Aa
toilet incident / procreation
I’ve seen previous questions involving toilet seats – you’ve been quite clear that they aren’t a risk for HIV... I’d just like to check this specific incident please. I went to use the cubicle at work and there was a patch of dry (I think) blood on the back of the seat. I normally sit quite far forward and reasoned that I would be able to use the seat without touching it at all. I didn’t think I had any cuts on my skin at the time. Since then, I’ve felt stupid for doing it and worried that if some blood did touch my backside then I might have rubbed it into the anal region when I was wiping, which could allow transmission. Or, it could have come into direct contact with a cut/scratch which I didn’t know about (I don’t think I scratched myself in that area since I woke up, so I guess any patches would have had a few hours to heal). Am I at any risk at all? It was a small office in Australia – I presume the odds of someone having it, multiplied by the risk of transmission would put it in the millions and I have more chance of dying of cancer this year?
I have been concerned about HIV in the past. Although it is a serious disease, I’m not so worried about the medical impact to myself with the availability of current and future treatments. It’s more about my ability to have a partner/family. I know that HIV+ women can give birth to HIV- babies. And HIV+ men can have their sperm washed if they don’t want to infect their partner. Worst case scenario, if both partners are HIV+, can they give birth to a healthy child? I presume the man could always have his sperm washed if he was an issue...
Thanks very much
I have been concerned about HIV in the past. Although it is a serious disease, I’m not so worried about the medical impact to myself with the availability of current and future treatments. It’s more about my ability to have a partner/family. I know that HIV+ women can give birth to HIV- babies. And HIV+ men can have their sperm washed if they don’t want to infect their partner. Worst case scenario, if both partners are HIV+, can they give birth to a healthy child? I presume the man could always have his sperm washed if he was an issue...
Thanks very much
MEDICAL PROFESSIONAL
Welcome to the forum. I'll try to help.
Few Australians have HIV (it's one of the most HIV safe countries world wide), so the odds that any blood on the toilet came from an infected person are very low. Second, even if it were HIV infected blood, sitting on it would not risk infection. In other words, I agree exactly with your own analysis: "the odds of someone having it, multiplied by the risk of transmission would put it in the millions and I have more chance of dying of cancer this year". Or of being hit by lightning.
It seems pointless to speculate on the impact of HIV on conception and healthy children, at least as far as you are concerned. You don't have HIV (and couldn't have caught it from the non-exposure event described here), so what's the point in worrying about it? The answer is that a) you are correct about preventing HIV during conception and delivery; and b) dually HIV+ couples indeed can have healthy children who don't have HIV.
Regards-- HHH, MD
Few Australians have HIV (it's one of the most HIV safe countries world wide), so the odds that any blood on the toilet came from an infected person are very low. Second, even if it were HIV infected blood, sitting on it would not risk infection. In other words, I agree exactly with your own analysis: "the odds of someone having it, multiplied by the risk of transmission would put it in the millions and I have more chance of dying of cancer this year". Or of being hit by lightning.
It seems pointless to speculate on the impact of HIV on conception and healthy children, at least as far as you are concerned. You don't have HIV (and couldn't have caught it from the non-exposure event described here), so what's the point in worrying about it? The answer is that a) you are correct about preventing HIV during conception and delivery; and b) dually HIV+ couples indeed can have healthy children who don't have HIV.
Regards-- HHH, MD
Thank you very much for your swift response Dr HHH. I guess over a lifetime these sorts of things happen to everyone - I don't want to go down the route of blaming myself for 'not being careful enough' and getting unnecessary tests all the time for non-incidents. There are things that are much worse than HIV which could unfortunately happen...
Knowing that even under the worst case scenario (I/we somehow caught it) we could still have a family is comforting for me and makes the whole issue, generally, less of a worry. I think you're right about speculating on conception though as it's a dozen steps down the line - I don't have HIV and I'll forget about it on your advice!!
Knowing that even under the worst case scenario (I/we somehow caught it) we could still have a family is comforting for me and makes the whole issue, generally, less of a worry. I think you're right about speculating on conception though as it's a dozen steps down the line - I don't have HIV and I'll forget about it on your advice!!
MEDICAL PROFESSIONAL
You should also understand that Australia's nationally funded sexual health centres are, collectively, the world's best network of STD/HIV clinics. World class expertise is readily available, especially if you live in or near an urban area -- and if you're in the vicinity of Sydney or Melbourne, you have access to the best of the best.
Dr,
I'd be very grateful if I could tack one last question on to this thread, regarding your last point - happy to pay for another one if not... I promise this will be the last.
One of my friends became HIV+ a few years ago, and after a few dodgy episodes (real risks as opposed to above) I felt the need for occasional testing. I only recently moved to Australia from the UK and would like to feel I can get an early test if another matter arises.
In your post http://www.medhelp.org/posts/HIV-Prevention/HIV-Duo-Test/show/1455591 you suggest the hiv duo test is at least 99% accurate after 4 weeks. As you probably know, the duo is very accessible in the UK, and has assured accuracy beyond 28 days.
I sent an email to the sexual health centre here in Brisbane asking what test they do. The lady who answered was able to confirm that all tests for HIV check for P24 antigen as well as antibodys. However, when asked if they still suggest a 3 month window (as all the websites in Oz still state), she said:
"depending on your history and risks sometimes and HIV test can show a positive result at the 6 week mark but a retest in a further 6 weeks would always be recommended."
I believe she was a nurse and perhaps isn't confident enough in how the test works or wishes to tow the 'company line' (which is understandable). But from what I've read, surely any decent antibody and P24 antigen test - NHS or Australian standard - will give a reliable result >99% accuracy, as you and many others suggest? Would that be a fair presumption?
Many thanks
I'd be very grateful if I could tack one last question on to this thread, regarding your last point - happy to pay for another one if not... I promise this will be the last.
One of my friends became HIV+ a few years ago, and after a few dodgy episodes (real risks as opposed to above) I felt the need for occasional testing. I only recently moved to Australia from the UK and would like to feel I can get an early test if another matter arises.
In your post http://www.medhelp.org/posts/HIV-Prevention/HIV-Duo-Test/show/1455591 you suggest the hiv duo test is at least 99% accurate after 4 weeks. As you probably know, the duo is very accessible in the UK, and has assured accuracy beyond 28 days.
I sent an email to the sexual health centre here in Brisbane asking what test they do. The lady who answered was able to confirm that all tests for HIV check for P24 antigen as well as antibodys. However, when asked if they still suggest a 3 month window (as all the websites in Oz still state), she said:
"depending on your history and risks sometimes and HIV test can show a positive result at the 6 week mark but a retest in a further 6 weeks would always be recommended."
I believe she was a nurse and perhaps isn't confident enough in how the test works or wishes to tow the 'company line' (which is understandable). But from what I've read, surely any decent antibody and P24 antigen test - NHS or Australian standard - will give a reliable result >99% accuracy, as you and many others suggest? Would that be a fair presumption?
Many thanks
* "will give a reliable result >99% accuracy" from 28 days....
MEDICAL PROFESSIONAL
Don't get hung up on test peformance that can be considered proved (99% for DUO at 28 weeks and beyond) and what experts believe is the truth (100%). No research has ever determined, nor will it ever be possible to know, whether true performance is better than 99+%.
And if you have had a test with "only" 99% reliability, it doesn't mean there is a 1% chance you have HIV. If you start with a risk of, say, 1 in 10,000 that someone has HIV, a test with 99% reliability makes it 1 in a million.
Here is a thread that explains why official advice often remains that a final HIV test be done at 3 months despite virtually 100% reliability at earlier times:
http://www.medhelp.org/posts/HIV-Prevention/what-is-the-window-period-for-hiv/show/1704700
I hope you can achieve success in overcoming your apparently inflated fears of HIV and concerns about test reliability, but I won't have any further advicet about it. Take care.
And if you have had a test with "only" 99% reliability, it doesn't mean there is a 1% chance you have HIV. If you start with a risk of, say, 1 in 10,000 that someone has HIV, a test with 99% reliability makes it 1 in a million.
Here is a thread that explains why official advice often remains that a final HIV test be done at 3 months despite virtually 100% reliability at earlier times:
http://www.medhelp.org/posts/HIV-Prevention/what-is-the-window-period-for-hiv/show/1704700
I hope you can achieve success in overcoming your apparently inflated fears of HIV and concerns about test reliability, but I won't have any further advicet about it. Take care.
Thank you very much for your last reply.. the info in the links is excellent and very clear. I take your answers as definitive (duo at 4 weeks / antibody from 6 weeks for low risk) although it is very helpful to know why others, including those who work in the test centres, may suggest otherwise.
You are reading content posted in the HIV - Prevention Forum
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Frequency of HIV testing depends on your risk.
Post-exposure prophylaxis (PEP) may help prevent HIV infection.
