[Question #2800] Clarification on non-sexual exposure

94 months ago

Howdy Doc,

Let me provide some context because I think this is a spike in an underlying problem of mine. I have a previous documented medical problem with anxiety that has not been a problem for quite some time. But still this feels a little anxiety like.

Now my situation: I have been dealing with a lot of stress recently and this often increases my anxiety. I think this is what happened today however given the significant stress I am under I wanted to double check my understanding with an expert. So here is what happened. Today a new client came in and as we shook hands for the first time he "missed" with his hand and ended up scraping my right hand with his right hand finger nails. I did not have time to check well while I was meeting him, but I did check afterward and did not see any overt wounds or any bleeding. I did have a couple small older wounds which did not appear to be bleeding but looked like older cuts or nicks. However, because my client told me of some recent high risk sexual activity, I became worried he may be HIV+ (or some other blood borne STI) and this scrape may have put me at risk. So this is my question: If I did have a scrape I did not notice or if one of these older wounds were open, can I be confident that this is not a risk or reason to test? Also, I assume that it is also not a concern were I to get any blood or other HIV secretions into my eyes or mouth or nose or ears or anywhere else that this is also not a concern and not a reason to test. Thank you for your expert advice.

Edward W. Hook M.D.

94 months ago

Welcome to the Forum. My goal is to assure you that the event you describe was a no risk event and that no testing is needed.

Let me first point out that despite this person's high risk sexual activity, statistically it is unlikely that he has HIV or any other blood borne infection. Most people do not.

Even in the unlikely circumstance that this person's had a blood borne infection, there are no instances in which HIV, HCV, is other infections have been documented despite the fact that such exposures have almost certainly occurred millions of time. This event is not a concern. There is no no need to worry and no need for testing. EWH

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94 months ago

Howdy Doctor Hook,

When I read your reply yesterday it really made me feel better. Thank you for that. When I woke up this morning I had a few lingering thoughts that I wanted to make sure I understood.

If my understanding of the transmission of HIV or other blood borne STIs is correct, even if my client had HIV and I did get his client's blood on my hands and this blood somehow got into a cut I may have had or my eyes, mouth, nose, ears, etc., this type of contact is simply not a viable route for transmission to occur and thus not something I need to worry about. I read in the forum that even a poke with an HIV+ needle that goes deep into someone's tissue is only a one in several hundred chance of transmission. Which means that contact with blood exposed to air that may get into a cut is just not a risk or if it is a risk it would be a one in a thousand or one in a million chance. Is this about right?

The only other thing concerning me is I have a few pimples on my face and what might be a coldsore on my lip and if my understanding of what you've written here and elsewhere is right, HIV+ blood contact with my pimples or coldsore is also not a risk for the same reasons I discuss above.

Lastly, is there a rule of HIV transmission I can keep in mind if these thoughts comes up again in a casual contact setting?

Much obliged for your expert advice

Edward W. Hook M.D.

94 months ago

You are correct- getting this persons blood on your hands, even with an open/recent scratch is not a realistic route for acquisition of infection, nor is transfer on your hands to your eyes, nose, mouth or other body sites. The risk for such an infection would certainly be far les than 1 in 1000.

Similarly, contact of HIV infected blood or secretions with a cold sore or pimples on your face would not put you at risk for infection.

Please remember, HIV is ONLY transmitted in adults through DIRECT sexual contact or injection of infectious material DEEP into tissue.

I hope this is helpful. EWH

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