[Question #6201] What should I do next?

17 months ago
Hello Doctors, 
I am an Indian-American, 27 years old healthy female. I am visiting Mumbai, India. While I was at a movie theatre in a mall, I tripped and fell in the dark while walking down the stairs. I injured my knees and the shin of my leg. I was wearing ripped jeans, so there were some abrasions on my knees which directly hit the stairs and My shin was covered with the jeans. But as I got home, I noticed, my shin had a big bad bruise with the scrapes and abrasions. I'm not sure if there were any bleeding points as it was too red and inflamed. As I fell in the theatre, the lights were out and it was too dark. I did not see where I fell and if the stairs had any suspicious items like needles/syringes around it. I'm worried with the incident described above, I might have put myself at risk, have I?
Is there a possibility of acquiring an infection like hepatitis and hiv in this manner? I don't know if there was a needle/syringe, but are community needlestick injuries risky? ( considering the public place setting and the geaography ) Is there a need to get tested? 
It has been more than 72 hours since the incident. Please tell me what should I do next?
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago
 Welcome to our forum. Thanks for your confidence in our service. I'll do my best to help. Exposures of this are typically no risk whatsoever. Environmental contamination does not ever lead to HIV infection.  Thus, if there were infected blood or secretions on the floor when you scraped your self you still would not be at risk. The likelihood that you were stuck with a needle on the floor is negligible since had a needle in there and this to skin it probably would have stayed there and even detected by you.

 I am sorry to hear that you fell. Your fall however does not represent a risk for HIV or other STI's. My advice is to try to put this episode behind you and move forward without concerned. I see no medical or scientific reason for testing related to the events you described. 

 I hope that you find this perspective and advice helpful. EWH 
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17 months ago
Thank you so much for your response. I'm relieved to know that it wasn't a risk. I thought of the same that had the needle been there I would have seen in, but I continued to run down  the stairs after I fell as I immediately stood back up to avoid any embarrassment and got out of the auditorium. Just wondering if there was a needle and if it fell off the clothes while I was running out? Does it change your assessment? 
 Thank you Dr. Hook for everything.
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago
While I understand you concern, the fact is that a needle would be most unlikely to come our in the manner you suggest.  Further, there would have been an obvious puncture wound.  I would not worry.  No change in my assessment or advice. EWH---
16 months ago
Thank You Dr. EWH. Your response really did comfort me a lot.
I had one more question for you. I don't do drugs.  I wanted to know what should be general precautionary measures for one with regards to a sexual intercourse? I mean I understand the condoms are safe. But other than that what should be taken care of in day to day life? I always look for discarded needles if any on the road after that episode? Also does showering before and after sex help in any way? Clean sheets/surface everytime we have sex? Also, is fingering a risk factor if he has his genital secretions on his finger and then if he immediately inserts it into my vagina? And how should one ever proceed with unprotected sex to start a family? sorry  for the awkward questions, just trying to understand the basics of how to adult without contracting HIV and other blood borne infections like hepatitis. 
Edward W. Hook M.D.
Edward W. Hook M.D.
16 months ago

I'm glad that my comments were helpful.  The best way to avoid sexual acquisition of HIV is to: 1. Ask partners if they have HIV and whether they have been tested for HIV.  If so when.  This information may help you to evaluate the risk related to that partner; 2. Use condoms correctly and consistently for penetrative sex; and 3. if you are having frequent high risk exposures, consider use of PrEP with anti-retroviral drugs taken on a daily basis to prevent HIV.

Many of the things you ask for are NOT risk factors for HIV.  Specifically whether or not bed sheets and towels are clean make no difference in risk.  Neither does masturbation (fingering) of an infected partner- even if you get their genital secretions on you and even if you have cuts or scrapes on your hands.  HIV is not transmitted in the course of normal daily activities.  If you wish to review other questions on HIV risk on this this forum, that will provide additional information.

With this, this thread is now closed.  As per Forum guidelines, there will be no further replies as part of this thread.  Take care.  Please don't worry.  EWH

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