Follow up questions over HIV & Sniffing Cocaine Risk

[dogstar123]

Dear Sirs I wrongly posted a question on the STD forum yesterday asking what the risk of HIV was from a cocaine sniffer. I was kindly answered by Dr Hook nonetheless. I just have a couple more points I want to raise for clarification.

In summary I used a cocaine sniffer 2-3 times at a party recently. The owner subsequently told me had been HIV+ for 10 years. My fear is contaminated nasal blood or mucous could have been on or inside the nozzle of the device when I put it briefly to my nose. I would sincerely hope I would have noticed, but the device nozzle was turned upside, filled and just handed to me. I simply didn't think...

1) Could you clarify why you are so certain no small quantities of blood (wet or dried) that might have been present in any of the HIV+ persons nasal secretions (which may have been on OR in the sniffer, I didnt notice) could not be of any risk? I have read that there is a theoretical risk some blood could be snorted along with the cocaine, greatly increasing the risk...

2) The guy said he was HIV+ for 10yrs. Does that strengthen the argument for lower risk?

3) Does the fact that the cocaine sniffer has a rounded nozzle tht sits just inside the nasal opening make a difference from a straw or banknote that tends to be pushed inside the nose?

4) I have a hole in my septum from years ago not caused by drugs. The membrane broke some time ago leaving the skin around the hole at times sensitive and liable to storing dried mucous and blood (from nosebleeds). The lower internal nasal tissue (inside the opening of my nose) is all intact and free from any broken skin. The day following the party I blew big pieces of dried blood and mucous out of my nose.  Does any of these factors increase or lower the risk I may have put myself in?

5) A leading UK HIV org told me they are seriously concerned that this may form a leading transmission mode over the next few years particularly within the hetrosexual community. Comments?

Thanks

[Edward W Hook, MD]

Sorry you had to spend an additional $15.00 for these other questions.  They really do not change my opinion.  Here are my comments:

1.  HIV lives poorly outside of the body and dies very quickly on exposure to air. this process is slowed somewhat if it is in a liquid but not much.  In addition, placing it into your nose is analogous to putting it into your mouth (the two passages are contiguous).  If you check this site out you will find our repeated statements that acquisition of HIV through the oral route is very, very rare, if it happens at all.
2.  If he was on treatment this would lower risk, otherwise no impact
3.   It makes it less likely to traumatize your nasal passages and thus, hypothetically, might be still lower risk than with a straw.
4.  No.  If anything it makes your risk lower, not higher as the healing process for your nose left scar tissue which would be less permeable to HIV than normal mucosa.
5.  I think this is overstated.  If rates of transmission through other means of exposure go down greatly perhaps this route of infection would increase in a relative sense but in absolute numbers, this remains a very, very low risk exposure and, in my opinion does not even warrant testing.  

I get the sense that my reassurances are not having much impact however, thus if you need to get tested for the sake of your own mental health, go on and do so, waiting until at least 6-8 weeks after the event before testing in order to have a totally reliable result

EWH

[dogstar123]

Thanks very much Dr Hook. Whilst it may seem I have gone a bit overboard in my additional questioning, you have seriously put my mind at rest and do not feel the need to go through with a test. I really appreciate your straight no nonsense responses. I've never been on this website before and all I can say is that I will be recommending it to all my friends for any issues they may have. Happy New Year to you and thanks again.