Conflicting information re: risk

[LilSprout]

Hello, Doctor,
Thanks for the great site!  I’d greatly appreciate some advice regarding an “incident” that occurred last week at my local Target store (MN).  I’ve poured over this site looking for something similar to what I experienced, and I’ve also contacted CDC and a couple of HIV clinics in my area, but have gotten very different responses.  Here’s what happened:  After using the toilet, before flushing, I noticed a few small (approx. 1 in. each) smears of pinkish/reddish colored “something” on the end of the toilet paper I’d just used.  After determining that it definitely didn’t come from me, I was immediately concerned.  I’m envisioning the person who just used the toilet before me either having a cut that they wiped on the dangling end of paper, or maybe  accidentally getting menstrual blood on their hand, and then just wiping it off on the roll, without  then disposing of it.   The CDC said HIV would have died in a short time, that it needs a host, and not to worry about it.  However, a woman at a local clinic thought  my experience “could be a problem”, and that I should come in to be tested for HIV/Hepatitis/Herpes, etc..!  She called it a freak occurrence, for which no one knows the risk.

1.)  What do you believe my level of risk for HIV is in the situation I described?  
2.)  Is it true that a greater risk for me may be hepatitis, herpes, or some other STD, since I’ve heard they are much more stable, and common,  than the HIV virus?
3.)  Since my fear is regarding  someone else’s blood  having come into contact with my genital  mucous membranes, (or possible small cut on hand)  can you clarify whether a woman’s inner labia is considered a mucous membrane through which the virus could be absorbed?  Or does it depend on the quantity of body fluid we’re talking about, and whether mucous membranes are abraded or torn?
4.) Is the CDC  the authority on HIV?  Some have accused the CDC of withholding info on cases to avoid panic.  Agree?   Thanks!

[H. Hunter Handsfield, M.D.]

Thanks for the thanks.

[LilSprout]

Thanks for your reassuring, prompt response.  While the rational (ableit small) part of my mind knew this scenario seemed ridiculously unlikely, the "what if" part took over, especially after talking with a nurse at HIV clinic, who frightened me with her "could be a problem"comment, recommending testing, etc..  From now on I'll only go to this site, the Mayo Clinic site, or the CDC!

I want to commend you on your honest, tough-love type of responses to worriers like me.  My mother used to tell me often, "It's time to grab your butt with both hands, and pull!"  Sometimes we anxious people need that type of comment.  Thanks much for your time and response.  God bless you!    

.

[H. Hunter Handsfield, M.D.]

Stopping only after the opening sentences:  Unless you had sex or shared needles with someone at the Target store, there is no HIV risk.  It's hard to imagine you're going to describe something that carries any realistic risk.  But now I'll read the rest of your questions.

Now I have done that.  Guess what?  There is no risk for anything and I cannot imagine why it might even have entered your mind.  You would have had to scoop up some of the red stuff and rub it into your body somewhere.

The direct answers to your questions are:

1,2) Zero risk for any of those infections.

3) Almost no infection is transmitted by contact with "just one virus".  It typically takes lots of infected secretions that have access to susceptible cells.  They call them STDs because you have to have sex to transmit them.

4) CDC gives the public fully complete and honest information, within the limits of practical issues in communication (e.g., brief responses to questions that might be complex) and that in some cases the research data don't provide clear answers.

HHH, MD