Bloody Paper Towel

[niugnep]

Hello Doctor. I have posted this question in the community forum before, but I feel like I need reassurance and scientific explanations from a doctor about my exposure:

I am very worried about an exposure a few months back. It was winter and really cold. Both my hands were so dry and chapped to the point that there were small bleeding cuts sometimes (By "bleeding cuts", I mean there were small shiny red lines on my knuckles and the surrounding areas, and if I pressed on them, red discharge would come out, possibly blood?) .

Anyway, I went to the public restroom to urinate, then washed my hands, and wiped my dry chapped possibly bleeding hands with a really bloody paper towel. There was a lot of relatively fresh blood, from possibly a previous person with bleeding nose, on the paper towel. I was really worried and checked if any amount of visible blood got into my hands. I didnt see any visible amount of blood getting onto my hands and thats why i didnt think of PEP at the time. I then immediately washed both my hands again with soap. Assuming the blood was HIV+, what are my chances of getting infected from this exposure? From a PURELY MEDICAL AND SCIENTIFIC point of view, do i need to get tested? (I dont want to give in to my OCD, and get tested for a non-risk event, if this is one).

[Edward W Hook, MD]

Glad to help. Take care. EWH

[niugnep]

Just want to say thanks one last time. I really appreciate what you do on this forum doc. As I promised, no more what-if or follow-up questions. That wouldn't be productive for me and my OCD. I'll move on.

[Edward W Hook, MD]

1.  See above. As I said before, HIV is virtually never cuased by surface contamimination but by introduction of contaminated materials deep into tissue as with a needle.
2.  Typically such tests are ELISA tests.  No further testing would be needed. EWH

[niugnep]

Doc, thanks a lot for the quick reply. I am taking meds prescribed by my psychiatrist for my OCD and your reassurance really comforts me. I have a few more questions though if it is ok:
1. When is skin considered non-intact enough to be a portal to hiv infection? Why does my definition of "bleeding cuts" not count?
2. on a separate occasion (not due to this exposure), I got tested for HIV and the test only says "Anti-HIV: Negative". I read that there are many kinds of HIV tests (i.e. HIV-1, HIV-2, ELISA, Western Blot, antigen, etc). What usually is an "Anti-HIV" test? Is it reliable?

Thanks a lot. I promise the two above will be my last follow up questions.

[Edward W Hook, MD]

Welcome to this Forum. the answers you will get are similar to those you have already received. from a "purely medical and scientific point of view" any concerns that you have are unwarranted.  HIV is not passed from person to person on inanimate objects, the only exception being hollow objects like needles where the blood is not exposed to the environment (temperature and drying).  As a result, outside of the body HIV begins to die immediately.  Further, surface contamination of the sorts of wounds you describe is not a risk factor, even if the blood is fresh (unlikely) and even if the person from who it came was HIV infected (also unlikely).

Don't give in to your OCD.  EWH

[niugnep]

I feel like the last paragraph is very poorly worded, my mistake doc. I'll try to re-word it below:

Anyway, I went to the public restroom to urinate, then washed my hands, and wiped my dry chapped possibly bleeding hands with a really bloody paper towel (I didn't notice there was a lot of blood on the paper towel until later, but it surely was not mine). There was a lot of relatively fresh blood on the paper towel (possibly from a previous person with bleeding nose). I was really worried and checked to see if any amount of visible blood got onto my hands. I didn't see any visible amount of blood getting onto my hands and thats why i didnt think of PEP at the time.

I then immediately washed both my hands again with soap. Assuming the blood was HIV+, what are my chances of getting infected from this exposure? From a PURELY MEDICAL AND SCIENTIFIC point of view, do i need to get tested? (I dont want to give in to my OCD, and get tested for a non-risk event, if this is one).