ONE time episode with non-intravenious drugs

[Nc1434]

Hello Doctors,

I apologize for wasting your time if this is a redundant question; however, I've learned with my HIV anxiety to not look through all the posts- as it really throws off one's psyche (in my opinion).

Anyway, I was getting ready to move out of town to begin a new job and having a going-away party to celebrate.  I'm really not the kind of person to take ANY kind of risky behaviors- never had unprotected sex, never done any drugs (other than marijuana probably 5 times ever) (I'm 22 btw).  Anyway, the party was with all my college friends in a very safe environment- closed party at a private school.  A girl I'd never met before (supposedly a student from Germany who was friends with some of my friends) offered me to try cocaine.  I'd NEVER even considered doing this and had I not been drunk and in a happy, euphoric state, certainly would not have done it.  Anyway, she had some kind of plastic thing that looked like an inhaler or some kind of nasal spray and I asked what it was and she only replied that she got it from Germany.  She sniffed out of it and then handed it to me and I did the same.  There wasn't any deep penetration into my nose- it felt fine directly afterwards and the next day- and I didn't see any blood on the "device" but again, I was drunk.  I also didn't feel any effects and shortly after examined my nose and didn't see any kind of powder or anything.  I may be imagining this because of my state but it seemed like what came out of the "device" was liquid.  I later asked my friends about it and they said that she'd told them it was coke and that they'd refused to use it; however, when I questioned her again, she said that it was an inhaler spray and laughed.  I have no idea what to believe but feel like I either did it incorrectly or it really wasn't cocaine.

My question is:
1) Does this pose any risk to me for HIV/ Hep C?  In my brief search I've read contradictory opinions on the subject.  Please explain your answer.

Thanks so much!

[Edward W Hook, MD]

Every case is different.  Examples of high risk would be rectal intercourse (active or receptive) with a partner of unknown status, or multiple genital exposures to a partner with known HIV infection.  Each situation is different bu tthese are two glaring examples.  EWH

[Nc1434]

Hello Dr. Hook

Sorry to bother you again; however, this question has nothing to do with my exposure or anxiety or anything, really.  I know from my history of reading posts on this site that yourself and Dr. Hansfield typically state almost every situation as "zero risk" or "low risk".  I realize that my situations have been particularly low risk, but upon reading certain posts where people had sex with prostitutes in Africa and had a condom break or had a number of unprotected episodes with strangers, I just don't understand what a "high risk" situation would be.  If you could elaborate it would really help me put things in perspective b/c my paranoia and one-time drug use being classified the same as these other events isn't (in my opinion) productive to keeping people away from risky behaviors.

Thanks again, I really mean it.

[Edward W Hook, MD]

Glad I could help. Take care. EWH

[Nc1434]

Thanks so much for the help.  I know I have a problem with this and am being treated for OCD.  I will not test and certainly won't consider PEP.  And- I'm completely done with any sort of illicit drugs.  Certainly not worth the worry, cost, or anything.  

Thanks again and keep up the great work.

[Edward W Hook, MD]

Nowhther or not you used cocaine would make little difference.

It would be foolish to even consider PEP.

Please don't worry.  EWH

[Nc1434]

Thanks for the prompt response.  Would it make any difference if I actually did cocaine (unlikely since I didn't feel anything). ?  I guess it's extremely unlikely either way and although I don't know her, this girl doesn't fit the demographic for HIV at all.  I guess I was more worried about Hep C since she obviously is a risk-taker.

So you're saying no testing, PEP, or anything should be considered?

And I'm done.  I promise.  Thanks!!!

[Edward W Hook, MD]

Welcome back to our Forum.  This was not a risky exposure. There are fables "out there" which use convoluted reasoning to suggest that sharing of devices to snort drugs such as cocaine can also transmit blood and, in this way, HIV or hepatitis (c or b, but I am aware you are vaccinated against hepatitis B so this is not a concerns).  I am not aware of any convincing studies however which demonstrate that this is the case.  Think through this logically:


1.  Your acquaintance would have to have HIV- very unlikely.
2. The would have to get infected blood on the device, also unlikely.
3. The virus would need to survive . Also unlikely, it turns out that cocaine and other drugs have modest antimicrobial activity.  Further the virus dies quickly on exposure to the environment.
4.  You would have to get the virus into your blood stream

Each part of this sequence of events would need to occur for you to be exposed which in turn would only make it possible (but statistically unlikely) to lead to your getting HIV.  Bottom line, you really do not need to worry about this event.  No testing is needed.

I hope my comments are reassuring. Take care.EWH

[Nc1434]

Hello

Just so I don't have to follow up with comments- I can only imagine how annoying that is, I wanted to mention a couple things.

The talk about me never doing drugs wasn't meant to be self-aggrandizing, I was simply stating that I'd have no damage to my nasal cavity or other risk factors.

Also, I'm honestly not too concerned about whether I did cocaine or not, I certainly never will again, but am more interested in whether something could have been transferred through the incident, regardless of drug use.  Like, for instance, if it was a saline nasal spray- would I be at risk for Hep C (I know that'd be more likely) or HIV.

Thank you so much- I want to get my life in my new city with my new job off to a great start and, although I've battled HIV fears before, think that an answer from you can set my mind at ease.

Thanks again, sincerely.