[Question #4995] Exposure or not?

26 months ago
Hello Doctor

I am a medical student and hence understand the common ways of spread of HIV like penetrative sex, vertical transmission, Intravenous drug use. However, an unusual incident happened today at the hospital and i need a little more clarity on that. I am currently rotating in Internal Medicine. This incident took place while shadowing the resident in the ED. The resident was examining a patient who had active bleeding from his arm. When i walked towards the resident, he took off the gloves he was wearing and without sanitising or washing his hands, shook hands with me while holding the gloves in the other. This could have led to a possibility that the patients blood may have come onto the residents hand. I had fresh, slightly deep abrasions on my hands which could have been a possible source of entry for the patients blood, through the handshake. Due to the residents seniority, I could not avoid shaking hands with him or asked him to sanitise his hands before shaking hands with him or even sanitise my own immediately after the handshake. It was around 15-20 mins later that i got an opportunity to sanitise my hands. I am now scared of acquiring HIV. I do not know the patients status. What should i do next? 
Edward W. Hook M.D.
Edward W. Hook M.D.
26 months ago
Welcome to the Forum.  The most important thing that you can do related to the events you described are to not worry.  The events you describe did not put you at any risk whatsoever for HIV.  HIV is more difficult to transmit than you think.  Points to remember:

1.  The resident was wearing gloves.  Gloves keep contaminating material on their surface, out of contact with skin.
2.  You do not know that the patient had HIV or any other blood borne infection.  Most people do not.  Even if he did, If the patient was on effective therapy and his viral load was undetectable, he was not infectious.
3.  HI V is not transmitted by touching or shaking hands, even if abrasions or fresh cuts are on an uninfected person's hands.

I see no reason for concern and no reason for testing related to the events that you describe.  Please do not worry.  EWH
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