Expert: Terry B - 12/11/2007

Question
Hello Terry, i've searched your archives but find conflicting info regards transmission via blood cuts/sores & couldnt find anything relating to my scenario etc so hopefully you can clear this up, my problem is uptown one night there was a girl on the floor who had been in a fight as she had a burst lip, i put my hand out to help her up as everyone else just walked past, when i got into the pub i notice blood smuged onto my hand presumably off her lip(which would be fresh blood), anyhow i washed it off & thought nothing more of it until on of my friends made a comment about HIV via blood now i'm worried sick & i have just very recently tested negative.My question is i have a cut on the same hand as the blood was on, the cut is about 6 (almost 7)days old & wasn't bleeding(as far as im aware) it isn't even a deep cut, i nipped my finger with scissors when using them & even when it was done it only bled a small amount does this constitute an open wound as the top layers of skin are open therefore skin integrity has gone? I'm worried that blood could have got in but as i was uptown i didn't have a good look, once i helped the girl up i went into the pub & washed my hands, what is the risk of transmission this way & could you help me by defining open cuts, wounds & what you would class as fresh etc is mine still classed as fresh as it hasn't fully healed, you can see a pinprick or two of dried blood where its healing & the top layer is missing kinda like when you pick dry skin off also will i need to get tested again if so will 3 months be ok or should i wait 6 months?? Thank you very much for your time and if there is a post out there & i missed it i appologise for wasting your time, Again thank you for the courteous service you provide, there isn't any websites like this in the UK, all the best, UK male

Answer
Dear UK Male:

Peace.  

First, thank you on behalf of the rest of humanity for coming to the assistance of the woman in distress.  

Secondly, let me thank you for your efforts in seeing if there isn't already an answer to this question.  From my perspective, it seems to be "define intact skin" month - third question on this in as many days, some of the others private and not posted.  

My research on the question has been interesting but not especially helpful as there are differences between cuts, scrapes, abrasions, and the rate of healing, as well as variables such as when the cut occurred, how deep, how long, etc.... This indicates a need for direct examination rather than online guessing.  In absence of such an opportunity, I will provide some thoughts that might help you move forward.

The wound you describe seems to be at least partially healed, the scab and initial action of your body to stop bleeding and begin the healing process provides greater protection than if it were an open (actively bleeding or seeping) wound.  
You did well to reduce the duration of your exposure by washing your hands.  
Being splashed by her blood, and not necessarily directly on your healing cut, is less dangerous than having applied your hand to her lip to stop the bleeding.  
The probability of her being infected with HIV in the UK is well below 10% even in people at high-risk.

Adding these factors together, I would suppose that you are not infected, but if you can access a physician for testing services, there are testing panels to check for indicators of HIV and Hepatitis infection.  I would talk to your doctor or clinic and explain the situation in detail; they may or may not see this as urgently as you do, and as I mentioned, I think your risk is low.  Even in health professions, the numbers of those who were infected from a similar exposure are very, very low.

I hope this is of some help, and recommend you to http://www.avert.org/needlestick.htm which addresses some of the transmission factors, though these focus on needlestick injuries.

I wish you the best - your risk seems very very low for HIV transmission but you may want to be tested for both HIV and Hepatitis.  My assumption would be you are not infected because:
1) you were not actively bleeding,
2) you are not sure if the area was directly exposed,
3) you washed your hands afterwards,
4) the blood was a smudge (low volume)
5) you do not know the HIV or Hepatitis status of the woman

I know this doesn't provide you with the definitive answer you requested, but it does reflect my best opinion.

The best to you and yours,

Terry