Toilet Bowl Question

Hello Doctors, I had an instance the other day that made me question whether or not it could have been an exposure to HIV and wanted to get your take on it. I understand that this may be far fetched, and slightly embarrassing for myself, but please bear with me.

Ok, so the other day, I arrived at my office at just around 9am and decided to take a number 2 in the bathroom. I work in a very corporate setting, and the bathrooms are only open to our immediate floor. I noticed that the water was still blue, which meant that I was the first to use the toilet that day (I know this because once it is flushed, the blue goes away for the rest of the day).

As I was getting done, I leaned forward to get toilet paper and the tip of my penis touched the front inside part of the porcelain toilet for about a second. I then noticed some urine on the opening of my penis and a tiny bit on the bowl where it touched. I assumed that it was probably mine, but then I started getting a bit paranoid.

Now, for argument's sake, lets assume this was someone else's urine who was HIV positive. I understand that urine, even HIV urine is sterile (correct me if I am wrong?), but what if this HIV positive person had blood in their urine as well? There was no visible blood of any kind for the record. AIDS.gov states:

"Other body fluids and waste products-like feces, nasal fluid, saliva, sweat, tears, urine, or vomit-don’t contain enough HIV to infect you, unless they have blood mixed in them and you have significant and direct contact with them. "

My questions are:
1. Would I be at risk if an HIV positive person's urine got into my urethra if there was blood (but no visible blood) in their urine?
2. Would exposure to the air and elapsed time have killed the virus in the blood/urine before I had my incident?
3. Can you put AIDS.gov's statement into perspective; How much blood and direct contact in the urine would be needed for transmission?

I appreciate everything, thank you!!

[Edward W Hook, MD]

Welcome to our Forum.  I would agree with you that these hypothetical questions are a bit farfetched and the short answer is that the scenario you describe is not associated with any risk for HIV.  The reasons for this are several-fold.  

One reason, as you point out, is that the amount of HIV present in bodily fluids such as urine is far lower than is present in other bodily fluids.  

Secondly, the HIV virus does not live long at all (minutes) at room temperature or on inanimate objects (such as toilet bowels).

Third, if HIV were to get into water, it would die/be killed almost immediately due to the absence of salt and other chemicals which allow organisms to survive.  Thus HIV in water would be killed by being put into pure water.

Thus, in the incredibly unlikely circumstance that the events you suggest could have happened, the answers to your questions are as follow:

1.  No, you would not be at risk if this were to happen. The HIV would already be dead.
2.  Yes.
3.  Perspective.  The government's comment is overly conservative.   Your risk of being struck by a meteorite is higher than your risk for getting HIV in the manner you describe.

Hope this helps.  EWH

[Beekay1211]

Thank you so much doctor, only one follow up:

When you say the virus would be dead in the the urine (with the hypothetical blood in it) because of exposure to air, time elapsed etc, you're saying this assuming the urine was still in a liquid state, and not completely dried, is this correct?

Thank you!

[Edward W Hook, MD]

Correct. EWH