[Question #9901] HIV scare

28 months ago

We work with residents to help them in the community- we went into bath and body works and my coworker was smelling soaps with a resident. He was helping her pick out scents. For some reason they put the soap on a paper towel that was near the sink where you wash your hands to test out the soaps. The resident had me smell the soap on the paper towel. Later I found out he was HIV +. I am concerned as I don’t know if he smelt it before me and I wasn’t walking around with them so I don’t know what they were doing. When I smelled the paper towel, I didn’t see any blood or anything that looked strange. I am scared as I’m worried if his mucus got on the paper towel or any tinges of blood I couldn’t see and I smelled it and it got into my nose or mucous membrane. I am pretty positive it didn’t touch my nose but I’m scared if I breathed in anything if something could happen. I was told by CDC and AIDS Vancouver that this was no risk. However, my PCP made me anxious as he said low risk and then impossible. I’m not sure if he was just stating like in general this is low risk without thinking. I’m just really worried to get tested and he said to test at 3 and 6 months. What is the testing recommendations? He is probably being overly conservative or trying to ease my fears bc I asked about the 6 month test as some resources still say that. Isn’t that outdated? Please advise.

Edward W. Hook M.D.

28 months ago

Welcome to the Forum. Thanks for your question. I understand the on occasion when one finds that they have been around a person with HIV and did not know it that questions can arise and I hope that my comments will be helpful to you.

HIV is more difficult to transmit than many people believe. It is transmitted only through unprotected penetrative sexual contact or sharing needles with an untreated infected person. Even the, less than 1% and most typically far less than 1% of such exposures result in infection. The events you describe were zero risk. HIV is not spread through causal contact with a surface contaminated by infected secretions (including mucus) or by saliva. No one has ever been infected through the sort of exposure that you describe and you certainly are not going to be the first.. Further, soap would inactivate any virus present. It sounds to me like your PCP was being cautious, perhaps overly so. There is no medical or scientific reason for concern or testing. I suspect that his recommendation to test reflected his sense that a negative test would provide you with peace of mind and forgot that in the interval of waiting for a test would be anxiety producing.

Again, this was a no risk event with no medical or scientific reason whatsoever for testing. Please don't worry. If any part of this response is unclear or you have additional questions, please don't hesitate to use your up to two follow-ups for clarification. EWH

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28 months ago

Thanks so much Dr.Hook! Can you please explain why no risk? Let’s say worse case scenario that my nose did make contact with any fluids, mucus (possibly with tinged blood) this still wouldn’t be a risk? Is it because I had no direct contact, if there were fluids that I smelled, they would be exposed to air? I don't recall seeing anything suspicious on the paper towel, but the unknown scares me. If he smelled it, I guess it would be his nose droplets if anything.

Also, I’m scared because someone on Quora said if you got trace blood in your nose, not just visible blood then this could be a risk.

Also can HIV lie dormant and not show up on tests or is this not possible?

Edward W. Hook M.D.

28 months ago

As I said above, "HIV is not spread through casual contact with a surface contaminated by infected secretions (including mucus) or by saliva. No one has ever been infected through the sort of exposure that you describe and you certainly are not going to be the first.. Further, soap would inactivate any virus present." HIV is not transmitted by contact with contaminated inanimate surfaces including tissues, toilet seats, counter tops, etc. HIV is not transmitted in saliva or mucus. HIV becomes non-infectious on contact with the environment outside of the body. HIV is not spread through inhalation. HIV is ONLY spread through DIRECT penetrative sexual contact or injection of infectious materials from an untreated HIV infected person.

I'm not sure what Quora is but the statement you report is incorrect. Please do not search for answers on the internet. Much of what is there is icorrect and misleading, either because it is out of date, taken out of context, or just plain wrong.

You need to put these concerns aside. EWH

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27 months ago

Hi Dr.Hook! Thank you so much for putting my fears at ease. I tend to have irrational thoughts and must add I have OCD. I was over this HIV fear but this event (smelling) really triggered me. Today I was concerned because I was pouring one of the soaps I got that day in another bottle and scraped my hand on the plastic circle that attaches the dispenser to the soap. I’m concerned if that guy who was confirmed HIV + scraped his hand first on the plastic in the same spot and blood was present (which is far fetched). Granted I don’t see any broken skin and it was 6 weeks ago (this upcoming Tues) when I bought the soap. Any CONCERNS here even though it sounds like no because you say no with inanimate objects and air exposure. Also, can HIV lie dormant and once you get a conclusive test, can you trust the results? Do I need to worry about the cut off numbers or just that it says non-reactive when getting tested? Will my test be conclusive at 3 months? I’m so thankful for you and always trust your advice.

Edward W. Hook M.D.

27 months ago

I suspect that you understand intellectually that the situation you describe was NO RISK for HIV or any other blood borne infection but that your OCD has gotten the better of you. No concerns, no need for testing.

Any value below the cut-off numbers is negative. These values from day to day for reasons related no the test, no the specimen from the person being testing.

Focus on you OCD.

EWH

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