[Question #2212] blood contact and HIV transmission

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93 months ago

Doctors,

Thanks for providing this service. Some years ago I asked a question on medhelp.com about a sexual exposure I had and Dr. HHH provided an answer.

My cousin is visiting my family’s house. He is gay and from what he tells me does not always practice the safest sexual behavior. Yesterday morning I was taking a shower before heading to school. My cousin came into my bathroom for a minute or two and grabbed some stuff from my drawers and asked if I had any bandaids. After a minute or two my cousin left and when he left I then got out of my shower. I dried off and did my regular post shower routine. This includes a bowel movement and using qtips to clean my ears and nose. To clean my nose I insert the Qtip into my nostril to remove excess snot/buggers. I did this and when I pulled the qtip out I noticed blood on it. That is very unusual for me. But later that night my cousin told me hed cut his hand and came into my bathroom afterward to look for bandaids. So my questions are: (1). If my cousin had somehow got drops of blood onto the qtip I inserted into my ears and my nose, would this be a risk for HIV transmission? (2). If my cousin had somehow got drops of blood onto my toilet paper and I then wiped my anus with that toilet paper, would that be a risk for HIV transmission? (3). Is blood contact a risk for HIV transmission if it is indirect like I describe here (ie; if it is blood that gets on an object which then gets into my body somehow)? Is there any reason I should be concerned about possible contact with blood that may have got on me as a result of my cousins cut? Do I need to get an HIV test? Thanks  

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Edward W. Hook M.D.
93 months ago
Welcome to ur forum.  I'll be glad to comment.  I would not worry about getting HIV from the events that you have described, whether or not he has HIV.  Let me first point out that even though your cousin is gay, less than 1 in 10 men with male sex partners have HIV.  Further of those who have HIV, if they are on treatment, effective treatment makes them essentially non-infectious to others.   So for these reasons it is unlikely that he has HIV or if he does, that he is infectious to others.

But, IF he did have HIV, I would still say that the risk for infection though using a q-tip that had his blood on it or from toilet paper that might have his secretions on it is miniscule and not something to worry about.  There are several reasons for this.  First, HIV is a fragile virus which becomes non-infectious almost immediately on contact to air and the environment.  Secondly, the virus tends to "stick" to fibers like cotton, cloth. or toilet paper and thus once in contact with this sort of material it is no longer a hazard for transmission.  While it is not relevant to the situations that you describe, it is for these reasons that HIV is not transmitted from person to person through clothing that might be wet with the genital secretions of an infected person even if they are rubbing against one another. 

I see no reason for testing related to the events you describe.  I hope this is helpful  EWH
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93 months ago
Dr. Hook, I read that a needlestick from an HIV infected needle is a one in three hundred chance of transmission. Is there any data to suggest that my being sick increases my risk? For example, if I have a sore throat//cold and then I get stuck by a needle, do you believe my risk would still be one in three hundred? Do you believe there is any biological reason to think that being sick would increase my chances of infection from a needle stick? Thanks
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Edward W. Hook M.D.
93 months ago
No, there is no scientific reason that you should worry that being sick would increase your risk for infection if you were stuck with a needle. Please remember as well that the 1 in 300 figure relates to health care associated exposures in which the needle stick occurs almost immediately after the needles was removed from an HIV infected person. The risk for a needle stick occurring when the needle is in the environment and has not been used immediately before the stick is probably substantially lower.  EWH
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93 months ago
Dr. Hook - thanks. I know my question may have seemed odd. It sort of seemed odd to me too. I've noticed that I'm having a lot of questions about what if this or what if that. I saw that I get another follow up question with you and I wanted to ask one question and for some basic guidance. I was at work today and a young man I work with offered me some candy. I took the candy several times, both poured from the bag and from his hands to my hands. I worried after, what if there had been some blood on his hands or blood on the candy. I did notice he had a pimple on his face that was a bit red and may have been bleeding.  I also noticed some redish discoloration on my hands but this may have been from the candy.  If there had been blood on the candy or on his hands that got onto my hands, is this any risk for me? Is it a risk for me eating this candy or using the hand he touched getting into my eyes or ears or nose or mouth?

Finally, these yes but and what if questions are bothering me. Is there a general rule I can follow so that when I have these what if questions I can say to myself, "well, Dr. Hook said I dont need to worry about HIV unless A, B, and C and unless A, B, and C, no what if questions really matter or are worth worrying or testing about."

Thanks so much
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93 months ago
Dr. Hook, I'm glad I caught you before you replied. This is a perfect example of my what if questions. Regarding the candy situation I mentioned above, I wanted to point out that I have a sore throat right now and I don't know if this makes a difference in my risk. Please let me know. Thanks again
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Edward W. Hook M.D.
93 months ago
I agree with you, your question IS a perfect example of your questions which are "what if" in nature and unrealistic.  Think about it- if you could get HIV from the sorts of casual interactions you are asking about, the infection would be far more widespread than it is.  Please remind yourself there are 2 ways which account for nearly all HIV transmission to adults- unprotected, penetrative sexual contact and direct injection of infected material deep into tissue with a needle.  It is not transmitted through eating or drinking material which might have somehow been contaminated with infected material, it is NOT transmitted by touching, hugging or kissing, and it is NOT transmitted by touching inanimate objects such a counter tops, toilet seats or towels which were used by persons with infection.  Further, have a cold, sore throat or other, every day illness does not make persons more susceptible to HIV.  The sorts of fears you have expressed in your questions have no basis in fact or even every day activities.  If you cannot accept this, I would urge you to seek the assistance of a trained counselor who might help you to address this unrealistic paranoia. 

This is the 3rd reply to your questions and therefore, as per forum Guidelines, this thread will be closed later today.  Please note that the forum does not permit repeated anxiety driven questions by the same users. This will have to be your last one; future new questions on this topic will be deleted without reply and without refund of your posting fee. This policy is based on compassion, not criticism, and is designed to reduce temptations to keep paying for questions with obvious answers; because experience shows that continued answers tends to simply prolong such anxieties, when the real answer normally should be professional counseling; and because such questions have little educational value for other users, one of the forum's main purposes. I trust you will understand.  EWH



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