[Question #974] 8 years old HIV risk at school ? very worried brother

88 months ago

Hello Doctors Im 26 years old from Rio ,Brazil and i have a 8 years old brother i will describe a very unusual situation that happened to my brother  3 weeks ago at school , i was not present because i was in vacation in Europe , so 3 weeks ago my parents went to get my 8 years old brother in school at the time school finish here at 5 pm , he found my brother scared and wet , he went to talk to the principal and he said that a older children have urinated on him on school grounds just before he was about to live he could not idetify the boy (of course he was scared that the boy would bet him) when i arrived i confronted the principal a woman and i told my parents to remove him from school because this is a public school in Brazil in Brazilian public schools 85% or more of students are poor people normally from favelas and sometimes we found kids involved with gangs and such so its not anormal for a 10 year old to think like a 15 years  old but let me go direct to the facts .As i arrived and my brother knew that he would not study on that school anymore but go to a private school , i had a conversation with him and he explained me that he was in the bathroom cleaning his hands when the older kid that he identified by name between 11-12 years old entered the bathroom exposing his penis  and urinating on his stomach , legs and chest . he said that he could not confirm if some urine have hit his face but he says that probably not or very litlee on the cheecks , i asked by father and he says at the day mostly his coat was weat but not soaked , he said that his face was also weat he said that was tap water because he was cleaning himself as he was disgusted with the situation . 

Do you believe theres is any HIV or STD risk involved in the scenario i described above ? 

its possible that some urine have splashed in his eyes and month , i know its dificult but i cant know if that could contain blood .its unlikely but a possibility 

Edward W. Hook M.D.
88 months ago
Welcome to the Forum.  I will be pleased to comment on this sad situation.  Although being urinated on is a most upsetting experience, there are do data to suggest that, even if the boy who urinated on your brother had an STI or even HIV, there is no risk for infection.  This is true even if the urine got on his face and eyes, I. His mouth, or on a recent cut or scrape.  Still not risk.  From an STI or HIV perspective, there is no risk and no need for testing.

I should add that it is also most unlikely that the boy who urinated on your brother had HIV.  

I hope this comment is reassuring to you.  EWH
88 months ago
Thanks for your answer Dr Hook . its very reassuring

i was worried of the possibility to the boy have HIV or a sti ( even Hep C ) because the boy was a poor Brazilian not discriminating poor people but poor people in Brazil live in very diferent standarts of ''poor'' people in America and europe those people here in Brazil would not be considered poor . many poor Brazilians will live without proper clean water and sewer system many young children walk bare foot in mud with sewer etc and most of this people that live in the soo called favelas think of HIV like in America in the early 1980's  of beeing a gay disease only , so when they are offered HIV testing they get offended as that would be a gay disease on their minds . thats why i doubt that the boy (for the young age ) and the parents have ever beeing tested for HIV , i read that HIV tests became mandatory in Brazil for pregnant women but i cant find when it began some say around 15 years ago .

There is also no HIV risk even if the urine contained blood and have entered my brothers eyes , mounth etc ? 

its dificult to get the facts when you talk to a 8 years old but my father could not see visible blood if there was blood that would be urine with traces , to be honest i with 26 years old have never urinated blood but as i said if this kid have a bad healthy because of live conditions .

also if this boy 11-12 years old had born with HIV would be apparent by now or people could just not know ?

this is a very sad situation even with no risk , the boy have not beeing punished by the school i heard from the principal that im use with American and European standarts as i have spent many years in this places and children urinate in each other is not something bad in Brazil certailtly it is i have beeing raised in Brazil and i know its not normal and nobody never urinated on me in schools .

i read that golden showers are a risk regarding to HIV only if visible blood is present ,that situation  would be similar to a golden shower ?

i appreciate your patience .

Edward W. Hook M.D.
88 months ago
Even among poor, untested persons in Brazil, most people still do not have HIV and even in the unlikely situation that this person had HIV, exposure to urine as described is not infectious.

If the boy you describe had been born with HIV and not tested, he would have most likely have died from AIDS long before he reached the age of 10 or 12.

Finally, to my knowledge, there are no good, well proven cases of HIV which have resulted from "golden showers".  The suggestion that this might occur is the sort of myth that is all too common on the Internet but is not fact.  EWH
88 months ago
Thank you for your answer again Dr Hook as this will be the end of our 2 follow ups i will just ask you my final doubts 

i understand its very unlikely that the boy that urinated on my brother had  HIV and i also agree with you on that .

my mother have contacted a infectious diseases specialist here in Brazil and she said  about the same as you that there was no risk even if urine have hit his face and had traces of blood ( what she said was almost impossible ) than she said to my mother that HIV testing was not required but i believe she have to had contacted the infectious disease specialist immediately not two weeks later because if that was the case PEP could be offered .

Do you believe PEP would be offered on that case or that is just not possible ?

I have discussed with my father and he also believe there is no problem to do a HIV test on my brother for peace of mind but my mother is beeing against it as she says the specialist she contacted said there was no need , well i cant do anything as this is not my son only my brother and i get concerned as he were my son .

If it was your son on that situation would you test him for HIV or would just not worry about it ?

i read on a old post discussed by you or DR HHH  i cant recall on medhelp that urine is sterile and actually have  antimicrobial and anti viral substances so even if this urine contained blood , still no risk ?

thank you very much for the help .
Edward W. Hook M.D.
88 months ago
If I saw a patient who had the experience you had, I would not recommend PEP and if they requested PEP I would not be willing to prescribe it.  I also agree with the specialist who your mother spoke with that there is absolutely not need for testing in this situation.  The situation you described. Was a no risk event.

As you know, this is my third response to your questions.  As per Forum guidelines, this thread will be closed later today.  EWH