Mar 26, 2011
Hello Dr. Bob,
What you do on this website is admirable. Thank you for sharing your knowledge and expertise about HIV and AIDS with the public.
I trust you, and I hope you can help me. I'm suffering from (and being professionally treated for) a debilitating fear of coming into contact with HIV in my day-to-day life. However, in the days between my once-per-week sessions with my psychologist, I am literally non-functional due to my fears. I have had to take a leave of absence from college because my fears have made it impossible for me to share bathrooms with people, go into crowded places where people who might have cuts might come into contact with a cut of mine, etc. Because I suffer from paralyzing anxiety attacks, I really hope you will consider my questions worth answering because it may sincerely improve my ability to live my life.
I have done much research in an attempt to logically dissuade myself from this (which has had a small but noticeable effect on my mental state), but I still have one worry I hope you can address for me. What is the MAXIMUM amount of time HIV can survive in dry form? I've read the following on the CDC's website and also in the archives on this website (from Dr. Horwath's post in the Mental Health & HIV Forum in 2006):
"Scientists and medical authorities agree that HIV does not survive well in the environment, making the possibility of environmental transmission remote. HIV is found in varying concentrations or amounts in blood, semen, vaginal fluid, breast milk, saliva, and tears. (See below, Saliva, Tears, and Sweat.) In order to obtain data on the survival of HIV, laboratory studies have required the use of artificially high concentrations of laboratory-grown virus. Although these unnatural concentrations of HIV can be kept alive under precisely controlled and limited laboratory conditions, CDC studies have showned that drying of even these high concentrations of HIV reduces the number of infectious viruses by 90 to 99 percent within several hours. Since the HIV concentrations used in laboratory studies are much higher than those actually found in blood or other specimens, drying of HIV- infected human blood or other body fluids reduces the theoretical risk of environmental transmission to that which has been observed--essentially zero."
A 1997 post from Mr. Sowadsky in the Safe Sex and HIV Prevention Forum reads:
"When we extrapolate this data down to natural concentrations of HIV, we can determine that HIV can only live for several minutes outside the body."
So what I want to know from you, Dr. Bob, is the following:
(1) Theoretically, if I am unlucky enough for a break in my skin to come into contact with dry HIV-infected blood within, say, 30 seconds of the time it dries, would there be a realistic risk of infection? Even though I believe the virus only lives for a short time when dry, can I become infected if the fluid has only been dry for less than "a few minutes"?
(2) So, the data from some lab studies was extrapolated in or before 1997 to indicate that the virus lives a few minutes after drying. Have we done a study in more recent years with the concentrations of HIV that actually occur in nature to prove with 100% certainty (and not just extrapolation) that the virus dies so quickly? If so, can you provide a source for me?
(3) How many minutes would have to pass before I could be certain that a dry fluid has been dry long enough for the risk to be absolutely zero and not infinitesimal/almost zero? I presume that, theoretically, blood that has been dry for 30 seconds by the time I touch it is still infectious since 30 seconds is less than a few minutes. I also realize that the probability of coming into contact with blood that has just finished drying by the time a cut on my hand touches it is infinitesimal within itself, but it is not zero, and the zero is what I'm searching for. So, for example, if my clothing touches dried blood, EXACTLY how many minutes could I wait before touching them with a break in my skin to be 100% sure that I have exactly 0 risk for contracting HIV?
(4) Diverging slightly, the CDC information reproduced by Dr. Horwath does not mention the concentrations of HIV in earwax. Is there enough HIV in this bodily fluid for contact with it to be a transmission risk?
Dr. Bob, I know my post is long, but I really have not found the precise answers to my specific questions addressed on The Body or anywhere else. In my case, because of the extremity of my mental condition, similar questions are of no help.
Please, please help me. Much of my mental state can only be helped by a psychologist, but no psychologist can provide me with the scientific data I seek from you.
I need you, Dr. Bob, and I hope you will answer me.
Thank you (very much),
Wanting My Life and Future Back
Response from Dr. Frascino
1. Theoretical risk would be essentially zero.
2. Sorry no, I can't provide you with such a reference, but I can reassure you that the environmental-transmission risk for HIV you are worried about is essentially nonexistent. Remember, we've been intensely studying and monitoring this virus for years!
3. Sorry, I can't give you an "EXACT" number of minutes, because there are many variables -- viral strain, viral concentration, ambient temperature and humidity, etc.
Actually I doubt these answers will give you the "peace of mind" you desire. In addition to a psychologist (non-M.D.), I would strongly recommend you see a psychiatrist (M.D.). Your degree of irrational fear, "paralyzing anxiety attacks" and obsession with possible environmental HIV transmission may well benefit from certain prescription medications in addition to your psychotherapy (counseling).
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