A worried Mom

Q1) I was checking out at a grocery store, the cashier cut her hand and there was a smearing of her fresh( less than a minute old) blood on the bag. I picked it up without thinking. I know there is no risk of hiv transmission if you were to get a small amount of hiv+ blood briefly on intact skin.

My main concern is what if I had a faint amount of the cashiers blood on my hands (that I did not see) and then before washing my hands, I unconsciously touched the corner of my mouth, inner nose or rubbed the corner of my eye? THESE ARE ALL MUCOUS MEMBRANES, and this perhaps faint amount of blood that could have been on my fingers was a mere 1-2 minutes old. Is hiv testing warranted or is this not a realistic mode of mucous membrane transmission.

Q2) At what time frame do ICMA or Elisa's become 80-90% definitive?  4 weeks? 6 weeks? etc. Or must I wait a full 12 weeks to put my worry to rest.

Q3) Is Elisa more accurate than ICMA?

All my best,
Stephanie

[H. Hunter Handsfield, M.D.]

Relax.  If HIV could be transmitted in the ways you imagine, AIDS would be a hundred times more common than it is and it wouldn't be classified as an STD.  For example, HIV is never, ever transmitted between household members who share kitchens, bathrooms, etc for years on end with HIV infected persons.  Anyway, the likelihood that any particular person in the US or an industrialized country (i.e., the cashier) has HIV is extremely low, less than 1 chance in 1,000.  Finally, it is not possible that there was a significant amount of blood on your hands that you could not see.

Truly, don't worry about this.  There simply is no risk and you definitely do not need HIV testing.  But if it will make you feel better, it's fine with me if you get tested for peace of mind.  I don't know what ICMA means, but all HIV antibody tests on the market are equally accurate.

Regards-- HHH, MD  

[Stephaniemom]

Thanks for your quick reply.

My understanding was that HIV can be transmitted through intact mucous membranes so I am a bit confused (although relieved) when you wrote 'Relax'. I guess I do not understand the subtleties of transmission.

I guess I'm just a worried Mom!

Thanks again for your time,
Stephanie

[H. Hunter Handsfield, M.D.]

Yes, transmission via mucous membranes is possible.  But not with the extremely scant amount of virus that could possibly be present on your hands given the situation you describe.  As I said above, if such mucous membrane transmission could occur with any frequency, non-sexual household transmission would occur at least once in a while -- but it has never been reported, even once.

You're fine.  Don't let this play on your mind.  But if you just can't get beyond it, feel free to get tested -- that is, if it will take a negative test to let you stop worrying.  (And no, this is not "code" that means I really think there was some risk.  There was not.)