[Question #6263] HIV worry

19 months ago
Hello,

My friend (male, 30 yrs old)  is HIV positive (recently diagnosed - a few weeks ago),  so I don't know if he is on medication or not, he doesn't talk about it. I saw him a few days ago and faced my HIV fear and shook his hand multiple times. Also noticed he had multiple scratches and scabs on his hands, just like anyone else that works with their hands, also a red area around his fingernail, he probably picked it with his teeth like everyone does, it was not dripping blood though. After leaving his store, I went to have dinner with another friend, had a nice steak. At the end I used my hands to finish the meat of the T-bone and thought nothing about it. Got home and examining my hands I saw a darker spot around my fingernail. So quick questions:

1) If the darker spot on my finger was blood from my HIV+  friend and got on my fingernail and UNDER my nail, is there any risk? Is the area UNDER the nail a mucous membrane? My common sense tells me no, but just checking with the experts.

2) Handshakes are no risk even if his scrape/cut comes in direct contact with my scrape/cut? talking about a fresh red cut or scrape, nothing that would bleed heavily.

2) I play soccer sometimes with him, and we do get scrapes and scratches on our arms as we fight for the ball. Any risk from his scrape touching directly mine? Obviously if I see him  bleeding heavily, I would stop playing and I think he would as well. So just direct brief contact between two scrapes or scratches, any risk?

I am in a committed monogamous relationship so I am looking out for both my health and my significant other's. Thank you for your time
Edward W. Hook M.D.
Edward W. Hook M.D.
19 months ago

Welcome to our Forum.  I'll do my best to help.  Before I answer your specific questions, let me provide you with a  generalization which may be helpful.  For all practical purposes, HIV is transmitted ONLY through DIRECT sexual contact or active sharing of instruments used to inject material deep into tissue.  HIV is NOT transmitted through shaking hands, ingesting food prepared by an infected person or other activities of daily living.  Further, if your friend is taking effective therapy for HIV, he is non-infectious even through the traditional routes of HIV transmission.  I would not worry in any way about the events and activities that you have described.  Specifically:

1.  Realistically, the dark spot that your describe was unlikely to be your friend's blood.  Even if it was, the exposure you describe would not put you at meaningful risk for HIV.

2.  Correct- no risk from shaking hands, even if someone has cuts or scrapes on  their hands

3.  No, their are no instances in which the sorts of contact and scrapes that occur during activities of daily living, including sports activities would lead to acquisition of HIV

I hope the information I have provided is helpful. The situations you have described are no risk events.  EWH

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19 months ago
Thanks so much for the quick reply. 

I see, so either sexual penetration or injecting deep into tissue. So why do the CDC and other websites say that if you have a scrape or cut and come in contact with an HIV + person’s scrape or cut there is a risk? Abundance of caution? Or just theoretical?

Not sure if he is taking medicines yet and I know that if recently acquired, this is when people are most infectious.  Does that change your assessment?

Also just for my curiosity:

1) The area under fingernails is a mucous membrane or not, just intact skin? Curious about blood going under the fingernail?

2) for the handshaking, just confirming your no risk assessment is for the situation when BOTH persons (HIV negative and positive) have scrapes or cuts that come in contact not just one of them and the other one has intact skin.

Thanks so much for clarifying 

Edward W. Hook M.D.
Edward W. Hook M.D.
19 months ago

The CDC tends to be very conservative in their recommendations, many of which are theoretical.  As I said, there are no proven instances in which touching of the sort you describe have been proven to lead to infection.

1.  Blood (if that is what is was) under the fingernails.  The tissue under the fingernails is NOT a mucous membrane.

2.  Repetitive.  No risk, even when both persons have cuts and scrapes on their hands.

Thus, no change in my assessment or advice.  There is no reason for concern related to the circumstances you describe and no reason for testing related to these events.  EWH

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19 months ago
Phew the relief! Thank you dr Hook. And the last question before you close this thread, even if he hasn’t started his medication yet and he could be highly infectious now, still no risk for me from the mentioned incident?
Edward W. Hook M.D.
Edward W. Hook M.D.
19 months ago

Sorry if I was not clear.  Irrespective of whether a person is on therapy or not, casual contact, including shaking hands or contact during athletic events, even if the person has blood under their finger nails and even if both persons have scrapes on their hands, is a no risk event for transmission or HIV.  Nothing you described suggests any reason for concern or any reason for testing. 

I hope this helps.  As you noted, as this is my 3rd response to your questions, as per Forum guidelines, this thread will be closed shortly.  Take care.  EWH

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19 months ago
Thanks dr Hook. Just confirming that regarding blood under fingernail, I meant his blood going under my nails. The way you wrote: ‘the person having blood under their fingernails’ thought you understood that I was talking about him.

The question was: if his infected blood goes under my fingernail, is that an entry to my bloodstream?

You did confirm it is not a mucous membrane, just making sure you understood my question.

Thanks for confirming 
Edward W. Hook M.D.
Edward W. Hook M.D.
19 months ago

No, even if his blood goes under your fingernail, this is still a no risk event.  I hope you will now be able to stop this needless worrying and move on.


End of thread.  EWH

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