HIV from sharing a pipe?

[Scared1972]

About a month ago I smoked some marijuana out of a pipe with my co-worker who is infected with HIV/AIDS. He has had the disease for about 20 years and it is very progressed at this point from what he has told me. Also he sometimes has visible lessions on the lips but did not seem to at the time we smoked. I also had extremely dry/cracked lips the day we were smoking. Now I am having feelings of extreme weakness/fatigue and muscle pain and my glands in my neck feel a bit swollen.  My tolerance for exercise has gone way down and I am worried my fatigue may be related to being infected with HIV. It could also be related to drinking and not getting enough sleep though but it does feel different than I have in the past. I want to ask an expert about this because I am concerned about having unprotected sex with my girlfriend after doing this. I know this is probably not something to be worried about but I want to educate myself so as not to stigmatize anyone.

Basically if you could answer any or all of these following questions that would be much appreciated:

Would you consider this a low-risk situation or virtually no-risk?

Would co-infection with the herpes virus make HIV transmission more likely in this manner?

Would small cracks on the lips from being chapped be likely to be able to be infected?

Should I pay to take a viral load test before being intimate with my girlfriend?

Have you ever heard of somone experiencing only muscle weakness and fatigue not accompanied by a fever?

Should I really be concerned at all about smoking the same pipe as someone who has AIDS? (I feel pretty bad about this if it really is not a risk at all.)

Thank you for your time!

[H. Hunter Handsfield, M.D.]

Welcome to the HIV forum.  The bottom line is that there was little or no risk of HIV transmission.  Still, nobody should share pipes or otherwise exchange saliva with anybody else.

There is no known risk of HIV transmission in this circumstance.  If not zero, the chance is exceedingly low.  Saliva inactivates HIV and oral exposure of any kind rarely results in HIV infection.  And at a personal level, I do put my money where my mouth is, so to speak:  my wife and I have shared drinking glasses with personal friends who are HIV infected and never have worried about it.  Your symptoms do not hint at a new HIV infection.  To the specific questions:

1) "Virtually no risk" is exactly the right way to put it.

2) Herpes simplex virus type 2, the usual cause of genital herpes, increases the risk of HIV transmission.  HSV-1, the usual cause of oral herpes, does not.  In any case, in the absence of an overt oral herpes outbreak, this should make no difference.

3) Chapped lips or "small cracks" make no difference.

4) You don't need a viral load test.  If I were you, knowing what I know, I would not get tested at all and would continue unprotected sex with my wife.

5) No, I have never heard of such symptoms as the only symptoms of a new HIV infection.

6) No, you should not -- but not because of HIV.  It's a bad idea for anybody to share pipes with anybody else.  Not because the risk of HIV transmission is high, but because of colds, influenza, etc.  This is especially cruical now, where H1N1 influenza is epidemic -- and could be absolutely critical if other kinds of epidemics come along, such as avian (bird) flu. There's also hepatitis and other enteric infections.  And even when it comes to HIV/AIDS, even if there is no risk, the anxieties and second guessing it can cause -- just as it is with you -- isn't worth the trouble.  "Just say no" to all your friends about this sort of behavior; you do not need to (and should not) discriminate against only those with HIV.

I hope this helps.  Best wishes--  HHH, MD

[Scared1972]

Thank you very much for your response Dr. Handsfield. I found your response to be extremely helpful. Good point about sharing the pipes, if anything he could probably get sicker from me because of his condition.

Much love!