I’m a nurse and I was admitting a patient status post motor vehicle accident early this morning. The patient had been in the ED for a few hours before coming to the unit so there was dried blood all over his hands. As I was giving him a pen to sign a consent form his finger brushed against my finger, but my finger had a cut/tear around the hangnail area that his finger made contact with.  Later I called his wife to get more information because he couldn’t remember much from his accident, his wife told me he was HIV positive. He then later told me he takes some medication named biktarvy. How likely is it that I have contracted it from him? I am extremely nervous and scared, I am in a relationship and I can’t stop worrying. 

The fact that the patient is taking Biktarvy is great news. This medication is the current therapy of choice for HIV and in the majority of patients eliminates any risk of transmission of infection by reducing the HIV viral load to undetectable levels.  In addition, despite the fact that you may have had a healing cut on your finger, the fact that the blood was dried wood further reduce and virtually illuminate any likelihood that it would contain transmissible HIV.  

Personally, I would not worry in the least about any risk of acquiring infection from the encounter you described. If you are concerned and so desire, my advice would be to notify the infection control specialists at your place of work. That might will lead to further investigation of the patients infection status and potentially lead to giving you postexposure prophylaxis although to be honest I really don’t make it is needed.  Please understand, the likelihood that you are at any risk for acquiring HIV from exposure to describe is a small, small fraction of 1% given the patient’s treatment status, the fact that the blood was dried, and the fact that the wound on your finger was not reset or actively bleeding. I am just trying to provide you with the options so that you can address this in a way that makes you feel most comfortable. 

I hope this perspective is helpful. Please don’t worry. EWH