[Question #7953] HIV Risk - cuts in bathroom

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50 months ago

Hi Doctor, 


My dear friend and housemate found out last week that he is HIV positive. We share a bathroom and living space. We’re just friends and have never engaged in an sexual activity. 


Following the news and given that I have recently entered an open relationship, I went for a STD/HIV test and started Prep. 


I’m slightly concerned as, on the morning he told me, I’d used the bathroom after him and I realised later that I have cuts on the base of my foot (I’d cut them on rocks at the beach the day before using the bathroom and him sharing the news) and I stood on our (potentially wet) bathmat that he had stood on before. 


Given that he’d used the bathroom and stood on the bath mat before me (I’m unsure if he had any cuts), is there any risk of me contracting HIV through the cuts on my foot and using the bathmat/bathtub? 


I’m also concerned as I’m now 4 days into using Prep and I’m worried I could’ve just contracted HIV in the bathroom prior to starting the medication, therefore any negative test I get at my next prep check up could be inaccurate? 


Looking forward to your response. 

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Edward W. Hook M.D.
50 months ago
Welcome back to the Forum and thanks for your question.  I'm sorry to hear of your housemate's recent diagnosis and hope that you are able to offer support to him in what is likely to be a time of need.  At the same time, I completely understand how his diagnosis might raise questions for you as to whether you are at risk from casual, inadvertent contact occurring while sharing the household.  I'm pleased to tell you that HIV is NOT transmitted trough usual household contact.  Not by sharing dishware, toilet seats, etc., and not though contact with surfaces (rugs, floors, toilet seats, etc.) which might have been contaminated by his bodily fluids or blood.  If you are not having sex with him and not sharing needles, you are not at risk and do not need to take special precautions.  Thus, in answer to your specific questions:

1, PrEP may be advisable in light of your new and open relationship.  It is not needed related to your housemate.  Should you be exposed (in the relationship) PrEP is virtually 100% effective when take as recommended.

2.  No risk from the shared bathroom, including related to residual material on the floor, in the sink,  or the wet bathmat etc.  This is the case even if one or both of you have cuts or sores on your feet.

3.  Given your description of your circumstances, you are not at risk for having acquired HIV from your housemate.  The likelihood that you are incubating HIV is virtually zero.

I hope this information is helpful.  If there are further questions or my responses are unclear, please use your up to two follow-ups for clarification.  EWH 

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50 months ago

Thanks for getting back to me Dr Hook. You’re absolutely right regarding the support - it’s a difficult time for him and I want to be there for him as much as possible. He’s just got back from his follow up appointment where the nurse said his viral loads is already pretty low - which is good!


As you can tell, I’ve previously suffered with sexual health related anxiety and this has triggered things. 


Just a few questions to ensure I don’t panic in future: 


There was at least 5 minutes between him using the bathroom and myself using the bathroom. I’m of the understanding that within this time, any fluid would’ve become non-infectious. Is this correct and would this have happened within seconds?


In terms of the cut on my foot, I don’t believe I was bleeding - in fact I only noticed the marks a few days ago and put the pieces together as to where these came from. These are nothing that caused any major pain or required stitches. can you outline what would be the requirements for a risky cut? Is this typically something that requires medical attention in these scenarios? Also, given there was a day apart, do you think my cut would have already formed a protective layer? 


Wet vs. Dry - I’ve read that HIV needs to dry out before it dies - I’m guessing HIV doesn’t survive in either wet or dry environments?


I also found some great quotes from your buddy Dr HH:


‘Here is ALL you need to know to go a lifetime without cacthing HIV:  Choose your sex partners wisely; use condoms for vaginal or anal sex with new or non-monogamous partners; and do not share drug injection equipment with anybody.  Do these and there is NO CHANCE you will ever catch HIV.  You should not need to spend good money to keep returning with questions with such obvious answers!’


‘Don't have unsafe sex with non-monogamous partners and don't share drug injection equipment with other persons. Disregard any and all other fears of transmission risk.’


I suppose these apply to this situation too? 


I will have a think if any other questions come to mind.

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Edward W. Hook M.D.
50 months ago
Straight to your follow-up questions.

Even though you were in the bathroom soon after he, there is still NO risk.  Remember that there is not even any risk from mutual masturbation in which partners get each others' genital secretions on one another- still no risk.  the virus becomes non-infectious within seconds of being outside of the body.

Cuts,  Remember, blood from cuts comes out, not in and to cause infection non-sexually HIV needs to be INJECTED deep into tissue.  Please don't worry about curs of scrapes, irrespective of the timing.

HIV looses its infectivity quickly outside the body for numerous reasons. Drying is part but not all. See my comment about mutual masturbation above.

The quote you found pretty much sums things up.  

EWH
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50 months ago
Thanks, Dr! So, to summarise: 

- I will NOT contract HIV by living with my HIV positive housemate, even when coming into contaminated surfaces, the bathroom, kitchenware etc. and I shouldn't worry about any cuts coming into contact with such surfaces? 

- The only way to contract it is via unprotected anal/vaginal intercourse and sharing intravenous drugs? 

- I can safely continue my course of prep without any worries and concerns of receiving a false negative result? 

Many thanks for all your help. 
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Edward W. Hook M.D.
50 months ago
Thanks for your summary. You have stated the information I have provided accurately. Please don’t worry. Take care. This completes this thread. EWH---