Tuesday will be 12 weeks and I tested with Oraquick on Monday (11 weeks 6 days) just to relieve anxiety.  I even came clean with the girl I was worried about infecting me and discussed my phobia.   I really don't know if she has been tested, but she did tell me she "doesn't have anything".   

 Thank you again for your time. I realize this is going beyond the scope of prevention and into the realm of treating anxiety.    I am putting some effort into moving on, and will not be offended in anyway if you feel like it's time to close this thread. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
Nobody has ever studied the difference between 12 weeks (84 days) and 90 days. Any difference would be meaningless. Don't worry about it. You can play "what if" games 'til the cows come home, but objectively and realistically you know it is pointless, even if part of your brain can't let it go. This might be my last reply in the world: "what if" I'm hit by a meteorite as I hit Return to send this reply. Could happen. But I'm not going to worry about it. In fact, here goes....

Done!
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37 months ago
Nothing in the news this morning about a doctor being struck by a meteorite so I'll trust that we're both ok
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
Yup, guess I dodged that bullet!

Take care and stay safe--   HHH, MD


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