[Question #3698] Factors in hiv transmission in non sexual situation?

33 months ago

Hello Doctors,

Firstly, I know that Dr Handsfield thought I asked some fairly irrational questions last time I wrote to him and I am hoping this will be ok to ask. My question is regarding the factors that may make the degree of risk higher in HIV Transmission in terms of ones own health. Basically the reason why some people might get infected and others may not and if it relates to immune system. I know that HSV2 increases the risk in sexual situations (something I have) but as long as condoms are used this won’t. I have had a monogamous partner now for the last year. What my question is regarding is in a non sexual exposure type situation will the individuals' stress levels, whether they smoke or not, their immune system, the presence of another STD, illness etc effect whether transmission may occur. Would it make a difference in a non sexual situation. Like with the flu, one is likely to get sick more easily if they are run down, is the same true for transmission of HIV. That one is more likely when exposed to hiv to catch this if their body is not running efficiently, tired etc. I had an incident where I do believe a small flicker of blood went into my eye yesterday from an individual of unknown status (looked higher risk category) .What bothers me is that I lost a big work client this week and have been intensely stressed (far above average – chest palpitation level), barely slept, and I smoked a few cigarettes today. I am concerned that I may have increased the risk level due to this. I am calming down and relaxing now and ate a good dinner but aside from what happened, this worries me. I am meaning an incredibly high stress level, felt physically please bear this in mind. There were an unfortunate number of stressful events that occurred in my life this week but now I am worried about this. I could not find the answer to this type of question online.

H. Hunter Handsfield, MD

33 months ago

Welcome back. I scanned but did not re-read your three previous threads in detail. However, it is clear that your concerns are on the same track -- and are equally unreasonable as last time.

It is a mistake to attempt to imagine scenarios in which HIV may be transmitted by means other than sex or overt blood exposure. Biologically, some of the things you suggest might make sense. But the main fact is that even the busiest HIV/AIDS clinics and research centers have virtually no patients without the traditional risk factors like unprotected sex, needle sharing, or being born to an infected mother. A few newly infected persons cannot initially say how and where s/he was infected, or claim a non-traditional source. In all such cases, it turns out they were being untruthful or they had risks they did not recognize, such as the surprise knowledge that a spouse was at risk (e.g. high risk sex with men but closeted, or a secret IV drug user).

If non-traditional scenarios like you describe here, or others like those in your previous questions, could transmit HIV with any frequency at all, there would be at least occasional patients who genuinely had HIV of mysterious origin. But the numbers of such persons, world wide, could be counted on one or two hands (and most of those from countries or social settings where denial of sex/blood risks is extremely strong).

Finally, I'm afraid you are wrong in your beliefs about the immune system and susceptibility to infection. Despite strongly held beliefs, it remains highly questionable whether having a "weak" immune system, from stress, diet, exercise, etc actually increases risk of any infection, including common cold etc. And certainly no evidence in regard to HIV or other blood borne infections. There is absolutely no scientific basis for fear that your stress level could somehow have led to acquiring HIV in the absence of the traditional sex and blood mechanisms.

I hope this information is helpful. It's also intended to head of any other concerns that might rise in the future concerning non-traditional exposures and fear of HIV.

HHH, MD

---

33 months ago

Hi Dr. Handsfield,

Thank you for the information. Apologies for the delayed response, I had a lot to deal with last week. Just one more thing. Are you saying if you get a small amount of blood into your eye this is not a risk for hiv. I thought there was a small risk. Thank you.

H. Hunter Handsfield, MD

33 months ago

I did not say there is no risk from such events. In theory, transmission might occur from getting "a small of blood into your eye". But in the earliest days of the recognized HIV/AIDS epidemic (early 1980s), public health officials concluded, and began to advise the public, that such events were too rare to worry about and can be ignored. That remains true today.

I'm going to ask that this be your last question along these lines. The forum does not permit repeated questions on the same topic, and future new questions from you about non-sexual risks of HIV and other STIs 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.

---

33 months ago

Ok. I had a fever and intense chills, along with muscle aches on Friday night. I also had a headache. I had no rash or sore throat. This was two weeks from the incident and lasted for around 24 hours. I understand I have little reason to be concerned but I will take a hiv test this week. In the meantime I will try not to worry.

H. Hunter Handsfield, MD

33 months ago

I have no further comment at this time. On the assumption that you would like the opportunity to post your test result later this week, I'll leave this thread open until you do so. But I won't have anything more to say until then. For all the reasons discussed, you can expect a negative result.

---