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Terrible anxiety about HIV infection
Sep 10, 2011

Dear Dr and most respected experts,

My greatest thanks to you in advance for your answer to my question below.

My brother, who is in China, in April this year went to a beauty shop to repair the hard skin on his feet caused by walking. He has been a very clean person in his sexual life and rarely has sexual activities because his wife and his son are living in another city. The guy in the beauty shop used three small knives to cut off the hard skin and my brother saw that the guy actually sterilized the three knives before he started his work. But he did not see whether the final knife, which was used for the final step, was sterilized. My brother later found that the skin on his foot was broken and bloodied. For the following months he felt extreme fatigue, a rash on his belly which disappeared after one week, a sore throat, and the most fearful thing was a swollen lymph node in his groin. He was very frightened. In the 8th week, he took HIV test which was negative and after 100 days he took another test which was also negative. In the meanwhile, he checked the best local hospitals and the doctors could not find out the reason for his swollen lymph node. Because he still has the swollen lymph node and feels extreme fatigue, he almost collapsed and is so fearful that he could hardly work thinking he was going to die soon.

He is going to take the HIV test after 6 months time but has already made arrangements for his death. I am in the UK. I cry together with him by phone and I don't think I would be able to lose my dearest brother.

Can HIV be transmitted this way and does that mean if he tests negative after 6 months we can make the final decision that he is free from the disease? How should he prepare for the six month test?

Thank you so much for saving us!

Response from Dr. Fawcett

Thank you for writing. While it is theoretically possible to transmit HIV in the manner you described, it is unlikely. It is appropriate for him to follow through with HIV tests and it is reassuring that they have so far been negative. A negative test six months after the incident can be considered conclusive that he was not exposed.

I believe the anxiety created by this incident, while understandable, is more harmful than the risk of exposure. While the risk of HIV is small, such chronic and intense worry can have both psychological and physiological consequences. He is doing what he needs to do in terms of testing. I would encourage you and your brother not to worry and to focus on the present, as difficult that can be.

-David



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