[Question #2702] What is the Risk of HIV?

44 months ago
Hello Doctor, I'm a 24 y/o Caucasian female, living in U.A.E from 7 months currently in India on a work trip. I would appreciate your response in assessing my chances of acquiring HIV from the following events:
1) I was sharing a room with a colleague and I'm unaware of his HIV status as he is a new acquaintance. I used the restroom immediately after he used it. I noticed that the toilet paper felt a lil wet. The instant thought that popped up in my head was that it could be his semen. So I refrained myself from using it. Even though I was trying my best to be careful, I negligently touched my genitals with the same hands and might have slightly inserted my fingers in the vagina in an attempt to clean the area. Only later I realised that I touched the wet toilet paper and used the same fingers to clean my genitals. Also I've folliculitis down there which I tried to break with my the same unwashed hands, giving open pin point sized cuts. However, I did not use the tissue paper at all after noticing and replaced the set with fresh ones. I'm scared about the toilet paper having semen over it and me putting myself at risk with cleaning my vagina with slight insertion of the same fingertips and then trying the break acne down there. ( sorry if it sounded gross ). Please tell me have I acted stupid and exposed myself to any risk for HIV? Would HIV be able to survive if there was semen and cause infection? Should i get tested? I tried to examine the paper for evidence of semen, but I couldn't draw any conclusions. Really freaking out. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
Welcome to the forum. Thanks for your question.

There is no risk for HIV from such an event, even if your new room mate is infected. Even with unprotcted vaginal intercourse with an infected woman, the risk is only once for every 2,500 exposures. Nobody has ever once been known or even suspected to have acquired HIV from contact with fluids, blood, etc in the environment. Having folliculitis etc makes no difference. I would also suggest it is very unlikely your room mate would have masturbated into toilet paper and not flush or discard it. You have not "acted stupid" in any way. (Whether or not HIV would have survived in wet semen doesn't matter. If so such exposures have ever resulted in transmission of the virus, the biological reasons aren't important.)

For those reasons, "really freaking out" is an unnecessary overreaction. There is no risk and you needn't worry at all.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

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44 months ago
Doc!!!Thank you so much for relieving my worries over this. Much appreciated. I thought it through and did realise that it would very unlikely that my roomie has mastrubated and left the tissue without discarding it. But again, people are weird and unpredictable. I'd still like to know even if the semen touched my vagina through my fingertips, it still wouldn't hold any risk for transmission?? ( considering there was semen on the paper and it was infected ). Sorry, but I would always consider the worst possibility and make sure I'm not at risk?? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
Yes, even if infected semen came into contact with your vagina in this fashion, there would be no risk. There has never been a known case of HIV transmission by hand-genital contact, fingering, etc, even when genital fludis were used as lubrication. As I said, even with complete intercourse, the risk is statistically low.

However, there is sort of an error in the figure of 1 in 2500 I mentioned above. That's the risk for a male after unprotected vaginal sex with an infected woman. For a woman in vaginal sex, the average risk is once for every 1,000 episodes if the man is infected. That's with full ejaculation deep in the vagina. Perhaps that will help you understand why the trivial exposure of the kind you mention carries no measurable risk.

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44 months ago
Thank you sir. I last question.
I work for a company that produces hearing aid. In a medical camp in India organised in a slum, I had a poor person, who came to me. I touched the woman's ear, holding the pinna and tragus. there was no apparent blood visible, but a lot of cerumen kinda secretion present. In the next minute i was demonstrating how to use the hearing aid on myself and touched my ears. I dint have access to a sanitiser at that moment. so i touched my ears. i don't have any cuts on the ears as of now. could the infection be transmitted in this manner? sorry, i'm a lil worked up. Not a hypochondriac but I'm a lil more careful when it comes to hygiene. please let me know what you think.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
No worries here either. It would appear you have an inflated sense of risk of HIV. I see an important clue in your statement yesterday "I would always consider the worst possibility and make sure I'm not at risk". You're taking those feelings much too far. Although "hypochondriac" probably isn't the right word, probably it's something similar, i.e. an inflated fear of contagion.

Even the busiest HIV/AIDS clinics never have patients without the known, standard risk factors: unprotected sex with partner(s) at risk, shared drug injection equipment being born to infected mothers or, rarely, health care workers injured with HIV contaminated sharp instruments. There are no other exceptions; when people show up with new HIV, even if they deny the standard risks, it always turns out they were being untruthful or had exposures they didn't recognize, like a spouse who, unknown to them, was an injection drug user or had sex with other men.

Do not have unprotected sex with new or unknown partners and do not share drug injection equipment with other persons, and you can be confident you will never catch HIV. Disregard any and all day to day contact with other persons or contact of any kind with any objects or fluids in your environment. Nobody ever gets HIV in this manner.

That completes the two follow-up comments and replies included with each question, and this thread will be closed shortly. Best wishes to you.
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