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Please help, v. scared and have been trying to find answers for three months! (I'm sorry to keep asking, but I don't know who else to ask)

Jan 29, 2009

Hi Dr. Bob,

I'm sorry to keep asking you and I know you're very busy, but i'm re-sending my question as I am extremely anxious and am hoping you can give me some answers.

I am a medical student. I had an incident 13 weeks ago in which I was taking down a dressing from a patient of unknown HIV and Hep-C status. I felt something sharp on my finger, and when i looked down I had poked myself with a metal clip from an ace bandage. The ace was not visibly dirty where the clip was, but the patient did have an open ulcer lower down on his leg. The clip was in white (not dirty-looking) ace bandage over gauze over unna boot, and it wasn't visibly bloody. I couldn't tell if the clip broke my glove, and I couldn't see a cut on my finger (but I've often noticed that needle-stick type punctures don't always leave a mark).

I have been freaking out ever since, worrying that the patient was HIV or HepC positive. At the time, one of the residents I was working with convinced me it was nothing and I should just relax. I know seriously regret not going to employee health and having the patient tested. My question now is, when do I get tested? I know three months is right outside the window period, so I will get tested. Do I then need to be tested again at 6 months? And what if the patient had both HepC and HIV? I've read that there can be delayed seroconversion up to a year if there is simultaneous infection. Is there any way to rule all of this out ASAP or will I have to keep testing for a whole year?

Please help, I am a very scared medical student and I am afraid of infection my fiance and my family. I want to stop this worrying as soon as I can!

Thank you so much for your patience, and I am praying you will be able to answer my question soon!

PS - I know I have anxiety issues, and I am being helped for that, but I just can't get these HIV worries out of my mind becuase I feel like I am goign to infect someone I love! I don't know what type of test to trust (i want to go anonymously to one of the government STD clinics in NYC but I'm afraid they will use a rapid test that isn't as accurate).

Response from Dr. Frascino


I agree with the advice your resident gave you. The incident you describe would not be considered an HIV or hepatitis risk. If my reassurance isn't enough to shake your worries away, get a single HIV antibody test at the three-month mark to put your unwarranted worries permanently to rest. Your problem is not HIV, but rather fear of HIV. I'm glad you are getting help for your anxiety issues. These types of irrational fears could severely compromise your effectiveness as a physician. Had you been evaluated by occupational medicine/employee health, I believe they too would agree with my assessment. Even after the fact, you can still report the incident and if needed get your HIV test through that program.

Dr. Bob

im giving myself a yahoo
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