the Risks of Skin-to-Skin Contact and HIV Transmission

Wound-to-wound contact?

Hello, doctor.
I would like to inquire about the following:
1.
A few days ago at a gathering, a pole dancer hugged me and rubbed her chest against my cheek.
I was concerned because I have acne and some shaving cuts on my face, and she also had some wounds on her chest.
Would contact between our wounds pose a risk of HIV infection? Is it true that for infection to occur, both parties need to have large, deep wounds with significant bleeding? Is it only when both individuals are bleeding profusely that there is a risk of transmission? I have read online that minor injuries in everyday life do not lead to infection, so would contact between acne or shaving cuts and blood from a wound not pose a risk? Am I at risk of infection from this encounter?
2.
If I want to get tested for HIV, how long after the potential exposure should I wait before getting a blood test to completely rule out infection?

Nìmíng, 20~29 year old female. Ask Date: 2019/08/16

Dr. Hong Yuanbin reply Internal Medicine

The contact you described does not pose a risk of infection, and there is no need for blood tests to rule it out.
Recommendations should focus on preventing unsafe sexual behaviors rather than assuming whether everyday activities could lead to infection.

Reply Date: 2019/08/16

More Info

When it comes to understanding the risks of HIV transmission through skin-to-skin contact, particularly in the scenario you've described, it's essential to clarify several key points regarding how HIV is transmitted and the conditions under which transmission can occur.

1. Transmission Routes: HIV is primarily transmitted through three main routes: unprotected sexual intercourse, sharing needles or syringes, and from mother to child during childbirth or breastfeeding. The virus is present in certain bodily fluids, including blood, semen, vaginal fluids, rectal fluids, and breast milk. However, it is not transmitted through casual contact, such as hugging or touching, unless there is direct exposure to infected bodily fluids.

2. Skin Contact and Open Wounds: In your situation, if both you and the individual had open wounds, there is a theoretical risk of transmission, but it is generally very low. For HIV to be transmitted through skin contact, several factors must be present:
- Presence of HIV in the fluid: The fluid must contain a sufficient viral load of HIV.

- Type of contact: Direct contact between the infected fluid and an open wound or mucous membrane is necessary.

- Depth and size of wounds: Superficial cuts, such as those from shaving or acne, typically do not provide a conducive environment for HIV transmission. The risk increases significantly if both parties have deep, bleeding wounds.

3. Infection Risk Assessment: In your case, if the contact was brief and involved only minor skin abrasions (like those from shaving or acne), the risk of HIV transmission is extremely low. The virus does not survive long outside the human body; it becomes inactive quickly once exposed to air. Therefore, unless there was significant bleeding and direct contact between the wounds, the likelihood of transmission is minimal.

4. Testing for HIV: If you are concerned about potential exposure, it is advisable to get tested. The window period for HIV testing varies depending on the type of test used. Generally, it is recommended to wait:
- Antibody tests: 3 to 12 weeks after potential exposure.

- Antigen/antibody tests: 2 to 6 weeks after exposure.

- Nucleic acid tests (NAT): 10 to 33 days after exposure.

5. Preventive Measures: To minimize the risk of HIV transmission in any situation, it is crucial to practice safe behaviors. This includes using protection during sexual activity, avoiding sharing needles, and ensuring that any cuts or abrasions are properly cared for to prevent exposure to potentially infected bodily fluids.

In summary, while there is a theoretical risk of HIV transmission through direct contact between wounds, the actual risk in your described scenario is very low, especially if the wounds are minor and not actively bleeding. If you have further concerns or symptoms, consulting a healthcare professional for personalized advice and testing is always a good practice.

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