Infection Risks: Minor Wounds and HIV Exposure

Infection risk

Hello, doctor.
Yesterday, I had a small wound on my fingertip caused by a sharp object, but it has stopped bleeding by today, so it can be considered an overnight wound.
However, today I came into contact with a person living with HIV who has a wound on their hand, but it was not bleeding and there was no unknown fluid; I just can't tell if it has scabbed over.
I am concerned about the risk of infection because I read online that only open wounds that are fresh and have a significant amount of bodily fluid pose a risk of transmission.
I'm not clear on the definition of a wound, so I would like to ask if there is a possibility of infection through the wound I described.
Thank you, doctor.

Wang, 20~29 year old female. Ask Date: 2021/12/29

Dr. Liao Zhongxin reply Internal Medicine

A.
According to data from the Centers for Disease Control (CDC) in Taiwan, HIV is transmitted through contact with blood or bodily fluids (such as semen, vaginal secretions, and 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 using condoms and water-based lubricants correctly throughout the entire act) with an HIV-infected individual, including oral, anal, vaginal intercourse, or other forms of bodily fluid exchange, all carry a risk of HIV infection.
2.
Blood transmission: (1) Receiving or coming into contact with HIV-contaminated blood or blood products.
(2) Sharing needles (including syringes and diluents) or sharp instruments such as razors and toothbrushes with an HIV-infected person.
(3) Receiving an organ transplant from an HIV-infected individual.
3.
Vertical transmission from mother to child: An HIV-infected mother can transmit the virus directly to her newborn during pregnancy, childbirth, or breastfeeding.
Assisting an injured person who is bleeding poses no risk of HIV transmission as long as the helper is not infected with HIV.
If the injured person is HIV-positive, the risk of transmission is negligible if the helper's skin is intact.
If there are open wounds, the chance of HIV infection through broken skin or mucous membranes is less than 0.1%.
B.
According to the Taoyuan Hospital HIV Care Center website, regarding Myth Two: If an HIV-infected person has an open wound, touching the area around that wound could potentially transmit HIV.
Many people imagine viruses or bacteria as cartoonish villains with sharp eyes and grotesque shapes, lurking in corners of the environment, such as on ceilings, tabletops, doorknobs, or even splashes on the roadside, waiting to jump onto a human host and launch an attack.
This cartoon model applies to many bacteria but is entirely 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, rendering it incapable of being a lurking villain.
Therefore, even if an infected person has an open wound that comes into contact with straws, cup rims, toilet seats, or clothing, 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 circumstances, there have been cases where individuals were infected with 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 do not fully meet the criteria of "large area," "large amounts," and "immediate," there is essentially no need to worry about HIV transmission.

Reply Date: 2021/12/29

More Info

When it comes to understanding the risks of HIV transmission, especially in the context of minor wounds and potential exposure, it is essential to clarify several key points based on medical knowledge and current guidelines.

Firstly, HIV (Human Immunodeficiency Virus) is primarily transmitted through specific bodily fluids such as blood, semen, vaginal secretions, and breast milk. The virus is not transmitted through saliva, sweat, urine, or casual contact. This means that the risk of transmission through everyday activities, such as touching surfaces or objects that may have come into contact with these fluids, is extremely low.

In your scenario, you mentioned having a minor wound on your fingertip and then touching someone who is HIV positive, who also had a wound but was not actively bleeding. The critical factors to consider here are the nature of your wound and the condition of the other person's wound.
1. Nature of the Wound: Minor wounds, especially those that are not actively bleeding and are not deep, generally do not provide a sufficient entry point for the virus. For HIV to be transmitted, there typically needs to be a significant exposure to a large quantity of the virus, which usually occurs in situations involving direct blood-to-blood contact, such as sharing needles or through unprotected sexual intercourse.

2. Condition of the Other Person's Wound: If the other person's wound was not actively bleeding and was scabbed over, the likelihood of HIV transmission is further reduced. HIV is a fragile virus that does not survive long outside the human body and is particularly vulnerable to exposure to air. Once exposed to air, the virus begins to degrade rapidly, making transmission through dried or scabbed wounds highly unlikely.

3. Risk Assessment: The Centers for Disease Control and Prevention (CDC) and other health organizations emphasize that casual contact, such as touching someone with a wound, does not pose a significant risk for HIV transmission. The risk is considered negligible unless there is direct contact with fresh, infected blood.

4. Testing and Anxiety: If you are still concerned about potential exposure, it is advisable to consult with a healthcare provider. They can provide guidance on whether testing is necessary based on your specific circumstances. Generally, if there is no direct exposure to infected bodily fluids, the need for testing may not be warranted. However, if you experience any symptoms or have ongoing concerns, seeking medical advice is always a good practice.

5. General Precautions: In everyday life, it is wise to practice good hygiene, such as washing hands regularly and avoiding contact with open wounds or blood. If you have a wound, keeping it clean and covered can help prevent infections from other pathogens, even if the risk of HIV is low.

In summary, while it is natural to feel anxious about potential exposure to HIV, the specific scenario you described does not present a significant risk for transmission. Understanding the modes of transmission and the conditions under which HIV is spread can help alleviate concerns and guide appropriate actions. If you have further questions or need reassurance, consulting a healthcare professional is always a prudent step.

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