Worried about HIV infection from dried blood in toilet when changing Nuvaring

[scaredinphilly]

Hello

First of all, thank you so much for being there to answer our questions. I've been worried for quite some days now and can't seem to get peace of mind. I was hoping you could provide some guidance on whether I've been at risk for HIV transmission.

The other day I went to the toilet at work to change the nuvaring (it's a birth control method that you insert in your vagina once a month and then remove 3 weeks later). When I was about to leave the cubicle I noticed a very small spot of blood on the door that definitively wasn't mine (half the size of a pinkie finger nail), near the door knob. It looked rather dry but couldn't really tell if it was 100% dry (the cubicle was empty though before I walked in). I am now concerned that, because I didn't notice it going in, I may have touched it unknowingly when opening the door and then inserted my hands in my vagina to remove the nuvaring, thereby possibly exposing the mucosa in my vagina to that blood. I'm not sure I touched the little bloody patch. I didn't notice any blood in my hands at any point in time, and I still had to undress myself and wipe myself after using the toilet and before actually inserting my fingers to remove the nuvaring, so that if I had blood on my hand I should have seen it at some point on my clothes or the toilet paper, which I didn't. However, I'm still very worried.

Would you consider I'm at risk for HIV? Can HIV be transmitted this way, if you touch infected blood that was either dry or in the process of drying on a flat environmental surface and then touch your mucosa? Are there any recorded cases of HIV infection from such environmental settings? Should I test for HIV?

Please advise

Many thanks

One worried user

[scaredinphilly]

Many thanks Doctor. This is reassuring

[Edward W Hook, MD]

I still would not be concerned about these sorts of transfers.  They occur quite often with genital secretions in the context of mutual masturbation yet there are no infections associated with masturbation.  No change in my advice.  EWH

[scaredinphilly]

Many thanks for your prompt reply Doctor. It is very helpful. I would just have one follow up question if you don't mind:

I understand that indirect transfer on someone's hands does not result in infection, because skin is a barrier against HIV. However, in my case I inserted my fingers into my vagina to remove the ring, hence touched the mucosa. Wouldn't that be a higher risk? Or you wouldn't be concerned about it either?

Thanks

Worried

[Edward W Hook, MD]

Welcome to the Forum.   I won't address the issue of whether or not you touched the blood spot you noticed or whether or not the person whose blood you noticed had HIV, both of which are unlikely but, instead, will comment on this issue of the potential transfer of infected material from person to person or from one person to an inanimate object, and then on to another person on a person’s hands.  We receive many questions on this topic.

The fact is that indirect transfer, either on a person's hands or on an inanimate object has never been shown to result in HIV infection.  The reasons for this are at least two-fold.  First the HIV virus is quite fragile and begins to die almost immediately after leaving the body and being exposed to the environment.  Dead or even "wounded/dying" virus does not efficiently cause infections.  The second reason is that with each transfer of blood or secretions, less of the virus moves from person to person (some is left behind) and one of the major determinants of the likelihood of infection is how many viruses a person is exposed to.  Thus, for both of these reasons, transmission of infection through the sort of exposure you suggest is quite unlikely and has never been reported despite millions of such exposures.

I would not worry about any risk for infection and see no need for testing related to the possible exposure you describe.  I hope this explanation and suggestion is helpful to you.  EWH