Testing Concerns

[concernedscaredafraid]

Hello Dr. HHH or Hook I tested for HIV at the Dallas County Health and Human Services Department. It was a Rapid HIV test as well as a Nucleic Acid Test for the virus itself and I was tested for syphilis as well. All of my tests came back negative and this was 47 or 48 days after potential exposure. I made sure to ask whether the testing facility re-uses needles/syringes and I was assured that they do not. However when I was tested, I noticed that the needle that was used to draw my blood was taken out of a small circular plastic container and I never saw an actual package being opened to indicate for sure that a needle was being used for the first time. I was tested at an STD clinic so If the needle had been re-used it certainly could have had HIV infected material in it, how long would the virus remain viable and able to infect inside of a used needle? I intended to test only using the oral fluids test but Ive seen Dr. HHH indicate that it takes longer to become reliable (3 months?) Assuming a worst case scenario and that the needle I was tested with had been re-used and was contaminated by HIV how long would the HIV remain viable and able to infect inside the contaminated needle (would the virus be exposed to air while dormant in the needle?)? Also assuming such a scenario does it matter that Blood was being taken from my body and the goal was never to place anything in my body, would that make it harder for me to be infected even if a needle had been accidentally re-used? Even if needles are replaced can a re-used can a used syringe cause infection? Should I re-test via an oral fluids test?
As a side question I've wondered is it entirely possible to rule out what are thought to be extremely inefficient methods of transmission of the HIV virus? For instance if frottage is thought to never transmit the virus but most infected people have multiple risks wouldn't the transmission always get listed as the greater risk?
Thank you Drs for all of your help!

[concernedscaredafraid]

Thank you for you help Dr. Best Regards to you

[H. Hunter Handsfield, M.D.]

The biological reasons for the low risk are irrelevant.  I doubt HIV can ever survive 30+ days in the environment, but who cares if it does?  Nobody has ever been infected by the sorts of events you describe.  And your analysis of sharp instrument injuries by health personnel versus stepping on a needle is exactly right.

That should end this thread.  Do your best to move on without another thought about it.

[concernedscaredafraid]

I feel much better Dr. HHH I have read this forum and I find your advice highly reliable and I think your answers to the questions are spot on. I initially felt much better after recieving a 6 almost 7 week negative precisely because of knowledge I gained reading your responses to other worried posters. Then I thought about the possibility of a re-used needle but initially dismissed the fear as irrational but I read online claims that HIV can survive in a needle up to 36 days, can I fairly read your response to mean that 36 days is not viable for hiv to survive in a needle and in fact unless the needle had just been used minutes before I'm home free. (This rings true and sounds spot on because IV drug abusers share works within minutes and those who get stuck by accident in a healthcare setting get stuck within a relatively short period of time but you never hear that someone steps on a syringe on the street and winds up with HIV because of it) Thanks again Dr. I really appreciate your help.

Best Regards

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

The Dallas Co. STD/ clinic is highly respected, a class act.  There simply is no possibility they would mis-use blood drawing equipment in any way, and certainly not in a manner that could risk infecting their patients with HIV or other blood-borne viruses.  In any case, it is probable that nobody in the world (in the past 20 years) has acquired HIV by having a blood drawn.

For that reason, I refuse to consider or comment on your "worst case scenario", that the needle was re-used; same for a syringe, with a new needle.  But even if either of these things happened, there would likely be no risk unless the needle had been used on another person within just a few minutes aheady of you.  

The answer to your last question is that if such low risk events -- frottage, hand-genital contact etc, could transmit HIV, then don't you agree that in the 30+ year worldwide HIV/AIDS epidemic, there would be at least one case in which such exposure was the only potential source of infection?  Yet there are none.

So none of your concerns have any basis either in science or in practical clinic policy.  Don't get retested, and definitely stop worrying about any of this.

Regards--  HHH, MD