Aug 28, 2001
I have noticed that the consensus is that hiv+ bodily fluids like blood have to come in contact with a mucous membrane, broken skin, or an actual puncture with a contaminated sharp to transmit the virus. My question is, what exactly constitutes an open wound or broken skin? When you refer to this do you mean a cut, etc. that is fresh enough to still be bleeding and broken skin that is "weeping" from an active dermatitis or something? If a cut or wound is not still bleeding would you consider it unable to transmit the virus to your bloodstream? Thus, would it not necessairly be considered a significant exposure if infected blood or body fluids came in contact with one of these non bleeding type, several hour old wounds? Thank you for your help
Response from Ms. Breuer
Every not-quite-fresh, weeping, not-yet-healed cut or abrasion is different, so the general principle is to keep anything covered that allows access to your bloodstream. One case that applies to your question is that of a caregiver who had extensive, weeping excema on her hands. Over the months of her caregiving, she came into contact with most of the patient's body fluids, and she did not wear gloves. She did acquire HIV infection.
The literature is not full of such cases; they're very rare. But they do happen sometimes. So the standard you need to apply, considering that it is possible, is what gives you confidence? What standard do you know you can keep up? What will keep your mind from playing scary scenarios? That's your standard.
As to your last question, the medical experts I have questioned agree that a cut that is several hours old is unlikely to allow the virus to reach the bloodstream--unless the cut is immersed in blood. The reason the cut isn't bleeding anymore is that a thin healing layer has already begun. Is it thick enough? Every case is different. Isn't this frustrating?
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