HIV - Prevention Expert Forum
Help with understanding
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This forum is limited to prevention of HIV and to safe sex in general. All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Help with understanding

Dear Dr, thank you for the practical and calming advice you give here in the forum. I am helping one of my family to understand the risks of HIV and other blood borne diseases. Unfortunately at school they were told that razors and toothbrushes could potentially transmit HIV which has caused what I assume is unnecessary anxiety, about having stayed with people who may or may not have had high risk experiences in the past, and the potential for sharing items like razors and toothbrushes. I saw the clear advice given on the forum here, yet before I found Medhelp I found quite conflicting information on thebody.com which I hope you can explain to me, so I can help reduce the fears of my family member. This particular expert quoted a higher than usual figure for transmission via a razor, I am guessing he is saying theoretically if certain things were to happen, the risk may be this high: http://www.thebody.com/Forums/AIDS/Meds/Q218875.html
However, if I am not mistaken, if seems Dr Hansfield explains that this sequence of events (the previous Dr assumed) and subsequent infection has an astronomical chance of occurring: http://www.medhelp.org/posts/HIV---Prevention/Seems-to-be-s-differnce-of-opinion/show/1012150
I just wanted to check if I have pieced that information together correctly, I was just quite taken aback by the figure given by the expert on thebody.com, and because I am not a doctor I wrestled with it in my mind for too long, before deciding it is best to ask. In other places on thebody.com I've seen experts quote toothbrush events as 'quite low' risk, or low risk because of rinsing or time delays between usage, or because no one had bleeding gums, however again, I've seen on the forum here the reassuring advice that although best avoided, in reality one shouldn't worry about toothbrush exposures (as for myself I sometimes have bleeding gums and was paranoid about others using my toothbrush!) Thank you Dr.
239123_tn?1267651214
Welcome to the forum.  Thanks for your question.

I don't interpret the response at thebody.com the same way you do.  The doctor there acknowledges some risk from shared razors, but indicates the risk is low.  More important, that situation concerned exposure to razors used by people known to have HIV.  The thread you cite on this forum discusses the possibility that a razor in a barber shop might have been used (once) on an HIV infected person, and, if so, the chance of infecting another person then shaved in the same barber shop.  These are very different scenarios.

My advice is to not worry about astronomically low chances of getting HIV.  The fact is that almost nobody ever shows up with new HIV who did not have unprotected high risk sex, or who did not share drug injection equipment with other people.  I am not aware of a single case, ever reported anywhere in the world, in which somone was believed to have been infected through shared razors or toothbrushes.  Therefore, I stand by the advice we have always given on this forum:  such risks are theoretical only.  Life is too short to worry about them.

Having said that, I encourage you to continue to assure that other people don't use your toothbrush.  Not because of HIV, but because that's a great way to catch colds, influenza, and other infections.  If you suspect someone else has used your toothbrush, just throw it away and use a new one (they only cost a dollar or less).

Regards--  HHH, MD
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Many thanks Dr for your reply. I was just taken aback by the Dr having said the risk would be 'less than 1 in 250' which seems quite high, as I've seen risks associated with vaginal sex as 1 in 1000. However, it seems he quoted that figure under the assumption there would be a lot of blood?

I seen here that Dr Hook mentioned it would not be a significant risk, in this scenario where a girl had shared a razor with a HIV positive flat mate, so I assume the '1 in 250' risk was only if there was an unusual amount of blood?
http://www.medhelp.org/posts/HIV---Prevention/Possible-risk-from-a-razor-/show/1483039
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239123_tn?1267651214
I agree his risk of 1 in 250 was astoundingly high and I don't agree with that detail.  Perhaps he was thinking it could reach that level if there were repeated sharing of the same razor over many months or more.  It certainly is nowhere near that level after a single use.  Or maybe he was thinking (as you suggest yourself) about a visibly bloody razor that caused a visibly bloody cut.

Trust me on this:  aside from sharing needles for drug injection, nobody has EVER been reported to have caught HIV by injury with a sharp instrument except in health care settings.  In all those instances, a medical instrumen (large needle, scalpel, etc) was overtly comtaminated with HIV infected blood and then immediately caused a deep puncture, cut, or gash in the health worker.

My final advice is that you stop searching this forum or anywhere else on the web about any of this.  Like many anxious persons, you apparently are being drawn selectively to comments that inflame your concerns.

That will end this thread.  I won't have any further comments or advice.
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H. Hunter Handsfield, M.D.Blank
University of Washington
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