Question for Dr. Handsfield

[hr21720]

Hi doctor, I asked a question a few weeks ago (account not working please do not delete this question) and was advised I did not need testing for HIV or Hep C regarding a single line of cocaine I did with a friend using the bill a minute or two after him. Was told it was a virtually no risk situation. It was the only time I have ever done it and I regretted it immediately, it was a small line, barely touched my nose, did not enter. I did not see any blood on the bill present if that matters and neither of us had any blood involved to my knowledge.  My friend- heterosexual male, early 20s has had a decent amount of female partners, does not use IV drugs, occasional cocaine user not heavy, may have shared bills with other friends in the past, none are heavy users. He told me he was tested at the start of the year for "everything" when I asked the next day. He also went a week or two after the event when he saw I was a bit nervous and asked him about it after surfing the net (mainly about hep c because some sites say this is possible to transmit, not as much HIV) and he tested for hepatitis and said he was negative. I do not know about the window period a whole lot, or if he did for sure test but he is a friend and I have no real reason to believe he would lie.  Overall, due to the nature of my exposure, and the fact that I have not had unprotected sex in months before I started dating a girl recently (I was tested negative for everything in July of this year) I have a couple quick questions: 1) Can I put this behind me from this one off encounter? Was it really not that risky?
2) Is it safe to resume unprotected sex with my girlfriend? 3)It has been almost 4 weeks and I am a worrier trying not to fall into overtesting like I have done in the past, I have not had any symptoms (no fever, nightsweats, diarrhea,  sore throat, rash etc) , have had lots of energy can I move on with my life and be fairly confident I am okay? Thank you doctor.  

[Edward W Hook, MD]

Far lower.

Thread is over.  EWH

[hr21720]

one thing that i have to ask just out of curiosity, i am feeling much better, but say if the person i did the line with did have hepc for example what would your professional estimate be for risk factor with no visible blood present? i know you say roughly for hiv and unprotected vaginal sex about 1 in 1000 estimate.  what would you estimate if the person was infected in my situation? 1 in 100? higher? 1 in 1000?
thanks doctor, my final comment.

[hr21720]

I will let it go, my anxiety has felt a lot better. Thanks for your help sir.

[Edward W Hook, MD]

In my opinion, there is no testing needed in this situation.  I am not you however and do not have your level of anxiety.  Testing for you is directed only at relieving your anxiety, not because it is needed from a medical perspective.  EWH

[hr21720]

one last point- say if my friend didn't actually get tested, or was in the window period or something (i think he did a line several weeks earlier with some friends) from this one off encounter, i can just let it go and move on do to the low risk nature and lack of any symptoms? I didn't ask to see the paper because I didn't want to be a pain or seem like I distrust him. I will not ask follow up questions, thank you doctor hook. I am just confused because sometimes you say a no risk exposure and other times you say testing may be needed. If I do not need to test I just want to put this event behind me and learn from it.
Thanks.

[Edward W Hook, MD]

Dr. Handsfield and I share the forum.  You got me.  FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients.

I believe I remember your earlier question and it was likely deleted because you could not accept the answer you received.  We'll try it again, not that the answers have changed:

1.  Yes, you should put this behind you. If your friend (who as described is rather low risk for HIV or hepatitis) was tested and negative for hepatitis after you shared the bill, then you could not get hepatitis from him. His blood test would be positive if he were infectious for hepatitis.

2.  Yes, it is safe to resume unprotected sex with your GF.

3.  Yes, you should be confident that you are OK.

EWH