Jul 11, 2010
Thank you for your time. As a monogamous heterosexual I have had one female sexual partner only. We have been married for 25 years. She has been tested and is HIV negative. I am not an IV drug user and have never had a blood transfusion. I was assaulted 2 years ago in a carjacking attempt. I sustained multiple injuries to my face that involved several open wounds to my mouth and several other areas on my face. I also sustained smaller wounds to my hand as I defended myself. My wife and I started to practice safe sex. Unfortunately I was unaware of post exposure prophylaxis. I started home testing for HIV within 2 weeks. I was negative until the fourth month. I was tested further and the Western Blot and subsequent CD-4 & viral load testing was done. My CD-4 was about 460 and the viral load was 3300. Testing was done again within a month, which showed my CD-4 dropping to 440 (approx) and VL 6600. Testing done within 3 more months showed my CD-4 up to 680 and the VL down to 3000 again. I have gone in for 3 and 6 month testing intervals since. My counts have stayed relatively unchanged and my CD-4 has gone down slightly 580 (approx). I am extremely fortunate and I am not on medication. I have tried to come to grips with this disease and hope I am doing well. I feel that I am. The one thing that has been hard is that I have been told there is no way I could have contracted this disease from my assault. I am sure that there was blood present from my attacker, I feel this because of the presence of his skin that was present in my mouth and transfer patterns on my shirt from his hands. My facial injuries were not large (abrasions, scrapes and punctures to my face and hands). I assure you that I have not participated in risky behaviors like unprotected sex and IV drug use. I have had no occupational exposures involving blood or body fluids. I've been told that there is the smallest possibility that there could have been exposure, however somehow they say that this means I could not have contracted the disease from an assault of this nature. I have even been told that this would be a medical first. Is this true? You can imagine the frustration of my situation.
One personal benefit from this situation has been a better understanding that this is just a disease and not a punishment. I guess we try to mentally insulate ourselves from terrible situations like disease, violence, poverty and other unfortunate life experiences. Somehow we feel safer if we can relegate these situations to people who somehow bring them on by some action on their part. This has changed mine and my family's view forever. Sorry for rambling. I know you time is valuable and I appreciate your consideration. Thank you.
Response from Dr. Holodniy
Calculating hypothetical risk of transmission is difficult, especially when there is no experimental evidence simulating the type of exposure you describe to provide us with any guidance if it is possible or not to be infected in this way.
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