Can STDs Be Transmitted Through Small Wounds? the Risks

The possibility of sexually transmitted infections being transmitted through wounds?

Hello, doctor.
A few days ago, I asked a question: During a high school experiment, I used a clean, newly opened lancet to prick my finger, resulting in a small wound that bled a few drops.
If the blood had not completely dried and my wound came into contact with someone else's wound or blood, could it transmit any bloodborne infections (such as HIV)? (During the experiment, we did not share any needles.) My current concern is whether HIV could be transmitted through the small wound caused by the lancet if the other person is infected.
I read online that a large wound and significant blood exposure are typically required for transmission.
Is that correct? Thank you for your patient response.

Xiao Xuan, 10~19 year old female. Ask Date: 2021/12/28

Dr. Liao Zhongxin reply Internal Medicine

A.
According to data from the Centers for Disease Control (CDC) in Taiwan, the Human Immunodeficiency Virus (HIV) is transmitted through contact with blood or bodily fluids (semen, vaginal secretions, breast milk) that come into contact with mucous membranes or open skin wounds.
The transmission routes include: 1.
Sexual transmission: Engaging in unprotected sexual activities (not consistently using condoms and water-based lubricants) with an HIV-positive individual, including oral, anal, vaginal intercourse, or other forms of bodily fluid exchange, carries a risk of HIV infection.
2.
Blood transmission: (1) Receiving or coming into contact with HIV-contaminated blood or blood products.
(2) Sharing needles (needles, syringes, diluents) or sharp objects like razors and toothbrushes with an HIV-positive person.
(3) Receiving an organ transplant from an HIV-positive individual.
3.
Vertical transmission from mother to child: An HIV-positive mother can transmit the virus directly to her newborn during pregnancy, childbirth, or breastfeeding.
Assisting an injured person who is bleeding does not pose a risk of HIV transmission as long as they are not infected with HIV.
If the injured person is HIV-positive, and our skin is intact, there is no risk of HIV infection.
If there is a wound, the chance of contracting HIV through contact with broken skin or mucous membranes is less than 0.1%.
B.
According to the Taoyuan Hospital AIDS Care Center website: Regarding Myth Two Response https://www.tygh.mohw.gov.tw/?aid=602&pid=150&types=&page_name=detail&iid=12667, if an HIV-positive person has a wound, touching the area around their wound could potentially transmit HIV.
People often imagine viruses or bacteria as cartoonish villains with sharp eyes and grotesque shapes, lurking in corners of the environment, such as ceilings, tabletops, doorknobs, or even splashes of water on the street, waiting to jump onto a human host and launch an attack.
This cartoon model applies to many bacteria but is completely inaccurate for HIV.
HIV cannot survive outside the human body; a drop of blood exposed to the environment will have its HIV virus die within minutes, unable to act as a lurking villain.
Therefore, even if an infected person's wound comes into contact with straws, cup rims, toilet seats, clothing, etc., as long as you do not "immediately" touch those surfaces, there will be no HIV present, and there is no need to worry about transmission.
In very rare extreme cases, there have been instances where individuals contracted HIV after a car accident due to immediate contact with a large volume of blood from an injured HIV-positive person.
The key factors are "large area" wounds, contact with "large amounts" of blood, and "immediate" contact.
In everyday life, even if an infected person has a wound, as long as the conditions of contact with the wound and blood do not fully meet the criteria of "large area," "large amount," and "immediate," there is essentially no need to worry about HIV transmission.

Reply Date: 2021/12/28

More Info

When it comes to the transmission of sexually transmitted diseases (STDs) through small wounds, it's essential to understand the mechanisms of how these infections spread, particularly in relation to bloodborne pathogens like HIV.

Firstly, HIV (Human Immunodeficiency Virus), which can lead to AIDS (Acquired Immunodeficiency Syndrome), is primarily transmitted through specific bodily fluids, including blood, semen, vaginal fluids, and breast milk. For transmission to occur, there must be a sufficient quantity of the virus present in these fluids, and there must be a route for the virus to enter the bloodstream of another person.

In your situation, where a clean, new needle was used to prick your finger, and then that small wound came into contact with another person's wound or blood, the risk of HIV transmission is generally considered low, especially if the wounds are small and not actively bleeding. Here are several factors to consider:
1. Size of the Wound: Small wounds, such as the one you described, typically do not provide a significant entry point for the virus. Larger wounds or those that are actively bleeding pose a higher risk because they can allow for a greater volume of infected blood to enter the bloodstream.

2. Amount of Blood: The amount of blood that comes into contact with the wound is crucial. If only a few drops of blood from an infected person were to come into contact with your small wound, the likelihood of transmission remains low. HIV is not highly infectious outside the body, and it does not survive long once exposed to air.

3. Viral Load: The presence of the virus in the blood of the infected person is also a critical factor. If the person has a high viral load (i.e., a high concentration of the virus in their blood), the risk of transmission increases. Conversely, if the person is on effective antiretroviral therapy and has an undetectable viral load, the risk of transmission is significantly reduced.

4. Immediate Contact: The timing of the contact matters as well. If the blood was still wet and fresh, the risk is higher than if it had dried. However, even fresh blood would need to enter your bloodstream through a significant wound to pose a real risk.

5. Other Factors: Other STDs, such as Hepatitis B and C, can also be transmitted through blood, but similar principles apply regarding the size of the wound and the amount of blood involved.

In summary, while there is a theoretical risk of transmission of bloodborne pathogens through small wounds, the actual risk in your scenario appears to be quite low, especially given that you did not share needles and the contact was limited. However, if you have any concerns or if you notice any symptoms such as fever, fatigue, or unusual rashes, it would be prudent to consult a healthcare professional for further evaluation and possibly testing.

For peace of mind, consider discussing your concerns with a healthcare provider who can offer personalized advice based on your specific situation and may recommend testing if deemed necessary. Regular testing for STDs is a good practice, especially if you have concerns about potential exposure.

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