Risk from breast milk in open wound

[concerned916]

Thanks so much for your work on this forum, I've gotten so much information and some comfort from looking at your other responses.  I'm worried about an incident that happened while at a strip club on 10/25.  I had a scrape on the back of my hand and while messaging a girls breast some fluid came out which she said was breast milk.  I could feel it between my hand and her breast for several seconds.  Not sure if it got in the scrape as it was on the back of my hand, but the scrape from earlier in the day had not scabbed over. Would never have even thought about a risk of infection from breast milk but it looks like there is one. Later in the dance the girl reached in side my pants and touched me, I immediately stopped her but now I'm concerned she engages in risky behavior and could be at risk.  My questions are:

1) Do I have significant risk from this incident?

2) Started feeling nausea and dizziness at 8 days just a few episodes over 2 weeks, temperature has ranged from 97.2 to 99.4 (I understand that this is not a fever) with one night that I maybe had night sweats, ankles and wrist have been sore and very tired.  Under more stress than I can ever remember worrying about this do you think these symptoms are from just stress or more significant? I do remember having vertigo like symptoms in stressful times several years ago.

3) I'm planning on visiting my family with children that often wrestle and play rought during Christmas, if I am at risk am I endangering them if I could be newly infected? I will also be using the same bathroom as others. I've read this is the time that it is to easiest to spread infection to others.  

I plan on testing with a home access test kit at 7 weeks to get some piece of mind and again at 3 months.

Thanks very much for taking the time to answer questions like this.

[concerned916]

Thanks for setting my mind at ease about this.  Guess you have a good point about the risky behavior, wasn't really thinking that one through.  Already got a test on order so I'll go ahead with it, but I'll be able to put it out of my head till then.

Thanks again for all your efforts here.

[H. Hunter Handsfield, M.D.]

1) Almost certainly there is no significant risk. Breast milk is not highly infectious.  Among infants nursed by HIV infected mothers, about 15-20% become infected after 6 months of breast feeding--i.e. swallowing a few ounces of milk per day for months on end.

You seem surprised that some women who work in strip clubs might sometimes "engage in risky behavior".  Duh.  But her hand-genital contact is of no consequence.  The chance she has HIV are very low anyway, certainly under 1%.

2) Read the forum to see innumerable discussions about the fact that symptoms NEVER are a reliable indicator for or against new HIV inection.  And your symptoms don't suggest HIV anyway.

3) Since you were at no measurable risk of catching HIV, there is no risk to your children through wrestling or any other contact.  Nobody in the world ever caught HIV through using the same bathroom as an HIV infected person.  Simply no risk.

Based on the exposure history you describe and your symptoms, you do not need HIV testing at all.  Should your test be positive, it will be from some other events that you don't describe here.  But if it will calm your nerves, it's fine with me.

Good luck--  HHH, MD