[Question #9079] HIV risk from a hair scratch in barbershop

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36 months ago
Hello Doc, so here is my case. In late May I went to this barbershop for a hair wash. The servant first moistened my hair with water, then turns off the water, started to shampoo me. He also gave me a little head massage. It was during the shampooing process when I felt painful and I then thought he had caused a scratch on my head through some little bumps or simply sharp nails. It was definitely painful. After that he washes my hair again with water. I wasnt paying attention to his hand, so i wasnt sure if there were blood on them. Would there be any risk at all of infecting hiv or other STIs? I was tested for HIV and syphilis 4 weeks, 6 weeks and 10 weeks after this event, all negative, would that result be conclusive even if we disregard how low risk my event was? 
Thank you very much.
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H. Hunter Handsfield, MD
36 months ago
Welcome to the forum.  Bottom lines: 1) Zero risk for HIV or syphilis or any other infection. 2) Your test results prove you were not infected.

Now a question for you. What in heaven's name made you worried? Why do you think such an event could have put you at risk? Where do people get these crazy ideas??? Nobody in the world ever caught HIV or other blood-borne infection from such an event. Your barber could have had HIV and spilled a quart of his blood on your scalp:  you would not be infected. Of course you didn't need testing, but your negative test results prove your ere not infected, and that would be the case even if you had been at high risk.

All is well. You do not have HIV or syphilis. Do not have any more tests. 

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD
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36 months ago
Hi doc, thank you for your answer, i appreciate that and I think that had made me feel a lot better. 
I do, however, have a follow up question regarding what you mentioned in your answer. " Your barber could have had HIV and spilled a quart of his blood on your scalp:  you would not be infected." could you please explain why? Because I thought this sort of contact could be dangerous and risky for hiv or other disease infection. Is it because of the shampoo or other stuff?

Also, some of the doctors out there are still telling me that i will definitely need 12 weeks (3months) for syphilis or even hiv. Is that an outdated opinion? Is the 45 days standard a conservative decision already?

Thank you very very much for your time.
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H. Hunter Handsfield, MD
36 months ago
Skin contact with HIV infected blood has little or no risk of transmission. But of course I used that analogy to tell you that even a much greater exposure to blood than you possibly had would still be no risk. The point is that it would be impossible for enough blood to be transferred to cause infection in the circumstances you describe. And yes, shampoo would still further reduce any risk; soaps and shampoos instantaneously kill HIV and other viruses.

I stress again you do not need testing. But once someone decides to test, they should do so long enough after a possible exposure to assure a negative result is reliable. With early HIV tests several years ago, that time was 12 weeks. Some sources are not up to date with modern tests and still recommend 12 weeks. However, with the standard HIV blood tests (antigen-antibody, i.e. 4th generation tests), 6 weeks is perfect. (Officially 45 days according to CDC, but 6 weeks -- 42 days -- is close enough and our normal advice on this forum.)

The time to truly conclusive syphilis tests has not been studied very precisely. Six weeks generally is sufficient, but sometimes it might take 6 months. But the chance of syphilis in this situation  was zero. 

I'm asking again:  Where and why did you ever come to think that something like this could be a risk for HIV, syphilis, or any blood borne infection? IT HAS NEVER HAPPENED, ANYWHERE IN THE WORLD! Your chance of being struck by a meteorite is higher than the possibility of any of these infections from the events you describe. Believe it and move on!
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36 months ago
Hi doc, thanks for answering again. Your words do help a lot and I truly appreciate it. I have one final question: in august 2018 I had protected sex and oral sex with this woman whose status I wasn’t certain of, and in Jan 2020, which is about a year and half later, I had my first ever hiv test. I also had a full body check that time and everything was negative and fine. My question is, would a negative result after a year and half be definite? Could that time be sufficient for hiv to go to the final phases and would I always be able to be tested positive if I were actually infected? I had several tests, around 6, since 2020 till today, and they are all negative. And I think my health status had been okay, does that assure I don’t have hiv? 

Thank you once again.
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H. Hunter Handsfield, MD
36 months ago
Thanks for your understanding. Any negative HIV test done long enough after the last possible exposure is 100% reliable, and that time is 6 weeks (or 45 days) with the main tests in common use and 6-12 weeks for older tests. Your negative test result over a year after exposure is proof you did not have HIV at that time. Also, receiving oral sex is zero risk:  HIV has never been scientifically documented to be transmitted mouth to penis.

You have been seriously over tested. Please never test again until and unless you have unprotected vaginal or anal sex with someone. There is no need!

That completes the two follow-up Q&As included with each question and so ends this thread. Thanks for the thanks. I'm glad to have helped. 
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36 months ago
also, "it would be impossible for enough blood to be transferred to cause infection in the circumstances you describe", does that mean its going to take lot of blood to have transfusion happen when i have a wound (without a needle)? 
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H. Hunter Handsfield, MD
36 months ago
*Sigh*. Yes, that is what would be required.

Very few people in the world have been infected with HIV by blood exposure, and almost all those occurred in health care settings several years ago, before testing eliminated transfusion as a means of infection. Even massive blood exposure of caregivers following vehicular accidents, war wounds, etc have almost never resulted in HIV transmission. YOU WILL NEVER GET HIV BECAUSE OF EXPOSURE TO BLOOD OR OTHER BODY FLUIDS IN DAY TO DAY LIFE OR INTERACTIONS WITH OTHER PEOPLE. Believe it!

This thread now is closed. 
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