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an africain want information about his risk
Aug 10, 2008

dear doctor , salam from mali in africain desert i have used google traduction to describe my situation because i want to be accurate and clair,one day a man who is serpositifs who was spitting in my face , so i had splash on my eyes and mouth ; of saliva and small quantity of blood , my eyes were oppended when the splash happend and i still remember i have an injury in my mouth , so dear frascino please i want to know if i can have hiv by this way , i repeat i had a splash on my eyes and mouth of saliva with quantity of blood , do you think that i have to make a HIV test or not , and HIV test is very expensive in my country and it is ashamed if i ask people for this ,,test because most people here are ignorant,, if i ask for hiv test they think that i have hiv and they will escape me ;please doctor please answer me in english and give lot of details because your information will be useful for me and my family and my small city thann you

Response from Dr. Frascino

Hello,

The risk of HIV acquisition from the situation you describe is negligible at best. I do not feel HIV testing is warranted.

I am very concerned that HIV is still so stigmatized in your community. I would like to strongly suggest that you, your friends and your family begin to change this dangerous situation. Certainly if you are afraid to even get tested, most likely there are many other people avoiding testing due to fear as well. This type of situation can fan the flames of the epidemic, and indeed it has in many areas of the world. I urge you to do all you can to promote HIV/AIDS awareness, education and prevention.

I'll reprint several posts that deal with situations like yours below. There are others in the archives. Have a look!

Good luck.

Dr. Bob

blood tainted saliva in eye Jun 11, 2008

Dear Dr. Bob,I know you have stated that your response to questions is not contingent on whether one sends a donation to your foundation or not, however,I will send 200 dollars to your foundation if you will please answer this question for me. No one can give more informative and reassuring answers than you, Dr.Bob. I know you have many demands on your time but I sense you have a big heart and I entreat you to respond. My situation: I was talking recently with someone I do not know well and during our conversation I felt his saliva hit my eye. After our conversation, about a minute later I wiped my eye with my hand. Later, I became concerned that since my eye is a mucus membrane that I may have contracted hiv in this manner. I read on your site that saliva is not considered to be a source of contamination for hiv and that it contains enzymes that actually kill the virus. So I am not concerned about this incident if it was only saliva that hit my eye. However,if for some reason the saliva was mixed with blood there could be the chance of hiv contamination. Since I can find no info on what the chance of getting hiv in this manner,eg.1 in 100, 2 in 500 I ask hypothetically what the figures would be if just blood had hit my eye? Also, I read that hiv is not airborne so if saliva tainted with blood hit my eye how would the airborne effect factor in? Most importantly, is it rare that people would have blood and saliva in their mouths or do alot of people typically have blood tainted saliva in their mouths? I would like to assume that it was only saliva. I hope that you will help me sort things out and help me put this into a realistic perspective. I suppose that people getting spittle in their eyes during conversation is a fairly common happening and if a person could get hiv in this way then most of the world's population would have hiv. Thank you for taking the time to read this. I hope you can offer me some reassurance concerning this. I would also like to start making monthly donations to your foundation which has helped so many,including people like me who need peace of mind. With kindest regards.

Response from Dr. Frascino

Hi,

First of all, thanks for your kind comments.

Regarding your concerns about HIV acquisition from getting spittle in your eye, your fears are completely unwarranted. You are correct: Saliva that does not contain visible blood would not be considered an HIV risk. Even if your lisping, spluttering, chatty partner did have some blood in his or her mouth from, say, gum disease or recent dental work or whatever, the amount of blood that could have realistically reached the mucous membrane of your eye via spray or spit would be so small that the HIV risk would still be essentially nonexistent. Even when a significant amount of HIV-tainted blood comes into contact with a mucous membrane, the chance of HIV transmission is only 0.09%! So in your case you have a person whose HIV status is unknown who gets a bit of spittle in your eye. And we don't know if there was any blood in the saliva. With all those unknowns and the exceedingly low risk of this mode of transmission, your personal risk becomes so remote that it's essentially nonexistent. To put it in "realistic perspective," your chances of contracting HIV are about as good as Mary Cheney's chances of having a three-way with the Bush Twins or Dick Cheney's chances of recording a public service announcement for PFLAG (Parents, Families and Friends of Lesbians and Gays). I see absolutely no cause for worry whatsoever. If my reassurance doesn't put your (unwarranted) worries to rest, get a single rapid HIV test at the three-month mark to put any residual fears permanently to rest. I certainly don't feel an HIV test is warranted for any reason other than calming your fears, OK? I'm absolutely sure you did not contract HIV from Mr. Spit-Sprayer.

Thank you for your generous gift to the Robert James Frascino AIDS Foundation (www.concertedeffort.org). Your one gift will touch many lives in a very meaningful way. On behalf of those folks struggling with the challenges of AIDS, please accept my heartfelt appreciation. In return I'm sending you my good-luck/good-health karma.

Be well!

Dr. Bob

blood to eye contact Mar 21, 2008

I was assisting in placing an ng tube. The persons nose started to bleed and while they were fighting the tube, they blew out of their nose and their blood flew directly in my eye. They are HIV positive. I am now on Combivir. What are my chances of getting HIV. I have two small children and I am very concerned. Thank you.

Response from Dr. Frascino

Hello,

The risk of HIV acquisition following mucous membrane exposure is estimated to be 0.09% (confidence interval 0.006% to 0.5%). Your statistical risk would be less, because you are taking PEP. Consequently the odds are astronomically in your favor that you will not contract the virus from this occupational shot in the eye. You can download a copy of the Department of Health and Human Services/CDC "Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HIV and Recommendations for Post-Exposure Prophylaxis" at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5409a1.htm.

Good luck.

Dr. Bob



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