[Question #3475] HIV Risk

36 months ago
First let me start off by saying that I do suffer from anxiety and OCD and this is something that happened about a year ago and it has started to worry me again. 

I work in a pharmacy and was helping a patient that confirmed he had HIV, he had dental surgery and I noticed he was had blood on his hands from messing with his mouth after I had handled his ID and his written prescription. I pick st the skin around my fingers a lot and was picking at the skin around my right middle finger when I noticed the blood on his hands. I am concerned that there might have been blood on his ID or his prescription paper that might have gotten into the wound on my finger. I picked the skin until it bleeds sometimes and fear the HIV infected blood may have gotten into an open cut/wound in my finger. 

I freaked out and initially went to see a doctor who told me that I had absolutely no risk of contracting HIV in this situation as HIV can not survive long once it hits the air, even it is still on the skin of the infected person. I initially put this fear being me. 

I am experiencing a sore throat and flu like symptoms, and for whatever reason it brought up the fear of contracting HIV from this encounter. Would it be possible for HIV to be causing these symptoms this far out? 

Is there truly no risk from the exposure that I had? I stupidly read on the internet that HIV can live up to 4 to 6 weeks outside of the body? Does this have any basis in truth? 

Do you recommend that I get tested? Should I continue to have sex with my boyfriend? I would feel terrible if I had this and gave it to him. 
36 months ago
I also wanted to add that I didn’t see any blood on the ID or paper and didn’t see or feel blood on my finger, but I can’t be sure that I didn’t have blood my finger and then some how wiped it off before I was able to see it. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
36 months ago
Welcome back to the forum. Thank you for your continuing confidence in our services.

You needn't be worried at all. Your doctor was right:  this definitely was a no risk event.

Your doctor is also correct that HIV cannot survive any length of time in the air. You either found overt misinformation or misunderstood something you read on line. But whether HIV can survive really isn't the point and not important. We know such infections never occur: therefore the biological reasons don't matter much. In the earliest days of the known worldwide HIV/AIDS epidemic -- in the mid-1980s, before HIV was even discovered as the cause -- public health officials were able to inform the public that there is no risk from non-intimate personal contact. How did they know? For the same reasons we have relearned time and again over the years:  there are no HIV infected patients without the traditional risks of unprotected sex or obvious blood exposure. If you think it through, you will understand that we all have non-intimate interactions with HIV infected people all the time:  they cook our food and serve us in restaurants, cut our hair, give us manicures, operate on us (yes, there are many HIV infected surgeons), exchange money with us at cash registers, and otherwise participate with us in daily life. And obviously some of those thousands of interactions (including your own, beyond this particular pharmacy customer you know about) had to involve the sort of blood contact that you are worried about. If these events carried risk for HIV, there would be at least a few HIV/AIDS patients who had not had sexual or drug related blood exposure risks. But there are none. Even in the busiest HIV/AIDS clinics, everyone has the standard risks:  when someone initially denies them, it turns out they were being untruthful or were otherwise mistaken, e.g. did not know a sex partner was infected or at risk. Even the household contacts of HIV infected persons never get it, even after 20+ years sharing kitchens, bathrooms, toilets, eating utensils, etc (assuming they are not also sex or needle-sharing partners with the infected person).

So no risk and you should not be at all worried. You should not be tested and should continue your normal sexual relationship and practices with your boyfriend.

My final advice is to stop searching the web about all this. Anxious persons, whether about HIV of life's many other risks, tend to be drawn to information that reinforces their fears and to miss or ignore the reassuring information that also is there. Nate Silver, the now famous statistician of fivethirtyeight.com, wrote a book about statistics, "The Signal and the Noise". It it he writes "Give an anxious person a computer with an internet connection in a dark room, and soon he'll be mistaking his cold for the bubonic plague." Don't make that mistake!

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

HHH, MD


---
36 months ago
So just to summarize, even if blood did get into a cut/wound on my finger the fact that it was in contact with air basically kills the HIV? If this is correct then everything is absolutely clear! 

Thank you for the reassurance doctor! 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
36 months ago
This is the wrong question and I suspect you realize it's your OCD speaking. IF the pharmacy customer had a bleeding wound, IF there was blood (enough to see) on the prescription, IF the blood were still wet and glistening, IF you had an open cut on your finger that was actively bleeding, and IF that cut came into direct contact with the customer's wet blood, then you MIGHT have caught HIV.

But probably none of those things happened. You are not at risk. Please do your best to stop worrying about this.
---
36 months ago
The customer did have a bleeding wound in his mouth and the blood on his fingers was still wet. I’m sorry to keep bothering you about this, but does the above info change your opinion any? 

Also, I have seen that saliva can possibly kill HIV, do you think the fact that he was bleeding from the mouth and his blood was mixed with saliva supports this claim? 

Again, I’m sorry to keep bothering you. I really am trying to work on my anxiety and ocd issues. I want to be able to live my life without every little thing sending into a bout of crippling fear. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
36 months ago
The entire point of my main reply above, which you haven't absorbed (maybe didn't understand? or just don't believe?) is that the bioloigcal reasons don't matter. Whether and how long HIV survives (not long), whether saliva kills the virus (it does) make no difference. The fact is that nobody has ever caught HIV from an interaction like you describe.

So no, none of this changes my opinion or advice:  you are not at risk for HIV from this event, do not need testing, and should continue sex with your boyfriend.

Finally, neither this forum nor online searching for the facts of HIV transission will ever be the means by which you will someday "be able to live my life without every little thing sending [me] into a bout of fear".  Simply hearing the facts or professional advice will never resolve the problem; there's always a "yes but" or "what if" question. Resolution will come only with adequate management and control of your OCD. Germophobia (elevated fear of contagion) is a common form of OCD and it seems you have it, at least in regard to herpes and HIV. Although I'm not a mental health expert, I believe you're going to need professional mental health care, which I suggest out of compassion, not criticism. I hope you'll follow that path.

Please note the forum does not permit repeated questions on the same topic or exposure -- and I put your herpes/chapstick thread in the same category as this one. This will have to be your last one; future new questions from you about non-sexual risks of HIV, herpes or any other infection, testing, and so on will be receive curt replies or none at all, without refund of the posting fee. This policy is based on compassion, not criticism, and is designed to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. I trust you will understand.

I do hope this discussion has been helpful, however, and helps you move on without worry. Best wishes to you.


---