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Questions
Dear Dr. Handsfield/Hook,
It is my pleasure to contact with you as I see you’ve done this fantastic job for a long time. I also happened to see, that you had to answer a lot of situation which seems to obvious and you have patience to react every time.
I hope my case will be the same, as I had 2 events which I think can be dangerous.
Firstly, I had my blood drawn for several occasions in the last 6 weeks (I have other medical concerns). The problem which I took notice, that nurses in these hospitals no more use needles which they actually open up in front of me from pouch. Rather they just take off the green cap from the needle. I live in Hungary. I heard that these’re the new disposable needles.
Q1: Is it physically possible to use them twice if the nurse was negligent or they can only used once because of their manufacturing origin?
The 2nd is a bigger one. I was in the UK and I French kissed a girl for 5-10 mins. What gave me concern is that DURING it, she was aggressively BITING my lips (it hurt too) and I felt that it made my lower inner lips non intact (I didn’t see it actively bleeding but I felt the “taste” of the non-intact skin - I think it was a superficial cut). When we stopped I went and saw a red vestige on my lips but scab hasn’t formed since (just small redness). Obviously I don’t know about her oral health (she had nice teeth but also had a boyfriend which gave me concern).
Q2: Is there ANY possibility to get infected in this manner?
Q3: I read one of the posts here at medhelp made by Nursegirl: http://www.medhelp.org/user_journals/show/546013/HIV-and-ORAL-SEX-The-Facts
Do you agree with these scientific facts (saliva inhibits HIV, diff PH damages virus, etc.)?
Q4: I read that you say that there are no doc cases, but I found this one which gave me extra concern: http://www.aegis.org/DisplayContent/print.aspx?SectionID=114141 Do you know anything about this?
Q5: Reading these 2 concerns, am I at ANY danger and should I have a duo test 4 weeks later?
Thank you and have a great day!
It is my pleasure to contact with you as I see you’ve done this fantastic job for a long time. I also happened to see, that you had to answer a lot of situation which seems to obvious and you have patience to react every time.
I hope my case will be the same, as I had 2 events which I think can be dangerous.
Firstly, I had my blood drawn for several occasions in the last 6 weeks (I have other medical concerns). The problem which I took notice, that nurses in these hospitals no more use needles which they actually open up in front of me from pouch. Rather they just take off the green cap from the needle. I live in Hungary. I heard that these’re the new disposable needles.
Q1: Is it physically possible to use them twice if the nurse was negligent or they can only used once because of their manufacturing origin?
The 2nd is a bigger one. I was in the UK and I French kissed a girl for 5-10 mins. What gave me concern is that DURING it, she was aggressively BITING my lips (it hurt too) and I felt that it made my lower inner lips non intact (I didn’t see it actively bleeding but I felt the “taste” of the non-intact skin - I think it was a superficial cut). When we stopped I went and saw a red vestige on my lips but scab hasn’t formed since (just small redness). Obviously I don’t know about her oral health (she had nice teeth but also had a boyfriend which gave me concern).
Q2: Is there ANY possibility to get infected in this manner?
Q3: I read one of the posts here at medhelp made by Nursegirl: http://www.medhelp.org/user_journals/show/546013/HIV-and-ORAL-SEX-The-Facts
Do you agree with these scientific facts (saliva inhibits HIV, diff PH damages virus, etc.)?
Q4: I read that you say that there are no doc cases, but I found this one which gave me extra concern: http://www.aegis.org/DisplayContent/print.aspx?SectionID=114141 Do you know anything about this?
Q5: Reading these 2 concerns, am I at ANY danger and should I have a duo test 4 weeks later?
Thank you and have a great day!
MEDICAL PROFESSIONAL
"people have many other sexual actions during one act (vaginal, anal intracourse, oral, etc), if a transmission occurs then they will document it as a consequance of those actions, altought it might happened during kissing".
That's true. On the other hand, there have been billions of episodes of kissing, fingering, and other non-intercourse sexual exposures between HIV infected and uninfected persons -- yet we never see patients with HIV who report only such exposures. When the initial story doesn't uncover an obvious high risk event like unprotected sex, the actual truth usually becomes obvious later -- another exposure or partnership was forgotten or denied. We just never see patients whose only possible exposure was kissing or fingering.
"do you think it is a big trauma which made it 10 fold riskier than a normal french kiss?"
If it did not obviously bleed at the time of injury, you can assume it had little effect on risk.
"Am I right that it only posses a miniscule theoretical chance if this girl had fresh blood in her mouth which I have not noticed?"
Yes.
Time to move on. Take care.
That's true. On the other hand, there have been billions of episodes of kissing, fingering, and other non-intercourse sexual exposures between HIV infected and uninfected persons -- yet we never see patients with HIV who report only such exposures. When the initial story doesn't uncover an obvious high risk event like unprotected sex, the actual truth usually becomes obvious later -- another exposure or partnership was forgotten or denied. We just never see patients whose only possible exposure was kissing or fingering.
"do you think it is a big trauma which made it 10 fold riskier than a normal french kiss?"
If it did not obviously bleed at the time of injury, you can assume it had little effect on risk.
"Am I right that it only posses a miniscule theoretical chance if this girl had fresh blood in her mouth which I have not noticed?"
Yes.
Time to move on. Take care.
Dear Dr. Handsfield,
Thank you very much for your detailed answer, it meant a lot. I also really apreciate the chance to have any follow ups. Actually, I don't have any, since as you said I don't have to think about this event from now on. Please confirm it, if this is the situation :)
I only apreciated NurseGirl's biological comments, because MAINLY I am a theoretical person, so the fact that it has not documented does not confirm me it cannot happen since people have many other sexual actions during one act (vaginal, anal intracourse, oral, etc), if a transmission occurs then they will document it as a consequance of those actions, altought it might happened during kissing. So it is better to know why it actually cannot have happen.
I would like to emphasize that the cut was not big in my lip and it was on my lip so there was a lot of oxygen among it, do you think it is a big trauma which made it 10 fold riskier than a normal french kiss? :O Am I right that it only posses a miniscule theoretical chance if this girl had fresh blood in her mouth which I have not noticed?
(Okay, I just realized that I had two follow ups .... :))
Thank you one more time and if I had any follow ups I will write it here! (Hopefully not after your answer to this)
Have a great day!
Thank you very much for your detailed answer, it meant a lot. I also really apreciate the chance to have any follow ups. Actually, I don't have any, since as you said I don't have to think about this event from now on. Please confirm it, if this is the situation :)
I only apreciated NurseGirl's biological comments, because MAINLY I am a theoretical person, so the fact that it has not documented does not confirm me it cannot happen since people have many other sexual actions during one act (vaginal, anal intracourse, oral, etc), if a transmission occurs then they will document it as a consequance of those actions, altought it might happened during kissing. So it is better to know why it actually cannot have happen.
I would like to emphasize that the cut was not big in my lip and it was on my lip so there was a lot of oxygen among it, do you think it is a big trauma which made it 10 fold riskier than a normal french kiss? :O Am I right that it only posses a miniscule theoretical chance if this girl had fresh blood in her mouth which I have not noticed?
(Okay, I just realized that I had two follow ups .... :))
Thank you one more time and if I had any follow ups I will write it here! (Hopefully not after your answer to this)
Have a great day!
MEDICAL PROFESSIONAL
Welcome to the forum. Thanks for your kind words about our service.
Your question is detailed, but it boils down to just a couple of basic issues. First, is there any risk of HIV from having blood drawn or having injections in doctors' offices? The answer is no. There have never been any HIV infections attributed to such events, at least not in the past 15-20 years. I am confident that the blood drawing equipment in use in Hungary makes ire-use difficult it not impossible, and that no nurse or doctor would be tempted to try to re-use such equipment.
Second, what about HIV transmission by oral exposure? The important fact is that HIV has never been proved to be transmitted by kissing, and if biting transmits the virus it is rare. (That you can find only a single case report, 17 years old, is evidence of how rare it is -- and even then, the report you cite certainly doesn't qualify as proof.) The summary by Nursegirl is excellent. However, I would encourage you to pretty much ignore the biological reasons -- saliva inactivating the virus, etc. What we know for sure is that such exposures virtually never transmit the virus; that's what matters.
As for your specific exposure, it is statistically unlikely a "French girl in the UK" has HIV -- probably under 1 chance in 1,000, likely even lower than that. But even if she did, can we say for sure that kissing is always zero risk? No, of course not; and I can imagine that if it ever occured, a traumatic kiss with bleeding would probably increase the risk. But even a ten-fold increase in transmission, when the baseline risk is virtually zero, also remains virtually zero. All things considered, you should view this as a zero risk event.
I do not recommend HIV testing, and if you have a regular partner, you can safely continue unprotected sex without fear of transmitting HIV. I think these comments cover all your specific questions -- but let me know if I missed anything.
Regards-- HHH, MD
Your question is detailed, but it boils down to just a couple of basic issues. First, is there any risk of HIV from having blood drawn or having injections in doctors' offices? The answer is no. There have never been any HIV infections attributed to such events, at least not in the past 15-20 years. I am confident that the blood drawing equipment in use in Hungary makes ire-use difficult it not impossible, and that no nurse or doctor would be tempted to try to re-use such equipment.
Second, what about HIV transmission by oral exposure? The important fact is that HIV has never been proved to be transmitted by kissing, and if biting transmits the virus it is rare. (That you can find only a single case report, 17 years old, is evidence of how rare it is -- and even then, the report you cite certainly doesn't qualify as proof.) The summary by Nursegirl is excellent. However, I would encourage you to pretty much ignore the biological reasons -- saliva inactivating the virus, etc. What we know for sure is that such exposures virtually never transmit the virus; that's what matters.
As for your specific exposure, it is statistically unlikely a "French girl in the UK" has HIV -- probably under 1 chance in 1,000, likely even lower than that. But even if she did, can we say for sure that kissing is always zero risk? No, of course not; and I can imagine that if it ever occured, a traumatic kiss with bleeding would probably increase the risk. But even a ten-fold increase in transmission, when the baseline risk is virtually zero, also remains virtually zero. All things considered, you should view this as a zero risk event.
I do not recommend HIV testing, and if you have a regular partner, you can safely continue unprotected sex without fear of transmitting HIV. I think these comments cover all your specific questions -- but let me know if I missed anything.
Regards-- HHH, MD
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