HIV - Prevention Expert Forum
non-intact skin risks
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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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non-intact skin risks

Hi Drs. H,

First off, thanks for your patience in this forum.  You provide a lot of information and wisdom and relieve a lot of anxiety.

The rational side of me kind of already knows the answers to my questions, but the irrational side of me needs a medical expert to kick me out of my anxiety-driven thinking patterns.  This past year I have frequented clubs/bars in San Francisco for gay men which are considered a high risk population from an HIV standpoint.
- Being a clean freak, I wash my hands a lot and they become chapped during the cold months.  Is there any HIV risk associated with chapped hands if I am in a lot of contact with people in these clubs?  I have avoided overt sexual contact (e.g. hand/genital), but clubs being as they are, there is a lot of touching and grabbing going on.
- If I get scratched by a person in this setting, is there an HIV risk?
- Is there any HIV risk associated with licking.  I've had a guy just come up and lick me and gently bite me which sounds odd as I write it.
- Can I assume that any testing is unnecessary and should only be done to alleviate anxiety and that you will compassionately tell me to seek counseling if I cannot get over the anxiety?
- Would you buy it if I said that I am not wasting $15 because I searched on "chapped hands" and "licking" and didn't find satisfactory results?

Thanks for your help and patience.
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Listen to your rational side.  I can understand your concerns.  As you describe it, you skirt risks, hanging out in somewhat higher risk settings but avoid what are clearly risky situations.  You question really comes down to whether or not casual contact can transmit HIV.  The answer is no.  The virus does not survive well outside the body and intact skin is a GREAT barrier to infection.  So what about chapped hands?  Well, I suppose in theory this might slightly increase risk but this is where theory and observations made over the past 25 years separate.  To my knowledge there has never been a case of HIV transmitted becasue of exposure to chapped hands (the same goes for healing cuts, etc).  I urge you not to worry about inadvertent grabbing, pinching, rubbing, etc.

As for your other questions:
Risk from a scratch - zero.  
Licking- zero risk. Just think of it a a big sloppy kiss.  HIV as never been spread by kissing.
Test- yest , it is unnecessary in the situations you describe except for the purpose of relieving anxiety.
Was this $15.00 well spent - your call.  I think, as your first sentence infers, you knew all that I said before I said it. On the other hand, if this helps, I am glad it did.  EWH
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H. Hunter Handsfield, M.D.Blank
University of Washington
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Edward W Hook, MDBlank
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