Concerns About HIV Infection Risks After Encountering Blood in Elevator

Infection concerns?

Hello, Doctor Hong.
Yesterday, while I was in the elevator, I noticed a large pool of red liquid flowing from the buttons to the floor.
I later heard that someone had vomited blood inside the elevator (I did not see it happen).
I was told that the floor was covered in blood, and the person had blood around their mouth.
They were also holding a plastic bag that contained a clump of blood.
When I entered the elevator, I only saw the blood flowing from the button area to the floor and did not notice blood in other areas, so I am unsure if it had already been cleaned up.
Since there was a significant amount of blood, I am uncertain if my body, clothes, or hair came into contact with it.
At that time, I did not have any open wounds, but my hands were dry and peeling from frequent washing, and I had some acne that might have small wounds.
I would like to ask you, Doctor, if my body (including areas like my dry, peeling hands or small wounds from acne, or other uninjured areas), clothes, phone, etc., accidentally came into direct or indirect contact with the blood, is there a risk of HIV infection? If I stepped on blood on the floor (while wearing shoes), is there a risk of HIV infection? Additionally, if the blood was not from vomiting (which could be corrosive to the HIV virus due to stomach acid) but rather from a regular injury, is there still a risk of HIV infection? I would like to know if there have been similar cases of HIV infection in such situations and whether prophylactic medication is necessary.
I apologize for the trouble, and thank you, Doctor.

Niming, 30~39 year old female. Ask Date: 2022/09/13

Dr. Hong Yuanbin reply Internal Medicine

Hello, based on the situation you mentioned, you are concerned about the risk of contracting HIV from contact with blood in an elevator.
However, since you did not have mucous membrane exposure or direct contact with fresh blood through an open wound, it currently appears that there is no risk of infection.
Therefore, there is no need for post-exposure prophylaxis at this time.
Thank you for your inquiry.

Reply Date: 2022/09/13

More Info

When it comes to concerns about HIV infection risks after encountering blood in a public space like an elevator, it's important to understand the transmission routes of the virus and the conditions under which it can be transmitted. HIV (Human Immunodeficiency Virus) is primarily transmitted through three main routes: sexual contact, exposure to infected blood, and from mother to child during childbirth or breastfeeding.

In your situation, the key factors to consider are the nature of the blood you encountered, the potential for direct contact with open wounds, and the environmental conditions of the elevator.

1. Nature of the Blood: Blood that is fresh and has not been exposed to air for a prolonged period contains the highest concentration of HIV. However, once blood is exposed to air, the virus begins to degrade rapidly. Studies indicate that HIV does not survive long outside the human body; it typically becomes inactive within minutes to hours, depending on environmental conditions such as temperature and humidity.

2. Direct Contact with Open Wounds: You mentioned that you have dry, peeling skin and some small acne wounds. While these could theoretically provide a point of entry for the virus, the risk remains low unless there was direct contact with fresh blood. If your skin did not come into direct contact with the blood, the risk of transmission is negligible. Wearing shoes also provides a barrier that significantly reduces the risk of infection through contact with blood on the floor.

3. Ingestion or Mucosal Exposure: If blood were to come into contact with mucous membranes (such as the mouth, nose, or eyes), the risk of transmission would be higher. However, you indicated that you were wearing a mask, which would help prevent any potential blood from entering your mouth or nose.

4. Type of Blood: Blood from a person who is HIV-positive can pose a risk if it enters your bloodstream through an open wound. However, blood from someone who has vomited may contain a lower concentration of the virus, especially if it has been mixed with gastric juices, which can degrade the virus.

5. Need for Post-Exposure Prophylaxis (PEP): PEP is a treatment that can prevent HIV infection after potential exposure. It is most effective when started within 72 hours of exposure. Given the circumstances you described, and if there was no direct contact with fresh blood, the likelihood of needing PEP is low. However, if you have any concerns or if you believe there was a significant risk, it is advisable to consult a healthcare professional for personalized advice.

6. Cases of Transmission: There are very few documented cases of HIV transmission occurring through casual contact with blood in public settings. Most cases involve direct exposure to infected blood through sharing needles or sexual contact.

In summary, while it is understandable to be concerned about potential exposure to HIV in a situation like this, the risk of infection from incidental contact with blood in an elevator is very low, especially if there were no open wounds or mucosal exposure. If you remain anxious about your exposure, consider discussing your concerns with a healthcare provider who can provide further guidance and, if necessary, evaluate the need for any preventive measures.

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