[Question #4637] Risk Assesment

28 months ago

Hello doctors!

Thanks for all the great work you have been doing. I’m fairly uneducated about HIV transmission so I’m a bit fearful of my situation, and I would hope you would assess my risk and whether I need testing.


I went for a massage, and it went great except that in the end I found some blood in my hand. Now I don’t know if it was my blood or the one who gave me the massage. It was a small spont. I, however, remember rubbing my eye--only rubbing (I did not have any cuts in my eye whatsoever). And I am afraid that blood went inside my eye and got infected with HIV. I am really scared doctors, so please tell me if I need testing for this incident.

  1. Is there any risk from rubbing my eye, while there was potentially a small spot of blood in my hand?

  2. Should I test, or it is not warranted?



Thank you so much!

Sincerly,  


28 months ago
And allow me to reiterate that my eye doesn't have any wound or cut. I only scratched it. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
28 months ago
Welcome to the forum. Thanks for your confidence in our services.

Contact of blood or other potentially infected fluids with the eye is generally listed as a potential route of HIV infectoin, and undoubtedly it can happen. However, it is exceedingly rare. While I haven't recently searched the scientific literature about it, during the 4 decade course of the known worldwide HIV/AIDS epidemic, I doubt there have been 10 reported cases of HIV transmission by blood splatter or rubbing into the eye.

I also have difficulty understanding how the massage worker's blood could have appeared on the palm of your hand; it seems more likely it was yours, not hers. But even if hers, also remember that the frequency of HIV in female sex workers is under 1 in a thousand, and probably lower for other massage workers.

So from all you say, I would consider this a zero risk event in regard to HIV. No worries at all, no need for testing, and no reason to modify your normal sexual practices, if you're in a relationship.

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

HHH, MD
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28 months ago
Thank you for responding Doctor! 
My other question is that if the eye is a route for HIV transmission, is it because there would be wounds or cuts, because I did not have any? In other words, if I don't have any cuts whatsoever in my eye, then is it a risk for HIV. I really want to resume my sexual life with my wife. Thank you again!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
28 months ago
No, the risk from eye exposure is because the exposed tissues are susceptible to HIV even without cuts, scratches, etc. Whether or not you had a cut in the eye makes no difference.---
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28 months ago
Doctor, if I decided to test, is there any difference between taking the test (fourth generation) at 4 weeks than to take it at 6 weeks? if yes, to what extent is the difference. and is it considered conclusive at 4 weeks? Moreover, if i decided to take the PCR with the fourth generation, would the combination be accurate?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
28 months ago
About 98-99% reliable at 4 weeks, 100% at 6+ weeks. PCR by itself is nearly 100% conclusive at 2+ weeks; the cominbation of PCR with AgAb is 100% at 4 weeks.

I think it's silly for you to pay the costs of these tests, especially PCR, based on the events described. Nobody in the world ever caught HIV from a massage that didn't incolude unprotected sex, and there is no chance you'll be the  first, regardless of the blood on your palm. There is under one chance in many million that you caught HIV. 

That concludes the two follow-up comments and questions included with each question and so ends this thread. I hope the discussion has been helpful.
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