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Expert: - 2/6/2011


Question
Hi Mr Gorkey
Two questions
1.i visited a dentist recently for teeth cleaning, the hygenist during the dental cleanup took out the water suction nossle and wiped it with a paper napkin and put it back in the mouth,now what it it was an old paper napkin used on a pevious patient that she used, i asked her but she said everything including the gloves were new and equipment sterilised and she used a new paper napkin,but i did not see her pulling out a new one, maybe she did and was holding the equipment used to clean the teeth with it,
now just maybe if the paper tissue was a used one does it pose any HIV transmission risk?
2 After a massage at a spa went in for a shower, there were cloth slippers so you have to have a bath barefeet, now what if there was some semen lying on the floor and i stepped on it, no cuts on my feet but have slightly broken dry skin on the heel or broken heel (non bleeding)dry broken skin..there was at least 1 hr 30min since anyone had used the shower.. would there be any transmission risk in this case.
keep up the good work Mr Gorkey.

Answer
Hello Jacki,

Welcome back.

In first case, I see no risk of HIV transmission. Transmission of HIV in a healthcare setting is extremely rare. All health professionals are required to follow infection control procedures when caring for any patient (universal healthcare precautions) to avoid any sort of infectious disease transmission. And in your case, there is no risk since it’s about paper napkin. Given the fact that HIV survives fairly short period receptor and the issue of universal healthcare precautions, there is no risk involved here.

Coming to second case, first I’ll focus again on the survival period outside receptor. Other major issues include that you did not had cuts on your feet and viral load (generally speaking, the concentration of virus needed to make one infected) is extremely low in these settings (showers at spa, swimming pools etc.). Therefore, no risk is involved here either.

Sorry for my delayed response.

I just want to convey may gratitude for the last words you wrote. Thanks.

Regards,
Gorkey

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Gorkey Gourab

Expertise

Social and behavioral issues related to HIV transmission, sexually transmitted infections, Human Rights issues, rights of marginalized populations, gender and sexuality, research design and analysis related social & behavioral issues, , computer assisted qualitative data analysis and data management (using ATLAS.ti, ANTHROPAC, NVivo 8)

Experience

Specialized in Medical Anthropology. Working on Social and behavioral studies related to HIV transmission as well as Human Rights issues. Specialization in gender, sexuality, masculinity, behavioral studies related to HIV transmission. Qualitative research, programmatic and M&E experience with MSM, hijra (TG), indigenous groups, female sex workers for more than 7 years.

Organizations
International Center for Diarrhoeal Disease Research, Bangladesh (icddr,b) as Manager - M&E (Qualitative) with Center for HIV and AIDS

Publications
International peer-reviewed journals & technical papers: (1) Khan, S. I., Hussain, M. I., Parveen, S., Bhuiyan, M. I., Gourab, G., & Bhuiya, A. (2009). Living on the extreme margin: Social exclusion of the hijra in Bangladesh. Journal of health, population and nutrition. (2) Khan, S. I., Hussain, M. I., Gourab, G., Parveen, S., Bhuiyan, M. I., & Sikder, J. (2008). Not to stigmatize but to humanize sexual lives of the transgender (hijra): condom chat in the AIDS era. Journal of LGBT Health Research (Special issue: issues on male sexual behaviors and HIV risk in South Asia). Working papers: (1) Khan, S. I., Gourab, G., Ahmed, T., Sarker, G. F., Chowdhury, F. K., Ghosh, S., et al. (2009). Understanding the operational dynamics and possible HIV interventions for residence-based female sex workers in two divisional cities in Bangladesh. Dhaka, Bangladesh: NASP, Save the Children USA and icddr,b. Presentations in scientific meetings and conferences: (1) Khan, S. I., Hussain, M. I., Gourab, G. & Azim, T. (2011, 16 March 2011). Use of a new approach to count and access diverse groups of hijra for scaling up HIV-preventions services in Bangladesh. Poster presented at the 13th Annual Scientific Conference (ASCON XIII), Dhaka. (2) Khan, S. I., Pasa, K., Gourab, G., & Islam, A. (2007). Indigenous populations of Bangladesh: Living with risks and vulnerabilities to STIs/HIV. 8th International Congress on AIDS in Asia and the Pacific (ICAAP). Colombo, Sri Lanka.

Education/Credentials
MSS (Anthropology), University of Rajshahi, Bangladesh

Awards and Honors
The Vanderbilt-UAB Fogarty International Center AIDS International Training and Research Program (AITRP)Scholarship for the training on HIV-AIDS related qualitative data analysis and manuscript writing (Center for Global Health, Vanderbilt University, Nashville, TN, USA)

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