Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
HIV Prevention (Expert Forum)
Stuck in foot by junkies needle
by chain123, Nov 01, 2009 08:52AM
I was doing community service for the city of San Francisco and we were picking up trash under the highway at Cesar Chavez... we were picking up trash in this little nook and came upon a sea of used needles, hundreds of them, amongst a lot of paper trash and other garbage. I picked up a bunch of the paper trash and right when I was leaving the area, i stepped backwards and felt a slight pain in the ball of my foot. I stepped forward and sure enough there was a needle where my foot was. The needle punctured the rubber sole in my shoe and went into my foot. I checked it out when we were done and there was a tiny spot of blood were the pain was. The needles that I saw there were the really fine typ, no girth to them at all, hair fine needle point. I went to the ER and received tetanus, Hep B vacine, and some anti-biotics in case of other infection.. I also have a prescription for the meds you take for 30days when exposed to HIV.. but the ER doctor was not an expert in HIV. What are the chances of getting HIV in this situation. I don't know how long the needle was lying there or anything, but there was a lot of them... please advise if I need to take this post hiv exposure medication.
Doctor's Answer
by H. Hunter Handsfield, M.D., Nov 01, 2009 11:18AM
, Nov 01, 2009 11:18AM
Welcome to the HIV forum.
To my knowledge, nobody has ever been known to have acquired HIV through injury by discarded injection equipment, even when that equipment had been used for injection drug use. It is primarily a theoretical risk. HIV dies quickly in the environment, and to my knowledge all sharp instrument injuries that have actually resulted in HIV transmission involved immediate injury of health care providers while in the process of providing care to HIV infected persons. Usually these involved large-bore needles, scalpel injuries, and so on, with obvious exposure to substantial amounts of patients' blood. Even in health care situations involving fresh exposures, infection rarely results from small-bore needle, superficial pricks, and so on, if there was no visible blood and a substantial, deep injury.
In addition, when a contaminated needle passes through materials like clothing, or even through a single layer of latex (i.e., rubber glove), most or all contaminated secretions on the surface of the needle are wiped clean, reducing the transmission risk. The thickness of the sole of a shoe would provide substantial protection.
For these reasons, the chance you were infected is exceedingly low. However, I cannot say there was zero risk. The ER doc was being conservative in prescribing post-exposure prophylaxis (PEP) in this situation, but s/he might have been following specific local guidelines, e.g. from the San Francisco or California health department(s).
The effectiveness of PEP depends on how quickly it is started. Every hour counts, and starting later than 72 hours is believed to have no benefit. Therefore, if in doubt, you should immediately start taking the treatment as prescribed. You can always stop later. Your eventual decision should NOT be based on my opinion or on the basis of any online source. You should find a health care provider who understands HIV prevention. There are, of course, hundreds of such persons in the San Francisco area. The San Francisco General Hospital emergency department would be a good option; or phone the San Francisco health department or the state health dept's HIV/AIDS office (in Berkeley) for their advice.
Thus, in summary: I doubt there was much risk and probably I would not take PEP if I were in your situation. But you need to check with official sources and/or locally knowledgeable experts. In the meantime, start taking the drug as prescribed. Please return to let us know what other advice you can find and your final decision on continuing it.
Good luck-- HHH, MD
To my knowledge, nobody has ever been known to have acquired HIV through injury by discarded injection equipment, even when that equipment had been used for injection drug use. It is primarily a theoretical risk. HIV dies quickly in the environment, and to my knowledge all sharp instrument injuries that have actually resulted in HIV transmission involved immediate injury of health care providers while in the process of providing care to HIV infected persons. Usually these involved large-bore needles, scalpel injuries, and so on, with obvious exposure to substantial amounts of patients' blood. Even in health care situations involving fresh exposures, infection rarely results from small-bore needle, superficial pricks, and so on, if there was no visible blood and a substantial, deep injury.
In addition, when a contaminated needle passes through materials like clothing, or even through a single layer of latex (i.e., rubber glove), most or all contaminated secretions on the surface of the needle are wiped clean, reducing the transmission risk. The thickness of the sole of a shoe would provide substantial protection.
For these reasons, the chance you were infected is exceedingly low. However, I cannot say there was zero risk. The ER doc was being conservative in prescribing post-exposure prophylaxis (PEP) in this situation, but s/he might have been following specific local guidelines, e.g. from the San Francisco or California health department(s).
The effectiveness of PEP depends on how quickly it is started. Every hour counts, and starting later than 72 hours is believed to have no benefit. Therefore, if in doubt, you should immediately start taking the treatment as prescribed. You can always stop later. Your eventual decision should NOT be based on my opinion or on the basis of any online source. You should find a health care provider who understands HIV prevention. There are, of course, hundreds of such persons in the San Francisco area. The San Francisco General Hospital emergency department would be a good option; or phone the San Francisco health department or the state health dept's HIV/AIDS office (in Berkeley) for their advice.
Thus, in summary: I doubt there was much risk and probably I would not take PEP if I were in your situation. But you need to check with official sources and/or locally knowledgeable experts. In the meantime, start taking the drug as prescribed. Please return to let us know what other advice you can find and your final decision on continuing it.
Good luck-- HHH, MD
Post Comment
