Sharing straws/bills

Dear Doctors:

In June of 2010 I had an exposure in which myself and two other friends snorted cocaine from a shared dollar bill. I only did it once. I am absolutely terrified about this exposure. What is the risk of contracting HIV this way? I've been told that it is zero, but my understanding is that there have been two documented cases of HIV through this risk.

And how likely is transmission this way for hepatitis C? Would you recommend testing for both HepC and HIV?

Is it possible that HIV can delay seroconversion for Hepatitis C?

My understanding is that Hepatitis C cannot delay seroconversion to HIV--is this true?

Thank you for your answers.

[Dr Sean Cummings]

Hello

It's likely that you will be fine for both hep c and HIV.

Cocaine does cause constriction of the blood vessels of the nose - and works as a local anaesthetic so it all goes a bit numb. If you stick a sharp object such as a straw or a rolled note or a tube of some sort up onto delicate tissue then you will very likely damage the tissue. Despite the vessel constriction you will have some bleeding. You then pass the tube on and whoever else has a snort cuts their nose too - the end result is you will all be sharing remnants of bloody snot and trying to suck it up into your nose.

There is a theoretical risk of transmission of blood borne viruses this way.

I don't know of any cases of HIV transfer this way - but Hepatitis C seems more lileky given that the hep c virus is tougher.


I don't buy the idea that you see peddled about a lot on the web that Hep C and HIV interfere with each others diagnosis. The presence of both viruses can cause problems - but the diagnostic dilemma is rare.

If I were you I'd relax a lot; ease back on future use of cocaine; but I'd also go and get yourself tested for both the HIV and the Hep c so you can put your mind to rest.

very best, Sean

[jobyd]

Dr. Cummings:

Thank you for your reply. I did get tested for Hepatitis C earlier this week, but wanted to gauge my risk factors with a doctor experienced in HIV/STDs and drug use.

I'm really not that freaked out about HIV as much as I am about Hep C. I also only did it the one time (I snorted a bit, not a lot) with a friend who had only done it one other time before me, but the people he did it with and shared were hardcore users, which is why I'm worried about him, and therefore me.

Thanks again, and I will try to relax.