Fingers, Cuts - Still Unclear

Question

You've been very helpful in the past and I've been happy to support your great work with donations. I've looked over your archives and it still seems the issue of HIV transmission through paper cuts, cutting fingernails too close, bleeding cuticles, etc. is still unclear. In one exchange a writer said he thought the cut had to be fresh and bleeding for HIV to have access to bloodstream. However, if the cut is bleeding out then there's no way for HIV to get in. And, for cuts that were not actively bleeding (no matter if 30 minutes old or several days) there is also no way for HIV to enter. So, this writer concluded that it was probably essentially impossible to get HIV through cuts (distinct from deep lacerations, of course) such as I listed above. You seemed to basically agree with the writer at the time. O-K, my incident was cutting fingernails too deep to the point where skin under nails was very raw and possible bleeding. Then 12 hours later was fingering a woman who was probably high risk and on her period. I remembered the fingernail cutting later. Don't think my fingers were bleeding at the time, but certainly very raw. The next day I bumped one of the fingers and it began to bleed. What is my risk with this fingering incident described above? Any documented cases of HIV transmission through paper cuts, raw and possibly bleeding skin under closely-cut fingernails, bleeding cuticles, etc.?? Thanks for your help. Fingers doing the walking in Asia...

Answer

Hello Fingers Doing the Walking in Asia,

You are asking for a degree of exact risk that is impossible for me to provide. Every questioner and every situation is different. I can only respond based on the specific information provided, applying it to general concepts related to HIV transmission risk. Think about it. There are paper cuts and then there are paper cuts. The severity, freshness, depth and location vary immensely. The same applies for cuticles, close cropped fingernails, etc., etc., etc. How can I possibly give you an exact black or white response to the question of "HIV transmission through paper cuts, cutting fingernails too close, bleeding cuticles, etc.?"

These are some absolutes that I can provide:

  1. The overall risk of HIV transmission via these routes is remote, but remains theoretically possible in some situations.

  2. If you or anyone else feels they have placed themselves at risk for HIV, they should get an HIV rapid test at the three-month mark. Continuing to worry and fret about "what-ifs" and trying to parse my responses to fit your specific situation is an exercise in futility and amounts to nothing more than mental masturbation. The bottom line: if you think you've been exposed, get tested. Period. Full stop. End of story.

Oh, and one other absolute: mental masturbation does indeed qualify as a non-risk activity.

Dr. Bob