Tongue Ring and HIV Risk

[Greg89]

Hello Doctor.
I dated a female for two years (I am male.) We recently parted ways.

She had a tongue ring that she had had pierced at a "friends" house, with a needle that could have been dirty. I don't think he had pierced anyone before her. I didn't think much of it at the time. We never used condoms together and had sex hundreds of times.

I am uncircumsized and I acquired HPV from this same girl.
My question is this.

1) What are the chances that she acquired HIV from this incident?
2) What is the chance of me acquiring it from her?
3) Do you see the need for testing for either of us?

[Greg89]

True, in piercing shops they are very careful.
But, there are a lot of people that have 'friends' pierce them with needles that could possibly be contaminated. Essentially what I was saying was that even if a needle had been used on someone else, the chances of that person having HIV are about 1%, so the chances of contracting it are pretty slim.

[H. Hunter Handsfield, M.D.]

More than that, your apparent context assumes that piercing is done without sterile precautions.  I'll bet most are done with the same attention to that as would occur in a medical office.  In those cases, the risk is zero regardless of how many people in the population have HIV.  Of course there are exceptions.  And I suppose one could argue that people at particular risk for HIV (gay men, CSWs, injection drug users) are more likely to be pierced than the "general population".  Even if so, the determinant of risk is the standard HIV risk behavior, not the piercing.

[Greg89]

and since 99% of people don't have HIV in the US, the chances of the instrument being contaminated would be extremely low.

Thanks doctor.

[H. Hunter Handsfield, M.D.]

The process of piercing would put someone at risk if the piercing instrument was contaminated with HIV infected blood, just as contaminated needles risk HIV transmission occupationally for health care workers or among injection drug users.  But simply having a pierced tongue, navel, or nipple doesn't mean the instruments used in piercing were contaminated. If everybody with a body piercing were at increased risk for HIV, then that would mean almost every woman.  Do you know any who don't have pierced ears?  (Not to mention a whole lot of men...)

[Greg89]

Hello, doctor. I'm back. My HIV test came back as negative.

I'm curious though. If sharing needles for injection drug use puts someone at a extremely high risk for contracting HIV, why are piercings not the same risk?

Worst case scenario, if someone is pierced with a hollow needle and someone who had HIV was pierced with that same needle before them, would that person contract HIV?

I'm wondering as to why piercing is not considered a risk, when other practices and occupational exposures are considered a risk.

[H. Hunter Handsfield, M.D.]

You are reaching for exceedingly unlikely risks.  Why not worry about things that have a more realistic chance of harming you, like being hit by lightning?  I mean that literally -- the chance is higher.  It mgiht be theoretically possible to catch HIV by tongue piercing, but I'll bet nobody in the world ever acquired it that way.

Please accept the reassurance and don't argue with it.  You can expect your HIV test to be negative.

[Greg89]

Thank you doctor.
She was not an IV drug user, or fit any of those criteria, to the best of my knowledge.

So, even if the guy wasn't a professional piercer, and it wasn't done in a shop (there is no evidence for sterilization) the risk is still pretty low? How long does HIV survive outside the body?

I've made an appointment to get tested tomorrow.

[H. Hunter Handsfield, M.D.]

I doubt that the tongue ring increased your partner's risk of having HIV, either from the piercing procedure or later sexual exposures.  Assuming you're in the US or other western/industrialized country, whether your partner was at risk for HIV depends on whether she was an injection drug user, a commercial sex worker, or the partner of a gay or bisexual man.  If none of those things, the chance she had HIV is extremely low.

1) I see no reason to suspect she had HIV.

2) If she had it, your risk of infection was roughly 1 chance for every 2,000 episodes of unprotected vaginal sex.

3) From the specifics of your question, there is no need for either of you to be tested for HIV.  However, it is generally recommended that all people who are sexually active outside permanent mutually monogamous relationships get tested for HIV and other STDs from time to time, like every 1-2 years.  On that basis, and because you're nervous about it, go ahead and be tested.  You can expect negative results for HIV.  (The chance is higher for other STDs, or course.)

Regards--  HHH, MD