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About Mark Behar
Expertise
Almost any question or concern about sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), gay men's health issues.
There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything.
Rather than trying to “prescreen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and conseqences of possibly “catching” something from someone who’s hotter than expected (pun intended!).
There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!
Experience
Family Practice PA since 1981;
Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answer STD questions submitted to their web site.
Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.
Organizations
Distinguished Fellow, American Academy of Physician Assistants; Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.;
Wisconsin Academy of Physician Assistants;
Florida Academy of Physician Assistants;
American Society of Colposcopy and Cervical Pathology (ASCCP)
Publications
Journal of the American Academy of Physician Assistants (JAPA)
Education/Credentials
Physician Assistant Certified, since 1982;
Masters in Physician Assistant Studies;
Colposcopy Recognition Award, American Society of Colposcopy and Cervical Pathology (ASCCP);
Awards and Honors
Colposcopy Recognition Award (CRA), from the American Association of Colposcopy and Cervical Pathology
Past/Present Clients
Brady East STD Clinic, Milwaukee, WI
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You are here: Experts > Teens > Health for Teens > Sexually Transmitted Diseases > Mucous membrane transmission of HIV
Expert: Mark Behar
Date: 10/14/2008
Subject: Mucous membrane transmission of HIV
Question
Hello Mark,
I was checking out at a grocery store, the cashier cut her hand and there was a smearing
of her fresh (less than a minute old) blood on the bag. I picked it up without thinking. I
know there is no risk of hiv transmission if you were to get a small amount of hiv+
blood briefly on intact skin.
My concern is what if I had a small amount of the cashiers blood on my hands (that I did
not see) and then within a minute or two, I unconsciously touched the corner of my
mouth, inner nose or rubbed the corner of my eye? THESE ARE ALL MUCOUS MEMBRANES,
and this perhaps small amount of blood that could have been on my fingers was a mere
1-2 minutes old. Is hiv testing warranted or is this not a realistic mode of mucous
membrane transmission.
A worried Mom.
Answer
Hi Stephanie,
Thanks for your question. Thankfully, mucous membrane exposures are NOT realistic modes of HIV transmission. In the worst case of occupational exposure-- getting stuck with a hypodermic needle that was just used on an HIV positive person (i.e., therefore having viable virus in fresh blood), the risk of new infection is extremely low-- less than 1% (if I recall correctly, it is 1 in 300 risk); and this may warrant occupational post exposure prophylaxis (PeP). Theoretically, if you have been drenched with fresh HIV infected blood that got in contact with the mucous membranes of your eyes, nose, or mouth, your risk would be much greater, perhaps warranting nonoccupational PeP. HIV testing is recommended only for baseline testing, and if you have had a significant risk of exposure.
One other set of occupations, that of blue collar contruction workers. Depending on what they may do, they are constantly getting cuts and scratches, touching objects on the work site, and touching other objects that had already been touched by others with such scratches. This is still a very low risk for HIV transmission and infection, although this general group may be at higher risk due to other factors-- multiple sex partners, perhaps illicit drug use, unstable economic and family lives, etc.
I don't think I would be very concerned or stressed! Good luck!
--mark
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