spitting

[dearWORLD]

Dear Doctors.  I work as a counselor for drug users. To make this short i was talking to a lady that currently injects heroin. she kept on spitting while talking. I felt that some of her saliva flew into my mouth. I'm not sure but please assume it did. Was i at risk of HIV or other diseases or HIV is not transmitted that way?

[Edward W Hook, MD]

Welcome to our Forum.  Good question.  Although HIV can be found in saliva in low concentrations, the amount present is very small and there is no evidence that HIV has ever been transmitted in saliva.   The enzymes and chemical constituents of saliva act to inactivate the virus and as mentioned above, the amount of virus present is quite small and it appears to require exposure to larger amounts of HIV for transmission to occur.  

In your own case:
1.  You do not know that his person had HIV.  while more common in IV drug users, most do not have HIV.
2.  On a theoretical basis there is minimal risk, even if she was infected.
3.  Experience shows us that there has never been a case of HIV transmitted in through spit/saliva.

Thus I would not worry about this event, as unpleasant as having your client's saliva spewed forth was,  there is no need for concern or for testing.  EWH

[Edward W Hook, MD]

Glad I could help. EWH

[dearWORLD]

Thank you doctor for your your answer

[Edward W Hook, MD]

I urge you to relax on not worry.  I've pasted in something I wrote about the sceintific meaning of minimal theoretical risk below:

"...we VERY frequently get questions asking if different types of exposures are "zero risk" or if prevention measures are 100% effective.  The answer to that is that this is scientifically impossible.  For a variety of mathematical reasons far too complex to go into here, all one can do with well conducted scientific studies is estimate probabilities.  By definition, any estimate, cannot ever be 100% certain because of the incredibly low possibility that someone will get HIV through a previously undescribed mechanism tomorrow.  On the other hand, when Dr. Handsfield or I say that something is virtually zero, very close to no risk, or of minimal risk, or use any other term to indicate a very small risk, that means "close to zero" in a world where zero cannot be attained."

Bottom line, don't worry about this or let it impair the effectiveness of the important work you do.  EWH

[dearWORLD]

Dear Dr.  Thank you for your answer its helpful.  
I meet people evry day as part of my job.  My concern is that i could get another client spit in the future and in your answer you said (minimal therotical risk). As appose to zero risk.    I mean do i worry ? Or just sit and relax and talk to people without worrying to get infected.