Expert: Terry B - 2/11/2008

Question
QUESTION: At the very end of a routine blood test, right before the phlebotomist was about to remove the needle from my vein, she realized she did not have a gauze pad within her reach. Instead, she removed the needle and put pressure on the site with her finger for less than a minute.  She then removed her finger to check the site and I noticed a little bit of smeared blood around the site, but not much.  I THINK she may have had gloves on, but I was so upset by what happened that I cannot 100% remember if she was wearing gloves or not.  If she was wearing gloves, I'm assuming tha would of protected me from HIV.  However, I am sick with worry cause I keep thinking what if she didn't have gloves on and what if she was bleeding or what if there was blood from someone else on the counter that she may have touched before working on me.  I didn't actually notice any blood on her, however, I really couldn't get a good look at her finger either.  Like I said there was a little smeared blood on my arm which I thought was mine, but I keep thinking what if it was a little of hers.  What are my chances of getting HIV this way? Could blood from her enter such a tiny pin hole on my arm? My PCP told me that I was extra protected because I was bleeding and the blood coming out would have protected me from anything getting in, if in fact she was bleeding.  Is that true?  Would there have had to be alot of blood on her to be a risk to me?  I'm pregnant and do not want to be under all this stress for the baby.  I'm sorry for this being so long and taking up your time, I'm just out of my mind scared.

ANSWER: Dear Laz:

Peace.  The person at risk in this instance was the health care worker who drew your blood.  Your Primary Care Provider is also right about the reduction in your risk because your blood was coming out - not going in (that is, your blood flowing outward after the needle was withdrawn, versus the needle being contaminated before entry to your skin and bloodstream).  The chances of their being sufficient blood, semen, or vaginal secretions on the finger of the health care worker so as to place you at risk is nil.

All that being said, I wish you peace, the very best with your pregnancy, and good health for you and your loved ones.

Terry

---------- FOLLOW-UP ----------

QUESTION: Thank you so much for your quick response, you have really helped to put my mind at some ease.  One last question I did want to ask is if I were to get an HIV test just to prove to myself that everything is ok, would you consider 3 month a long enough time period to give me a conclusive result?  Also, would pregnancy in any way affect my test result using te standard antibody test? For example, would it cause the antibodies to take a longer time to show in my blood? Also, I thought I read somewhwere that pregnancy can increase the chances of false positive result.  I wasn't sure if that had any truth to it.  I'm truly hoping to just forget about this and put it behind me and not even feel the need take the test, but in case I need the proof, I was just curious about the testing.

Answer
Dear Laz:

Peace.  Yes, pregnancy can and sometimes does interfere with the standard ELISA/Western Blot test - false positives and the dreaded "indeterminant" - and would cause you unneeded anxiety and stress.  I see absolutely no risk to you in the incident you describe and advise against testing for those reasons.  

Talk with your Primary Care Provider about this if you think you might have other potential exposures, and be aware that up to a 10% 'false positive' exists for some of the other tests as well.  S/he can get the latest clinical information from her local AIDS Education and Training Center.

Again, I wish you and yours the best.

Sincerely,

Terry