Open cut - blood transmission?

[worriedcustomer]

This evening I had a really embarrassing and concerning experience. It was with this guy (I'm a male too) who I'm seeing and we're both thinking of becoming serious with each other. We fooled around a little bit, mainly just kissing (no sex was involved). Both of us were shirtless. For myself, I have some acne on my chest - some of which is still healing/scabbed over. Well, while we were "caught up" in the mood, rubbing up against each other, it turns out my partner rubbed up against me TOO hard. I looked down at him and saw that he had blood, my blood on his lip. We both freaked out and cleaned ourselves up which essentially ended the evening.

I do not know his HIV status, even though he's insisted to me he is negative and has shown me records of his last test showing he is negative (from July of 09). I'm concerned that perhaps he had a cut on his lip which may have been bleeding a little which could have gotten into/mixed with my own open actively bleeding cut? Assuming this to be the case, what is my risk of HIV here? I don't know how "deep" acne sores are in terms of abrasions on the skin. Regardless of how shallow or deep it is, it certainly was bleeding and thus, I'm assuming, susceptible to HIV transmission. So considering all of this, what would you say about my exposure risk? Should I be tested?

I'm really worried about this, as I've had very little sexual encounters in my life. I look forward to your help.

Thank you.

[Edward W Hook, MD]

Welcome to the Forum.  Even if your partner was infected, which, given his history and test results is very unlikely, this was a no risk exposure.  The bleeding from his lip was superficial and IF (it may not have) gotten into an acne wound, it is most unlikely to lead to infection.  Experience with literally tens or thousands of situations of this sort indicate that for HIV to be spread through wounds, the blood or infected material must be injected or otherwise introduced deep into tissue, not through shallow, surface contamination.  Your exposure was superficial and therefore no risk.

Normally I would state that no testing is needed in this situation.  You however have indicated that the two of you are considering getting into an ongoing relationship and, that being the case, there is probably some value to both of you knowing each other's status.  Why not go together to a health care provider or your local health department for testing.  A good start to any sort of relationship is to be aware of each other's infection status, not only for HIV but for other STDs as well.  In the meantime, I urge you not to worry about this event, it was no risk.  EWH

[Edward W Hook, MD]

This does not change my assessment.

I think if you stop to think about it a moment, you will know why there are no data on the depth of injection needed to cause infection.  Not only does it almost never ocur with surface woulnds but such studies would be unethical and the events are too rare to effectively study.  Time for you to stop worrying.  EWH

[worriedcustomer]

Looking over this again, I was just wondering, Dr. Hook, if you were assuming that my partner was the one who had the active cut and that I just had acne scabs? To reiterate again, *I* had an actively bleeding acne wound. I don't know if he had bleeding on his end. Does this change anything? Also, I was wondering, does the transmission risk rate increase by the size/depth of the acne wound in the skin? Thank you.

[worriedcustomer]

Dr. Hook,

Thank you for your guidance. I truly appreciate it. I will try not to worry, but I am a worrier by nature! My partner stated on previous occasions that he would be willing to go and be tested, which I forgot to mention. I will certainly take what you said re: mutual testing to heart.

Thank you again!