Should I be concerned?

[Bahmed]

Dear Doctors,

Almost a week ago I had sex with an escort. The entire eposide was protected sex at all times. However, when I finished, I noticed some fluid on my condoms and touched it with my thumb. Then I lit a cigarette. A couple of minutes later, I went to the wash room and saw that the fluid I touched was blood. I washed my hands and forgot about it. But now I am getting concerned.

I bite my nails all the time and hence my fingers have broken skin and cuts all the time. Even though I know for sure that I didnt have a bleeding cut at that time, I am concerned that that some of the blood from my thumb and index finger could have entered my bloodstream thru my nail biting cuts that could be microscopic and not visible. In addition, when I lit the cigarette, some of teh blood from my thumb could have been transfered to the cigarette filter end and when I smoked, could have come in contact with my lips and entered my bloodstream that way or thru teh mouth. I didnt have any bleedings gums or other cuts on my lips or in my mouth at that time.

Now I afraid about this episode since when I read on the internet, I see all sorts of opinions. Even CDC says open cut or wounds can be potential entry for HIV.

Hence, I am asking for ur professional advice. Is this something I should be concerned about? Am I risk for HIV or even HCV or HBV for that matter?

Thanking you in advance for your advice.

[Edward W Hook, MD]

Correct- shallow cuts and scrapes are almost never a meaningful ris factor, nor are cuts that are an hour old. EWH

[Bahmed]

Thanks a lot for this doctor. I really appreciate your response. You really calmed my nerves.

Yes my intercouse was condom protected at all times. Just one other thing for future reference. When we talk about cuts or wounds, I read on your other posts that it has to be actively bleeding (meaning fresh) and quite a meaningful cut or wound to actually provide an entry point for HIV, HBV or HCV, right? Something that is an hour old for that matter has actually started to heal and would not pose any threat?

[Edward W Hook, MD]

Welcome to our Forum... I'll be happy to comment,  I presume that your sexual intercourse was condom protected.  If that is the case, then you have nothing to worry about.  HIV does not survive outside the human body and so when genital secretions of blood get on a person's fingers or are transferred to another part of the body it does not lead to infection because the virus dies almost immediately.  Similarly, ingesting or swallowing HIV if it were to get into your mouth, whether on a cigarette or directly on your fingers would not cause infection either.  There are no reports of transmission of HIV, Hepatitis B, or hepatitis C from one person to another by swallowing or ingestion infected secretions or blood.

Finally, the sorts of cuts and scrapes people get on their fingers form biting their nails or through the sort of trauma that leads to cuts and sores on many people’s fingers are not deep enough to lead to transmission of infection.  For HIV to be transmitted through a wound, the wound must be deep into tissue and the infected material must be delivered directly into the wound.  

Thus, based on your report, I see no reason to worry and in fact, no reason to even test.  I hope this answer is helpful to you  EWH

p.s.  By the way, the chances that the commercial sex worker you were with had HIV is very, small. most CSWs do not have HIV.  EWH