[Question #4102] Scared

32 months ago
Hello Dr. 
How are you? 
I want to know if there is any risk of HIV with surface contamination? For example, If I sit naked on a surface which might have infected body fluid, then is there a risk for HIV transmission? Also, is there any risk with hand contamination to the vagina? Like, If i am bathing in a hotel room who's bathroom area/door knobs/taps might have infected fluid on them, and if I wash my vagina from inside, will there be any spread of HIV? lastly, If i use public bathrooms, and the pot water splashes back up into my genitals, can it cause any spread of HIV? 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
32 months ago
Welcome to the forum. Thanks for your question and among the most common on the forum:  What is the risk of HIV from exposure to blood or body fluids in the environment?

The answer is zero risk, or very close to zero. To my knowledge, in the 3+ decades of the known HIV/AIDS epidemic, with millions of infected persons world wide, there has never been a reported case of infection by such contact. How do we know? The busiest HIV/AIDS clinics never have patients who didn't have the traditional exposures, i.e. unprotected sex, shared drug injection equipment, transfusion (in the days before accurate blood testing), being born to an infected mother, and so on. If other exposures could lead to infection with any appreciable frequency, obviously there would be at least a few patients without traditional exposures. But whenever someone attends such a clinic and claims not to have had the traditional risks, it always turns out they were wrong. Some lie about exposures and others are unaware, such as having a partner at risk, e.g. the woman who was unaware her husband has sex with other men or is an injection drug user. As another example, the household contacts of HIV infected people never catch the virus even after years of sharing bathrooms, kitchens, towels, and even beds (assuming they aren't sex partners).

It was data exactly like this that allowed health experts to reassure the population that casual contact is not a risk for HIV, in the earliest days of the epidemic (early 1980s), even before HIV was learned to be the cause of AIDS.

As for the specific kinds of events you describe, such things must have occurred millions of times world wide, right? And still no known cases of HIV that didn't have sex, injection drug use, etc. So common sense tells you these things simply don't matter.

Why isn't there occasional transmission by these means? There are no final answers about the biological mechanisms. But they have to do with the fact that most people whose blood or body fluids might be on doorknobs, toilet seats, etc don't have HIV. If they do, drying and exposure to air rapidly kill the virus. Also, for infection to take hold, HIV in large amounts must contact specialized cells that generally are deep inside the body or in the bloodstream. Not enough virus is carried on hands and fingers for infection to take hold. (Even with unprotected sex with an infected man, with infected semen deposited in the vagina, the average chance of HIV transmission is once for every 2,500 events. How high then could it be with the minor exposure amounts you have mentioned?)

Use common sense hygiene, i.e. avoid direct contact with wet blood whenever you can, and wash with soap and water afterward. But even without that care, you are not at risk and do not need to be worried about any sort of exposure to HIV in the environment. Have only safe sex and don't share drug injection equipment and you can be certain  you'll never catch HIV.

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

HHH, MD

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32 months ago
Thank you so much for your reply, it was indeed extremely detailed and informative. 

I do not take drugs and practice safe sex. So I guess, that rules out the risk for me. but in any case, if I have fresh abrasions and paper cuts on my finger and in any case, if exposed to infected fluid accidentally, does it hold any risk?

Also, usually, how long is HIV infective outside the body? 

Thank You again.


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
32 months ago
"if I have fresh abrasions and paper cuts on my finger and in any case, if exposed to infected fluid accidentally, does it hold any risk?" I can't answer any better than above; re-read the paragraph starting with "Why isn't there...." Any risk is theoretical and exceedingly small and it's not something to be worried about. I also cannot guarantee you won't be struck and killed by a meterorite, but I would not recommend you do anything to prevent it.

"how long is HIV infective outside the body?" It doesn't matter how long HIV survives. If there is no such transmission, who cares? Anyway, it can be anywhere from a couple of minutes to a few days, depending on whether the infected fluids stay wet or dry out; temperature; humidity; and perhaps other factors.

If you come across obviously contaminated situations, e.g. obvious blood, it's best to avoid direct contact; wash afterwards if there is contact; and clean it up, using any common soap or disinfectant. If you don't take these precautions, almost certainly you will not be infected. But just use common sense!
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