[Question #6682] Exposure Risk?

13 months ago
Hello & Good morning,
I'm a healthy 24 years old female. I have been sexually inactive since 14 months. My last STD check was 1 year back, which was negative for all. I traveled from Connecticut to Chicago last night. I checked into the hotel last night and as I woke up this morning I noticed a tiny blood stain on my pillow case. I might have been fresh, just before I checked in. What concerns me is, I had a cut on my knuckle from opening a lens case whose seal cut me. The cut was  It was only a few hours old and uncovered. I did not have a bandage to put on it. I am concerned if the blood on the pillow had some Hepatitis or HIV infection, it would put me at risk for acquiring it. Is there a possibility of me getting infected? Was this event a risk? Do I need to get tested?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
13 months ago
Welcome to the forum. Thanks for your question and your confidence in our services.

You needn't worry at all. Finding blood in this setting, possibly fresh, certainly is esthetically displeasing. However, it carries no risk of infection with HIV or any other blood borne infection. There has never been a reported or even suspected case of HIV from exposure to the virus through a contaminated environment. The same probably is true for viral hepatitis, although I don't follow the hepatitis scientific literature as closely as I do for HIV. These viruses die rapid when secretions dry; and even if the virus were suriving, it would be almost impossible to expose your own cells and tissues required for virus transmission.

HIV is pretty hard to transmit. If you have unprotected vaginal sex with an HIV infected male (not on treatment), with ejaculation in your vagina, the chance you could be infected is around 1 in 2,500. (That's equivalent to having unprotected sex with infected men once daily for 7 years before transmission becomes hiighly probable.) With that risk from a large load of virus deep in your body, perhaps you can understand how the trivial exposure you hypothesize -- your knuckle cut coming into contact with dried blood (or even moist blood) -- must be exceedingly low indeed. And as I said, even when people have been awash in blood (e.g. helping right after an auto accident, gunshot wound, or other major trauma), few if any HIV infections are known to have occurred.

Don't get me wrong:  Do try to avoid major blood contact and wash your hands promptly if it happens. Most important, as a sexually active women (most of the time if not in the past year), choose your partners thoughtfully and use condoms. Also avoid shared drug injection equiopment (should you ever get into the drug scene). That's all:  no other precautions need be on your mind. And for sure you do not need testing on account of the events described here.

I hope these comments are reassuring. Let me know if anything isn't clear.

HHH, MD
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13 months ago
Thank you so much for you response. It indeed was very aesthetically displeasing and distressing. Your answer was reassuring and I will definitely confide in it and not get tested. 
I always have protected sex. But when you say to choose the partners wisely, that has been one of my concerns all this while. While I have been only in 1 sexually active  relationship. I often am in a dilemma how to consider somebody for a sexual intercourse? Ask them to get tested before getting intimate? 
I have never indulged into drugs and dont plan to. 
Any precautions in particular to make sure that I never contract HIV/Hepatitis c? vaccinator. for Hep.b . Other STDs dont concern me as much as I know they are treatable. Not that I dont take extra caution. But just want to make sure I do this right to stay in good health :)

Thank you for everything Doc. You're indeed a blessing to amateurs like me :)


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
13 months ago
Well, we're STD experts here, not sexual health counselors. Of course it's not always to be certain about a prospective partner's risk level. But meeting people in social situations, getting to know one another, and avoiding quickies (e.g. bar pick-ups) is tried and true. Being introducted by friends. Nowadays, with online dating, most people are truthful when asked directly about sexual lifestyle, past STD history, etc. Assuming you're in the US or maybe western Europe, from an HIV standpoint you'll be very safe simply by being wary of men who also have sex iwth men or who use drugs by injection. Outside those groups, the frequency of HIV in straigh men is very low. (Not always, of course. For example, the HIV risks are much higher in some population groups and inner city setings.)

I assume "vaccinator" is a typo -- you're vaccinated against hepatitis B virus. Hepatitis C virus isn't a risk, despite what you can find online.  I tis NOT heterosexually transmitted:  the only proved sexual transmission of HCV is among men having potentialy traumatic (i.e. blood-associated) rectal sex witn other men. The spouses and regular heterosexual partners of persons with HCV have no greater chance of being infected than anyone else, assuming they are not also needle-sharing partners. As for other STDs, of course you should have the HPV vaccine. And finally, of course use condoms until/unless mutual monogamy is assured. If unprotected exposures do occur, be tested for gonorrhea and chlamydia from time to time.

Thanks for the thanks. I'm glad to have helped.
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