[Question #1995] Dr hook HIV medical settings

91 months ago

DR hook I belong to poor family and have spent hard earn money just to reach you my question is on medical equipment in hospitals..test message my request is to speak to you..and one other exposure

H. Hunter Handsfield, MD

91 months ago

Welcome to the forum. As clearly explained in the instructions and FAQs, users do not have the option to select the moderator who replies to their questions and I will be answering yours. Dr. Hook and I have been close colleagues for moret han 3 decades and our opinions and advice always are the same, even if our online styles differ. I look forward to your questions.

HHH, MD

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91 months ago

Oh I see well I can talk to you about my other exposure or .maybe ask the medical question to dr hook later .I read your profile on medhelp dr hunter was just a bit scared to talk to you .

My risks are HIV on the environment

I know if one has gets mastutabed(handjob ) by escort even if vaginal secretions are used as lubricant on penis it does not matter . Because you have stated that good news is that if one comes in contact with HIV outside the body nobody can get infected this way . If secretions were rubbed on penis on finger inserted in anus with secretions that can include HIV don't matter . Correct ? Dr hook says no risk

2) I am worried if escort used some secretions on my face do the eyes and nose also protect? I know no body has been infected with secretions into the eye . But how does the nose protect for e.g if I picked my nose after fingering an escort with fluids and inhaled later can anything go through the nose .

I heard nobody has been infected through the nose maybe through cocaine use and that was poorly documented . So how do people get infected through the nose ? How do I know what fluids go into my nose .

Further more I worry because nobody knows when HIV becomes nonofectius but I heard dr hook state that logically once HIV hits the air it can no longer transmit . I will try to find the question on this forum again and show you .

3) a bit irrational actually If condom pack was already open and one just didn't check the condom . If small vaginal fluids were present inside the condom before applying the condom on my penis . That also wouldn't matter because HIV fluids would have been from outside the body (intentionally contaminate a condom ) and then I had a hand job . you say HIV blood or secretions outside the body in environment just don't count and how a person would fail if he tried to contaminate a condom ?

4)I also want to talk about purchasing condoms in my village and basically I have issues with moist items . Because someone told me HIV can survive as long it's wet .and I worry applying wet items basically . On wounds or I just begin to wonder if HIV is in it . I am basically having future problems for e.g just using some fluid on my face because I worry about eyes and nose .

5)But you dr hunter state that nobody gets HIV once it's outside the body which means the environment ? . That means whatever hiv fluids I unknowingly come in contact with it can not infect me to he eyes ,nose ? I am now a good person and don't use any escort services But now the worry has gone to environment exposure because I don't know if HIV is on an object that is bit wet or just a simple bottle which has fluids .

91 months ago

Sorry to say I was scared to talk to you , I was just worried you need to give time to people who are actually at extreme risks and i didn't want to think I am wasting your time or maybe you will just get angry so can I ask question whatever is in mind ?

H. Hunter Handsfield, MD

91 months ago

Thanks for these questions. Dr. Hook and I have identical expertise; we both answer all questions of all types with, we think, sensitivity. And no questions ever are a waste of time -- except sometimes when some users keep asking the same questions repeatedly, out of anxiety, knowing the replies won't change. In any case, you should ask your "medical question" in this thread and not start a new one for that purpose.

Directly to your questions:

1) You have misunderstood Dr. Hook or other sources you have read. IF someone had fresh HIV infected secretions on the fingers and, while those infections were still wet inserted that finger into a partner's anus, HIV (and other STDs) MIGHT be transmitted. We have never said such exposures are zero risk: in theory they could happen. However, such events are obviously very rare, so the real work risk is low. No HIV infections have ever been known to have been tranamitted in this manner, but that doesn't mean it cannot happen. Dr. Hook and I agree that for practical purposes there is no risk.

2) Similar reply. In theory, such exposure could result in HIV transmission. But it has never been known to happen. Also, I would point out that "escorts" -- by which I mean expensive female sex workers by appointment -- tend to be at low risk for HIV and other STDs. They typically know how to protect themselves, select clients at low risk, often use condoms consistently, and get tested frequently for HIV and other STDs.

It isn't really known how rapidly HIV becomes non-infectious. "When it hits the air" may be possible, but it's probably more important to just remember that once infected blood or secretions dry, the virus is dead and cannot be transmitted.

3) I'm not sure I understand. Are you assuming the possible contamination of a condom that hasn't even been taken out of its wrapping? How could that happen? I cannot imagine someone intentionally contaminating a condom. Why would anyone do that?? I won't speculate about outlandish scenarios that will never happen. (In other words, I agree with your comment that this question is "a bit irrational".)

4,5) As you apparently have seen in other replies I have written, nobody in the world gets HIV without having sex with an infected partner or sharing drug injection equipment -- or being a baby born to an infected mother or through breast feeding. Nobody ever catches HIV from the environment, regardless of contact with wet or moist secretions. This is nothing to worry about. As suggested by my replies to your other questions, you are too worried about the biology of whether or not HIV can survive in the environment. That's not what you should focus on. HIV is hard to transmit (which is why even with unprotected vaginal sex, transmission risk is only about 1 chance in a thousand if one partner has HIV); and transmission through environmental contamination is not known to have occurred -- regardless of HIV survival in the environment.

I hope these comments are helpful. If you also have a medical question about HIV or STDs, please ask it now.

Best wishes-- HHH, MD

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91 months ago

Doctor hunter you are right when we nobody becomes infected with HIV once it's outside the environment. And yes I was focused on when HIV dies . And have future concerns I got tested for HIV week ago (negative )

1) doctor I am just worried about using any liquid products On my face simply because I just don't know what HIV fluids can look like actually. How can I protect the eyes and nose ? Or HIV cannot live on any other fluids ? Is it safe to have a normal facial massage from massage parlour Anything goes into eyes and nose should I worry ? But at the same time it's outside the body (environment ) no risk ? .. I am concerned about the drying part

2)For e.g if HIV breast milk is on a glass and that we'll never dries up shouldn't the virus be dead after air exposure like it cannot reproduce after well few minutes .it needs a contained environment for e.g in a syringe . But outside in a glass I know body secretions would dry up but breast milk won't .can you shed some light on this ?as an educational question for me thanks

3) another confusion have people with cocaine been infected and how were they infected? Or was this not proven And can I not worry about anything going into the nose ? .

4) irrational question there was story that condoms were injected with HIV in my village even the police showed up .i want to ask even if somebody were to do something like put hiv secretions inside a condom . And I brought a packed condom home . Would it even matter because it would have been out in the environment ? . How can I extra clean the condom ? . And would I give risk to my future wife . It's basically for both of us . And yes I am not it a westernised country . people started using a balloon instead of a condom in my village . To many details would be awkward with this but I know how semen looks like so just incase if I open a condom after an hour or ill be safe ? Or can I just simply wash it before use . (Yes I am worried and I need your help ) as condom is also remains a bit wet and is not dry .

Again this will be HIV in environment no risk ?

6)But in normal English it's all in the environment and nobody gets infected once HIV outside is the body ? Regardless of eyes ,nose or whatever object one applies on a wound like a (gauze ) .

HIV Outside the body is automatically a no concern and should be avoided ? Except syringe ? And how to be HIV free forever

91 months ago

Just a to let you know I have never done cocaine in my life and never will was just confused

H. Hunter Handsfield, MD

91 months ago

In the earliest days of the known AIDS epidemic (early to mid 1980s), public health officials were able to reassure the public that HIV is not transmitted in the environment or by non-sexual day to day contact with other people. This was even before the virus was discovered. How were we able to do that? It was because even the busiest clinics taking care of persons with AIDS never saw anybody who had not had unprotected sex with high risk partners or who had not shared drug injection equipment. There never were patients whose only contact was sharing households, bathrooms, cocaine sniffing straws, eating utensils, etc, etc. And there still are no such patients. If contacts like you are worried about could spread HIV, don't you think we would see such patients at least once in a while? But we don't. Everyone with HIV has the traditional risk factors.

1) There are no liquid products you might use that could possibly be contaminated with HIV. And even if they were, e.g. if you rubbed contaminated lotion into your hands or face, HIV would not be transmitted. This is a frankly irrational fear.

2) This also is an unwarranted fear. First, how in heaven's name are you going to come into contact with a glass full of breast milk? Anyway, breast milk is less risky than you fear. Yes, it can be the source of HIV in nursing infants. However, only 15% of babies nursed by infected moms become infected, and that's after an average of 6 months, swallowing a 100-300 ml of infected breast milk every day. It's a very low risk.

3) Your assumption is untrue. HIV is no more common in cocaine users than anyone else, unless they also are injection drug users, sex workers, etc.

4) This sounds like an outlandish story. Even putting HIV inside condoms would result in transmission only once for every several thousand exposures. If you were an evil police officer who wanted to infect people with HIV, this is not how you would do it. This isn't something to worry about.

To avoid HIV your entire life, have only monogamous sex with an uninfected partner; if not monogamous, use condoms; and do not share drug injection equipment with anyone else. That's all. There is nothing else to ever worry about in regard to HIV.

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91 months ago

Dear doctor first thank you I was not expecting a warm reply in such a fashion .so thank you I do I need you clear somethings even if you change your answer it's well okay .

1) Dr hook said somebody got infected by HIV doing cocaine into nose but he did say it was poorly documented like maybe 10 people got infected . I would like to agree that nobody got infected from getting HIV fluids into the nose . And I in general do not want to get infected from getting anything into my nose with out knowing I mean how would I know what went into my nose . So would your answer still stand that nobody infected from getting HIV fluids into the nose and it's only in theory ? . Maybe I miss read what doctor hook was saying correct ? It's in (q#939 co infection and risk )so will this be different to my case in everyday life ?

2) If I get any fluids that I don't know about on my eyes and nose can I never worry about eyes and nose exposure ? . . And I think you also stated that ones nose should also be bleeding heavily to even allow any fluids to enter from outside or I am wrong here also ? I won't be the first in history to get infected this way ? From some liquid or unknown fluid

3) When I was talking about breast milk I was just talking in general that HIV milk will never dry up so would air exposure kill HIV ? I meant that HIV would die in the milk because it cannot reproduce but yet it would remain wet after a few minutes because it won't have host to survive and it would die in environment even though it remains wet and liquid form . by no means I was talking about digestion of milk my apologies for not being clear with you . It was talking about HIV survival on breast milk if it was just in glass and would HIV die on it from air exposure because it never drys up

4) This is the final point which im going to hold on to . nobody gets HIV from the environment . What you meant by HIV from the environment means once HIV was outside the body HIV fluids contact to eyes ,nose , contaminated objects on wounds

Is a no risk as HIV is outside the body this doesn't include touching blood or secretions this includes cuts nicks , eyes nose contact with HIV fluids outside the body . And no documented cases also .

HIV from environment= HIV outside the body there no risk regardless of wounds nicks ,eyes nose contact . Or from objects except syringe . Can you shed some light on this

Thank you and well goodbye and I think your right that I should not time HIV survival but think of it as outside the body and environment if that's what you meant or maybe just once clarification on what you meant hiv in the environment in future that would clear all doubts but thank you again doctor hunter

H. Hunter Handsfield, MD

91 months ago

Thank you for the kind comments. However, I'm not sure I can answer these final questions very well.

1) I am unaware of any confirmed cases of HIV transmission by shared cocaine snorting equipment. If your statement about Dr. Hook is correct, I think I agree -- maybe a claimed case or two but not proved. But what does it matter if there really was one case? Or two or three? If this occurs, it's obviously extremely rare and might not be a risk at all. So what does it matter?

2) If you were to take HIV infected genital fluids or blood and rub them into your eyes, of course you could be infected. But this isn't going to happen -- and as far as we know, the small amounts that probably contact eyes or mouth during sex are not enough to be a risk. So again, why does this matter? You will never get HIV from such an event. (But of course I suggest you not test fate -- do not intentionally put anyone's blood or genital fluids on your face.)

3) I still don't understand. Why would breast milk be different than any other fluid? Presumably HIV would die when it dries. But exposure to air alone probably is not enough to kill HIV. You have to understand that nobody has done research on these sorts of things, because it doesn't matter. Many experts assume air exposure might inhibit the virus, but we don't really know and I don't see that it matters. Why spend time and energy on something that almost certainly doesn't matter in terms of real-world risks of transmission?

4) You correctly understand what I mean by environmental exposure. But again, we really don't have scientific answers about HIV survival in the environment. But we DO know that nobody gets infected from environmental exposure. Therefore, the biology of it -- whether HIV survives in particular fluids, with drying, on exposure to air, etc -- doesn't matter. If there is no risk, why would anyone care?

That completes the two follow-up comments and replies included with each question and so concludes this thread. I hope the discussion has been helpful. My final advice is to disregard HIV risk except through sex or needle sharing; and otherwise disregard HIV entirely.

Best wishes and stay safe.

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