HIV and HBV Transmission Risks: A Guide for Concerned Partners

Inquiry about the transmission routes of HIV and HBV?

Hello Dr.
Hong, I would like to ask you a question on behalf of my girlfriend.
She has a small wound on her toe due to paronychia.
Last night, she called me and mentioned that while she was on her way home, a worker passed by her with dried blood on his elbow and spat in her direction while riding his bike.
She is worried that she might get infected with a disease because of this.

I have already explained to her that the man had a bandage on, so there shouldn't be any direct contact.
Furthermore, my understanding is that even if he is a carrier, the likelihood of my girlfriend getting infected is very low since there was no direct contact with blood.
I also believe that dried blood would lose its infectious capability quickly, and as for saliva, I think it’s even less likely to transmit any virus, as I have not heard of saliva being a common route of transmission.
As a pharmacy student currently engaged in remote learning, I find myself in a bit of a bind.
My girlfriend is still studying in Taichung, and despite my explanations last night, she remains anxious.
This morning, she called me again expressing her fears.
I also consulted some of my former high school classmates, and they said she is overthinking it, but she insists that my classmates are still students and not actual doctors.

I feel quite helpless and decided to reach out to you for assistance in addressing her concerns.
Otherwise, I might have to suggest she see a mental health professional, as she has become increasingly anxious since the pandemic began, often asking me about various pneumonia symptoms.
Of course, I am hesitant to suggest she see a mental health specialist just yet.

I apologize for bothering you during such a busy time at the hospital, and I appreciate your help! Thank you!

Hsiang, 20~29 year old female. Ask Date: 2020/04/17

Dr. Hong Yuanbin reply Internal Medicine

Hello, the viral load of HIV in saliva is very low, so transmission does not occur through saliva contact, nor does it occur through contact with wounds.
The primary mode of HIV transmission is still through sexual intercourse, so you can reassure her about this.
Thank you for your question.

Reply Date: 2020/04/17

More Info

Understanding the risks of HIV and HBV transmission is crucial, especially for individuals who may have had potential exposure to these viruses. Your concerns regarding your girlfriend's situation are valid, and it's important to clarify the transmission routes and the associated risks.

Firstly, let's address the specific scenario involving your girlfriend and the worker. The primary modes of HIV transmission include unprotected sexual contact, sharing needles, and from mother to child during childbirth or breastfeeding. In the case of HBV (Hepatitis B Virus), transmission can occur through contact with infectious body fluids, including blood, and through sexual contact.
1. Dry Blood and HIV: When it comes to HIV, the virus does not survive long outside the human body. Once blood has dried, the likelihood of HIV being transmitted is extremely low. The virus becomes inactive when exposed to air, and studies suggest that it cannot be transmitted through dried blood. Therefore, even if the worker had dried blood on his elbow, the risk of transmission to your girlfriend through casual contact is negligible.

2. Saliva and HIV: Regarding saliva, it is important to note that HIV is not transmitted through saliva. The concentration of the virus in saliva is significantly lower than in blood, semen, or vaginal fluids. Therefore, even if the worker spat near your girlfriend, the risk of transmission through saliva is virtually nonexistent.

3. Open Wounds and Blood Exposure: While your girlfriend has a small wound due to her condition (onychomycosis), the risk of infection would depend on direct contact with infectious blood. Since the worker's blood was dry and there was no direct contact, the risk remains very low. However, it is always advisable to keep any wounds clean and covered to prevent infections from other pathogens.

4. Anxiety and Mental Health: It is understandable that your girlfriend is feeling anxious about this situation, especially if she has a history of anxiety related to health concerns. The COVID-19 pandemic has heightened many people's fears about health and illness. Encouraging her to speak with a healthcare professional, such as a counselor or psychologist, may help her manage her anxiety more effectively.
5. Testing and Precautions: If your girlfriend remains concerned, it may be beneficial for her to consult with a healthcare provider for peace of mind. They can provide information on testing for HIV and HBV, as well as discuss any other health concerns she may have. Regular testing is a good practice for sexually active individuals, especially if there are concerns about potential exposure.

In conclusion, based on the information provided, the risk of your girlfriend contracting HIV or HBV from the described encounter is extremely low. It is essential to communicate these facts to her to help alleviate her fears. Additionally, promoting a healthy dialogue about anxiety and encouraging her to seek professional help if her worries persist can be beneficial for her mental well-being.

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