Sharing cocaine snorting note and HIV

[1901]

Sir,

I read a post from a couple of years ago dealing with the risks of HIV transmission through sharing bank notes for snorting cocaine. You posited that there was zero risk from this.

I have had an exposure through this method- I have shared a bank note to snort coke with a sexualy active gay man (I am unaware of his status) between 1 and 5 times. I saw no obvious blood on the note at any time, but later in the evening and the next day, when I blew my nose some small amounts of blood came out. I have had an HIV test in the recent past which has cleared my sexual history- in other words, this is the only "risk" behaviour that I have not been checked for.

Although in the past you have said there is zero risk from this, other (reputable- I'm not talking about the alarmist, unhelpful sites out there) seem to contend that there is at least a theoretical risk from this (i.e. possible but no one knows of any actual cases). In essence, I am wondering:

1. If you stand by your previous advice that this is a zero-risk exposure, or if not, how risky you think it is; and

2. If you would recommend getting an HIV test on the basis of the above information.

In closing I have two final remarks:

1. I apologise for asking what is, to a large extent, a repeat question, but given the (reputable) conflict of advice and the fact that the last question of this type was in 2005, I feel it was justified; and

2. I would like to say what an amazing job you appear to do on this site, and offer you my best wishes.

[1901]

Sir,

Many thanks. I will probably wait and go for routine testing in 6 months when I have a normal STD check up. Your advice and reassurance is much appreciated.

Keep up the good work- and I'll keep off the coke (which is probably why I'm a little paranoid).

As ever.

[H. Hunter Handsfield, M.D.]

There is no disagreement here.  I agree there might be theoretical risk.  But since there has never been a single case reported or suspected to have been so transmitted, I conider the real risk zero for practical purposes--and so should you.  You do not need testing for HIV, at least not on account of the transmission risk and/or medical considerations.  If emotional considerations demand it--that is if you aren't going to get the idea off your brain otherwise--it's fine with me if you get tested.

Thanks for the thanks about the forum.  Best wishes--   HHH, MD