Expert: Terry B - 10/10/2008

Question
Dear Mr. Terry:
What do you think about long term being infectious of HIV absorbed on surface of cosmetic concealer stick (looks like lipstick) after application on open pimple? I used this stick of my friend to cover freshly squeezed out pimple.

Answer
Dear Ivan:

Peace. Well, as you can probably guess, I don't think there's a study of shared cosmetic products, so we're back to the basics of assessing your risk by applying some important facts.

1) Route:  You speak of an open wound - "freshly squeezed" - which would suggest a break in your body's protection against pathogens.

2) Fluid:  HIV is transmitted (outside breast feeding and medical procedures) by blood (and blood products), semen, vaginal secretions.  The drying process causes the cells in which HIV resides to fall apart - so completely dried blood, for instance, would not place you at risk.  Unfortunately for our analysis, though not deeply familiar with the product you describe, I would assume some moisture could theoretically trap infected cells - but 'long term' makes it unclear if the product had been used recently.

3) Amount: The amount of the fluid to which you are exposed increases or decreases your risk (more, greater risk; less, less risk).  While in the case of sharing injection equipment, a minute amount is of significant risk, the odds of your using a cosmetic stick with visible blood on it seem small; the odds of a blood cell containing reproducible HIV being in contact with your bloodstream through the pimple are small as well (the cosmetic covers not just the break in the skin but the surrounding skin as well, correct?)

4) Area: The smaller the area exposed, the less the risk.  Because you already describe a break in the skin in the area exposed, this factor is to be considered, but because the break is small (versus a larger wound) the risk is less.

5) Duration:  The longer you are exposed, the greater the risk.  

6) Concentration of virus:  HIV is present at greater concentrations (viral parts per mm3 of blood) at time of initial infection and late stage disease.  Medications can suppress the virus to undetectable levels, even though they can not yet eradicate HIV from the body.

7) General Health:  Persons with other infections are more likely to contract HIV in an exposure.

Lastly, to contract HIV from another person, that person need be HIV infected.

While I don't see (based on all these factors) significant risk in what you did, using other people's personal hygiene products can transmit not only HIV (razors) but other infections, and isn't good practice.

The long answer is to give you ways to assess risk in the future, not representative of deep concern that you are infected.

The best to you and yours,

Terry