[Question #3627] Risk assesments

34 months ago
Dear Doctor. I am back again after 15 months and I am still in a loyal monogamous relation 

Here is my story. I traveled with my brother for few days and we shared the same hotel room. We were sleeping in the same bed and he woke up in the middle of the night saying he had an erotic dream and came into his underwear. He went to the washroom and used water and toilet paper to clean himself and then washed his hands with a bar soap. He dropped everything in the toilet 
I went right after him to the toilet and I seated into the toilet he used. I had some splashes of toilet water touching my rectum. After this I used the same soap bar he used to clean myself. I am wondering if this can be a risk if we assume he is HIV +. I don't know his status but all I know is that he is sexually active (he is hetero) 

My second concern is during this stay I went for a non sexual massage in a very clean place (5 stars hotel with very respectful therapists). The massage was great and when I finished I noticed a small scratch in the hands of the masseuse. there was scab on the scratch. when I asked she said this was from her cat scratch. I am wondering if it is possible to get contaminated if this scab went into contact with the scratches I have in my body (psoriasis, scratches from football, etc..) 

Thanks a lot for your help 

Best Regards
Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago
Welcome back to the Forum.  I will be providing your information this time.  Before I get to the specifics of your exposure, let me point out to you that HIV is not easily transmitted to others.  It is transmitted ONLY through DIRECT penetrative sexual contact or injection of infected material and even in those situations, less than 1% of exposures to infected persons lead to infection (the likelihood of infection varies depending on the sort of exposure).  HIV is not spread through contact with genital secretions which have been exposed to the environment such that one might encounter on a contaminated toilet seat or in a shower that had been used by an infected person.

As for the situation that you describe, there is no risk for infection. First, it is statistically unlikely that your brother has HIV, even if he has had other sexual partners.  Secondly, HIV would not survive in splashed toilet water or on a bar of soap so there is no risk for infection to you.

Regarding the second events that you describe, once again let's start with the fact that it is unlikely that the masseuse had HIV.  Even if she did, the sorts of exposure to a scratch that you describe, even if it was fresh, would not put you at risk for HIV.  In both instances you mention, that you might have your own scratches of a rash related to psoriasis or other dermatological process does not change my assessment in any way.  Still no risk.

Thus there is no need for concern related to the events you describe, nor is there even a need for testing.  these were no risk events.  EWH