[Question #1941] One more clarification

46 months ago
Hello doctor, 

Thank you for answering my previous question, I very much value your opinion. I have taken much comfort in your expert advice. I do not mean to be repetitive but I wanted a bit of clarification about my previous question. 

You mentioned that environmental exposure is no risk, generally because there is little HIV infected blood or other fluids in the environment. This made me feel better. However, today a repair crew was in my apartment and I am worried that one of the workers may have cut himself while conducting repairs. I did not see any overt pools of blood, but I did see a redish stain on my counter island (I cannot be sure if it was blood). At the time, my water bottle was on the island and the worker left the building. I wanted to get your opinion on the most bad possibility. If this worker had cut himself and if he did touch my water bottle and get blood on it and this blood then came into contact with my coldsore, is it true that this is still a no risk situation? What I am looking for is assurance that EVEN IF blood was on my water bottle and then came into contact with my coldsore that because of the biological reasons you previously mentioned this is a no risk situation. 

I do not mean to be repetitive or unappreciative. Your previous advice was very comforting to me and I have been going to restaurants and coffee shops without ANY concern! I thank you for this. My concern here is that there may have been HIV blood in my environment and so I want to be more sure that EVEN IF I was exposed in the way described above this is not a risk for me or my girlfriend. Thanks
46 months ago
Oh yes, and I also wanted to know if HIV-2 is similarly fragile as HIV-1 (I believe the worker may have been an african immigrant). Thanks 
Edward W. Hook M.D.
Edward W. Hook M.D.
46 months ago
Welcome back to our Forum. As it happened, I picked up this question rather than Dr. Handsfield and will be answering this question.  FYI, Dr. Handsfield and I have worked together for well over 30 years and while our verbal styles differ, we have never disagreed on our analyses or the fundamental advice we have given to patients or clients on our Forums.  Reading his earlier replies to you reminded me of this because I agree with all that he has already said. 

Before I get to your most recent and specific question, please allow me to comment in a more general fashion.  It seems to me that you are overly concerned about your risk for HIV through non-sexual exposures.  Please remember that no matter where you live or work, most people do not have HIV and that, as Dr. Handsfield indicated, there are NO instances in which environmental contact which did not include injection of infected material immediately and directly deep into tissue has even been suggested as the source of an HIV infection- not ever.  Not in HIV clinics, not in Hospitals and certainly not in non-patient care settings.  Thus is the highly unlikely circumstance that the material you noted was blood, and that the person it was from had HIV, and that it somehow contaminated your water bottle or was even somehow directly transferred to your cold sore, there would still be absolutely no risk for HIV whatsoever.  The situation you describe was an entirely no risk event. You are far more likely to be struck by lightening today than to get HIV from the circumstance you have described.

Regarding your question about HIV-2, yes, HIV-2 is equally as "fragile" as HIV-1.  Still a no risk event.

I hope my comments will be helpful to you.  EWH
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46 months ago
Thanks doctor. 

Does your analysis of no risk on HIV infected blood getting into my cold sore (or anyother way of getting into my body and infecting me) would apply equally to semen or any other HIV contaminated fluid? 

I really appreciate your response. 
46 months ago
Sorry, I was not clear.

 I wrote:

 "Does your analysis of no risk on HIV infected blood getting into my cold sore (or anyother way of getting into my body and infecting me) would apply equally to semen or any other HIV contaminated fluid?"

What I meant was:

"Does your analysis of me not being at risk if HIV infected blood got into my cold sore (or any other way of getting into my body and infecting me other than sex or needle sharing) apply equally to semen or any other HIV contaminated fluid ?"

Thanks

Edward W. Hook M.D.
Edward W. Hook M.D.
46 months ago
Yes, my analysis does include the possibility of HIV-infected semen or other bodily fluids  getting into your body through your cold sore or body from other environmental exposures.  As I said above, I think you are worrying entirely too much about environmental contamination with HIV- it is not a meaningful route by which HIV is acquired, irrespective of whether the exposure is to blood, semen, or other infected secretions.  There would be no risk to you of indirectly inoculation of your cold sore with infection-causing HIV from the environment.  EWH
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46 months ago
Dr.

I have reviewed the website guidelines and I understand this is the last follow up I'm allowed before this thread is closed. Thank you for giving me the chance to ask some clarifying questions. I hope you know just how much your expert guidance has assisted me.

At my health club today a man I see there frequently was chatting with me. As we parted, he put his hand on my shoulder. In the exact spot he put his hand on my shoulder, I had some pimples I had been picking at and a mole I had been picking at. Obviously these pimples and mole were not gushing blood, but I had been picking at them so there may have been some skin damage. I understand sweat does not transmit HIV. But I worried, what if the man I was speaking with happened to have blood on his hand which got into my pimples or mole? Is this a risk?

I believe what would be most useful for me is a principle I can appeal to when I become anxious in my daily life. Something along the lines of, "If you don't X, Y, or Z, then you have absolutely no realistic chance to contract HIV and certainly do not need testing or PEP"

Again, I much appreciate your advice. It's a joy to be able to, for instance, have a meeting at a coffee shop this morning and, despite my coldsore, have no fear of drinking or eating.
Edward W. Hook M.D.
Edward W. Hook M.D.
46 months ago
HIV is not ever transmitted by touching, even if a person has infections blood or secretions on their hands and happens to touch an open sore, a rash or skin lesions including pimples.  HIV is transmitted ONLY through direct sexual contact (not indirect contact with genital secretions or blood) or by  injection (not touching or passive transfer on an inanimate object) of infectious material deep into tissue with a hollow bore needle.  Thus, if you do not share needles or have sexual contact with an infected person, there is no risk and no reason for concern.  Casual contact with infected persons, contact with surfaces or inanimate objects which might be contaminated with infectious materials, and even kissing (including deep kissing) is NOT a risk for HIV.

I'm pleased my comments have been helpful to you., I hope you will be able to go forward without unwarranted fears from here on out.  As you know, this thread will be closed later today.  Take care.  EWH
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