Expert: Gorkey Gourab - 3/31/2009

Question
QUESTION: Hi,

An incident happened about 5 days ago that is worrying me. I had shaved off some hair from the back of my neck. I did not cut myself but the skin had become red like it sometimes becomes after shaving and it was feeling a little irritated. If I rubbed my fingers over the area it would hurt a little.
I was trying to figure out what happened and so I asked my roommate to check and see if I had got any rashes on my skin. He felt the area with his fingers and said that there was not cut although the skin was reddissh.

I then noticed that my roommate was occasionally rubbing a wound on his arm with his fingers. It was a partially healed open wound that was not actively bleeding at that time. However, if you looked at it you could see that it was reddish and a little bit wet.

I am little bit concerned about this occurance. As my friend was rubbing his wound just before I asked him to examine the skin on my neck (say just 20 seconds before that). Could this be a possible risky situation for HIV transmission? I know about the main ways in which HIV can be transmitted but it can also be transmitted from one wound to another (via blood). Although I am unsure if there would be sufficient blood/fluid in this case.

About my friend I can say is that he is of unknown HIV status. He has been quite careless with some things and I have been urging him from quite some time to get tested but he refuses to do so and continues to remain careless.

Could you please provide your opinion and advise on this as this has started to stress me a lot.

question


ANSWER: Hello there!

Thanks for the nice question. I think the following facts may help you out:

HIV can be absorbed directly across any mucous membrane, reddish skin/wound or urethra for example. An infection, inflammation, or cut, etc. is not must. HIV can and does permeate intact uninfected mucous membranes (Frascino. J. R., 2006). Therefore, HIV can be transmitted this way.

Now, let’s come to your case. HIV survives fairly shorter period (few seconds) without receptor. As you are not aware about your friend’s HIV status, and the contact was made after 20 seconds or more; based on most of the literature I’ve gone though, there’s no possibility of HIV transmission in this case.


Best regards,
Gorkey

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

QUESTION: Hi Gorkey,

"HIV can be absorbed directly across any mucous membrane, reddish skin/wound or urethra for example. An infection, inflammation, or cut, etc. is not must. HIV can and does permeate intact uninfected mucous membranes (Frascino. J. R., 2006). Therefore, HIV can be transmitted this way.
"

This would mean that I am actually at risk. Should I get tested ?


I am concerned because the skin on the back of my neck was slightly damaged. During the shaving at one point the razor was applied with a little bit more pressure and it had grazed the skin which had subsequently become reddish and I would feel a buring sensation if I touched it with my fingers. However, I did not bleed.
I can say that it was not bleeding actively, i.e. when I touched it with my fingers no blood came on my fingers. However, it was grazed and had a few minor scratches (and maybe little cuts like little red lines that hurt a little). I do not know the exact extent of the skin damage but one day after that little red spots (small lines) appeared that indicate that there was a minor abrasion.

My friend had a wound(not a scratch) that was open and was partially healed. Partially meaning that blood was not dripping out (it was clotted) but there was no skin covering the wound and it appeared to be watery and reddish. My friend was rubbing this wound with his fingers and almost immediately after that he touched my infected skin for some time.

So, I would just say that the top layer was interrupted. However, it was not a deep cut and blood did not flow out of it when I was grazed with the razor. Also, my friend touched the area atleast 15-20 minutes later (after I returned from the Saloon).

Could fluid from my friend's semi healed open wound infect the skin on my neck (as he was rubbing his wound just before he touched my infected skin)? Is testing warrented for this?

Thank your for all your help and I am anxiously waiting for your reply.

quesion

Answer
Welcome back!
I read your reply line by line. If it's 15-20 minutes later, then there's no risk of HIV transmission, that's for sure. However, there's a risk of STI transmission, provided that your friend is infected with STI.
Sincere regards,
Gorkey