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Heroin/cocaine speedballs and HIV risk
Mar 12, 2012

Dear Doctor,

My husband is HIV positive and I recently had an injection shot of cocaine/heroin by him. I used a new needle to take the injection, and the water and surface of the cigarette carton where I mixed the cocaine/heroin with water was clean also. Unfortunately, I don't know for sure if the cocaine/heroin substance was contaminated with invisible bits small dried blood from him. I would like to know what my chances are of getting HIV from this as I have heard that HIV dies quickly outside the human body. If this is true, why does it still survive in syringes and needles?

Also, my second question is this: an HIV positive friend rinsed his used needle in a water bottle. My husband used this rinse water from this bottle to inject heroin/cocaine into his body. My husband now has HIV. I believe it was from this rinse water that he had contracted the disease. I would like to know why the virus had not died outside the human body and let him contract this disease? If my husband had contracted this disease in an easy situation like this, then what are the chances of me contacting the disease when I used all new water/syringes but the cocaine/heroin itself could have been contaminated?

Thank you and regards,

Confused.

Response from Dr. Fawcett

Thanks for writing. Speedballs (a combination of heroin and cocaine) are common among injection drug users and, like any injection drug use, carry a very high risk for HIV. It is true that the HIV virus is fragile outside of the human body, capable of surviving only a matter of minutes. In syringes, however, HIV can remain active for much longer (days and even weeks) if there is enough fluid in the syringe. For that reason it is extremely important never to reuse or share syringes, water, or any other drug paraphernalia. Remember even cleaning needles with bleach is not risk free, it is a last resort.

In the situations you described it is unlikely that the virus survived in a dried state but sharing needles and/or water is much higher risk. Be sure to get tested for both HIV and hepatitis and since your possible risk involves people known to be HIV positive, you should continue getting tested through the six month post-exposure mark.

Take care,

-David



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