Hello and thank you for your inquiry.

We understand that you would like to know if a 4th generation HIV Ag/Ab test you received 5 weeks after receiving oral sex can be considered conclusive.

We agree with the doctor that receiving oral sex is a Neglibigle Risk encounter, meaning that there is a potential for HIV transmission, but there has never been a confirmed report of transmission from this activity.

Seroconversion is the period of time during which HIV antibodies develop and become detectable. It is often, but not always, accompanied by flu-like symptoms including fever, rash, muscle aches and swollen lymph nodes. These symptoms are not a reliable way to identify seroconversion or to diagnose HIV infection. (2) If your symptoms are actually attributed to seroconversion, then your blood should test positive for HIV antibodies.

Fourth-generation HIV tests can detect HIV infection in 50% of people by 18 days after infection; 95% of people by 34 days after infection; and 99% of people by one and a half months after infection. Fourth-generation HIV tests and the INSTI rapid test have a sensitivity of about 99.9%. (1)

Recommendation: Since this is a negligible risk, you have already tested negative at 5 weeks post encounter, and have already consulted your doctor, no further action is advised.

Regards, AIDS Vancouver Helpline Volunteer, Dyson

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the previous posted question titled "finger pricked with lancet and fingered CSW 24 hours later with same finger". From the information given, this scenario is determined to be Negligible Risk (There are no evidence or no documented cases of transmission).

A Negligible Risk states that there is a potential for HIV transmission to occur because there is an exchange of body fluids. Also keep in mind that there has never need a confirmed transmission report through this scenario.

The second part of the question was asking about finger pricks. Finger pricks with a lancet usually heal spontaneously within minutes in non diabetic people and do not pose a threat for HIV infection.

The normal recommendation for a negligible risk is as follows: There are no evidence or no documented cases of transmission refer to Physician for more personalized answers. Although the recommendation is not to get a HIV test done we would suggest that you go ahead and get a HIV test done to know your status and for your mental and physical well being.

Regards,

AIDS Vancouver Helpline/Online, Danielle

Hello and thank you for your inquiry.

We understand that you would like to know the risk level associated with receiving unprotected oral sex. Receiving unprotected oral sex is classified as a Negligible Risk activity for transmission of HIV. Negligible risk means that it is theoretically possible to transmit HIV this way, but there is no evidence or documented cases of such a transmission.

Though the risk of acquiring HIV from receiving oral sex is negligible, several factors can increase that risk, including sores in the mouth or on the penis, bleeding gums, and the presence of other sexually transmitted diseases (STDs). Other STDs, such as syphilis, herpes, gonorrhea and chlamydia, can be transmitted during oral sex. (1)

To further reduce your risk of acquiring or transmitting an infection while receiving oral sex, you might consider using a condom. I have included a link below with some information about safer oral sex practices.

Recommendation: There are no evidence or no documented cases of transmission. Please refer to a physician for more personalised answers.

Regards AIDS Vancouver Helpline Volunteer, Dyson

Hello. Thank you for contacting us with your question.

We understand that you would like to know whether multiple 4th generation HIV tests you've had after receiving oral sex are considered conclusive. You are also concerned about HIV transmission to your child through saliva.

Receiving oral sex is considered a Negligible Risk for HIV transmission. This means that there is theoretically a risk of acquiring HIV in this manner, but there has never been a documented case of such a transmission.

According to the Canadian AIDS Treatment Information Exchange, Fourth-generation HIV tests can detect HIV infection in 50% of people by 18 days after infection; 95% of people by 34 days after infection; and 99% of people by one and a half months after infection. Fourth-generation HIV tests have a sensitivity of about 99.9%. (1) Since all four of the tests you had were past the one and a half month window period, you can consider each of these test results to be conclusive. Late sero-conversion is extremely rare and occurs only under certain specific conditions. A sore throat is not indicative of an HIV infection in the absence of a positive HIV test result. A sore throat could be attributed to any number of causes.

In regards to passing HIV to your child through saliva, some information about how HIV is transmitted might be helpful. In order for an HIV transmission to occur, all three of the following conditions must be met:

1 - There must be HIV present in a bodily fluid. The five bodily fluids that carry the HIV virus include: blood, semen (including pre-ejaculate), vaginal fluids, breast milk, and rectal secretions. (2) HIV is not transmitted through saliva.

2 - The bodily fluid containing HIV must have direct access to the bloodstream. This can be through cuts, tears, rips, mucous membranes, open sores, or needles. (2) This condition did not exist in your scenario

3 - Transmission occurs through a risky activity in which the first two conditions are met. (2) Unprotected anal or vaginal sex and sharing hypodermic needles for injection drug use are examples or high risk activities for transmission of HIV.

Recommendation: There are no evidence or no documented cases of transmission from this activity. Consider seeing your doctor if you require more personalized answers or to address your sore throat.

Regards, AIDS Vancouver Helpline Volunteer, Dyson

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the risk of HIV transmission from making contact with a dog leash which may have contained your boyfriend's blood and the blister fluid of your friend. From the information given, this scenario is determined to be Negligible Risk (there is no evidence or no documented cases of transmission).

The scenario mentioned above does not meet the three components of the transmission equation. It does not satisfy the transmission equation because the fluid from your friend's blister has been exposed to the outside environment. HIV is not known to survive for prolonged periods of time outside the human body (such as on surfaces) and it also cannot reproduce outside the human body (1).

The HIV transmission would be satisfied if there was direct contact between your boyfriend's wound and the fluid from your friend's blister. However, because the fluid was already exposed to an environmental surface (in this case being the dog leash) and there is no evidence of direct contact, the possibility of transmission is Negligible.

Recommendation: There is no evidence or no documented cases of transmission. Refer to Physician for more personalised answers.

Regards,

AIDS Vancouver Helpline/Online, Mahtab

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the risk of acquiring HIV through fingering a vagina. You are also concerned about symptoms (frequency of defecation) that you have been experiencing. From the information given, this scenario is determined to be Negligible Risk (There are no evidence or no documented cases of transmission).

The scenario mentioned above does not meet the three components of the transmission equation(1). It does not satisfy the equation because:

• To acquire HIV, there must be direct access for an HIV containing fluid to enter your bloodstream.

In the scenario that you provided, you say that you engaged in fingering a vagina. Fingering is considered a Negligible Risk activity. This means that there is a theoretical possibility, however, there are no evidence or no documented cases of transmission. This is because for the transmission of HIV to occur, there must be direct assess for fluid containing HIV to enter the bloodstream. These direct assess points include inside of the vagina or anus, the urethra of the penis, open cuts and sores(in theory), musocal membranes, and points of needle injection. You say in the description that there were no cuts on your fingers at the time of the activity, therefore, there was no direct access for any fluids containing HIV to enter your bloodstream.

We cannot link the symptoms (frequency of defecation) that you are feeling to HIV acquisition. Yet, these symptoms could be indicative of various other infections. We recommend that you consult with your health care professional to attend to these symptoms.

Recommendation: There are no documented cases of transmission through fingering. Consult with your Physician for more personalized answers concerning the symptoms you have been experiencing.

Regards, AIDS Vancouver Helpline/Online, Hilary

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about going on PEP from performing analingus. From the information given, this scenario is determined to be Negligible Risk (There are no evidence or no documented cases of transmission). This scenario is deemed Negligible as bodily fluids can be exchanged.

In order for HIV transmission to occur bodily fluid containing HIV must have direct access to the bloodstream of an individual who is of HIV negative status through a high risk activity.

In this scenario bodily fluid can be exchanged, but no high risk activity occurred. High risk activities include unprotected sex, sharing needles, unsafe tattoos or piercings, or vertical transmission–from mother to child (1).

High risk activities of a sexual nature are either unprotected vaginal or anal sex. If you are engaging in high risk activities there are biomedical approaches such as PrEP and PEP that help lower your risk of acquiring HIV. Refer to your physicians for further information. Since this activity is not considered high risk it is not recommended to take PEP.

PEP should be used only in emergency situations and must be started within 72 hours after a recent possible exposure to HIV (2). Some examples of emergency situations include possible exposure during sex (condomless sex or condom breakage), shared needles and harm reduction products, or if a sexual assault occurs (2). It is not a substitute for regular use of other proven HIV prevention methods, such as pre-exposure prophylaxis (PrEP), which means taking HIV medicines daily to lower your chance of getting infected; using condoms the right way every time you have sex; and using only your own new, sterile needles and works every time you inject (2).

Recommendation: There are no evidence or no documented cases of transmission refer to Physician for more personalized answers. PEP is not needed in this situation.

Regards,

AIDS Vancouver Helpline/Online, Danielle

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about whether there is a possibility of HIV transmission due to the dental assistant making contact with the glass which had blood on it, and then subsequently making contact with blood in your mouth. From the information given, this scenario is determined to be Negligible (there is no evidence or documented cases of transmission).

The scenario mentioned above does not meet the three components of the transmission equation. It does not satisfy the equation because there is no evidence of HIV from the blood in the glass making direct contact with any wounds in your mouth.

As you have mentioned, the dental assistant made contact with a variety of surfaces, including the waste glass and the dental tools. There does not seem to be any direct contact of blood from previous patients to the wound in your mouth. Further, HIV outside the body or drying HIV causes a significant reduction in HIV concentration (90-99%) [1]. HIV does not survive for long periods of time outside the human body and it also cannot reproduce outside of a human host. As such, since the blood from previous patients had been exposed to the environment, it cannot pose a risk of transmission; the chances of HIV acquisition are Negligible.

It is worth mentioning that dental practices in unsanitary environments are unethical and illegal. Any form of medical practice is contingent on cleanliness of the work environment, professionalism, and the health of the patient. Nonetheless, based on the description of the scenario you have provided, there is still Negligible risk of HIV transmission, meaning there is an extremely unlikely chance you have had an exposure to HIV.

Recommendation: There is no evidence or no documented cases of transmission. Refer to Physician for more personalized answers.

Regards, AIDS Vancouver Helpline/Online, Mahtab

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about acquiring HIV from blood coming into contact with a scratch. From the information given, this scenario is determined to be Negligible Risk (There are no evidence or no documented cases of transmission).

In order for HIV transmission to occur bodily fluid must have direct access to the bloodstream through a high risk activity.

In this case of blood being transferred to a phone, then onto your hand, may result in HIV transmission only if your cut was actively bleeding/fresh (1). An example of blood being transferred this way could be my cutting each others hands and making a blood oath. In this case though it is unlikely that HIV transmission occurred if the cut was not fresh.

HIV outside of the body or drying HIV causes a rapid (within several hours) 1-2 log (90%-99%) reduction in HIV concentration (2). This essentially means that HIV does not survive long outside the body.

Recommendation: There are no evidence or no documented cases of transmission refer to Physician for more personalized answers.

Regards,

AIDS Vancouver Helpline/Online, Danielle

Hi there,

Thank you for your inquiry. From what we gather from the question, you were asking about the possibility of HIV transmission from a finger (that may have had semen) penetrating your anus.

From the information given, this scenario is determined to be Negligible Risk (There are no evidence or no documented cases of transmission). Semen is considered to be an avenue for HIV transmission. Yet, in order for HIV transmission to occur, there needs to be fluid with direct access to the bloodstream. Because your partner potentially had semen on his finger, this would not warrant direct access.

Due to this, your risk of HIV acquisition is quite low. Although you may have an excess of blood or open sores on your anus, there is still little risk when there is not a direct avenue between the bodily fluid, and your bloodstream.

Recommendation: There are no evidence or no documented cases of transmission refer to Physician for more personalized answers.

All the best,

AIDS Vancouver Online/Helpline, Cody

Hi there,

Thank you for your inquiry. From what we gather from the question, you were asking about your risk of HIV acquisition given a scenario where vaginal fluid and spit is used for lube in mutual masturbation.

From the information given, this scenario is determined to be of Negligible Risk (There are no evidence or no documented cases of transmission). Vaginal fluid is one of the 5 main bodily fluids that carry HIV (blood, semen, breast milk, vaginal secretion) (1). Due to this, there is technically a potential for HIV risk due to the presence of bodily fluid with direct access to your bloodstream. However, we would consider this act to be Negligible due to the volatility of HIV when exposed to environments outside of the body.

Saliva is not considered to be an avenue for HIV transmission, and in this case, is not the main concern.

When exposed to environmental surfaces for any amount of time (in this case, from the condom, to the hand, to the penis) any HIV that may have been in the vaginal fluid would be rendered inactive relatively quick. HIV outside of the body causes a rapid reduction in concentration, and is not particularly virulent in these conditions (2).

Recommendation: There are no evidence or no documented cases of transmission refer to Physician for more personalized answers.

All the best,

AIDS Vancouver Online/Helpline, Cody

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the possibility of acquiring HIV and other STIs after receiving a blowjob. From the information given, the HIV risk in this scenario is determined to be Negligible Risk (there are no evidence or no documented cases of transmission), but the risk of acquiring other STIs, such as chlamydia, gonorrhea, syphillis, Herpes, and/or HPV, is present.

The scenario mentioned above does not meet the three components of the Transmission Equation, although there is a theoretical risk of HIV transmission if there is a lot of HIV-containing blood present in the saliva of the person giving the blowjob. In terms of the other STIs I have found a very informative website to address your first and second questions. Please refer to the STD Risk and Oral Sex - CDC Fact Sheet for specifics about the risk of acquiring the previously listed infections through receiving oral sex. Using a condom for future sexual encounters will help to lower your risk of acquiring HIV or other various STIs.

Please note that each of the STIs has a specific test that can be conducted to detect if you have the infection. Chlamydia and Gonorrhea are often tested on a urine sample or a swab, whereas syphilis is typically tested from a blood sample and in come cases a swab.

Recommendation: There are no evidence or no documented cases of HIV transmission through receiving oral sex. Please refer to a physician for more personalized answers and to inquire about other STI testing.

Regards,

AIDS Vancouver Helpline/Online, Marie

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the risk of acquiring HIV from fingering a woman while having a blister on your finger. From the information given, this scenario is determined to be Negligible Risk (There are no evidence or no documented cases of transmission).

The scenario mentioned above does not meet the three components of the transmission equation(1). It does not satisfy the equation because:

• For HIV transmission to occur, the 3 components of the transmission equation(1) must be met. There must be a bodily fluid containing HIV(ex: blood, vaginal fluids, breast milk, anal secretions, semen), direct access to the blood stream(ex: inside the vagina or anus, mucosal membranes), combined with a risky activity(ex: unprotected vaginal/anal intercourse, mother-to-child, sharing needles).

This scenario has been assessed as Negligible Risk. This means that while there is a theoretical possibility of an exchange of bodily fluids if the blister was big enough and popped while inserted in the vagina, there are no evidence or no documented cases of transmission this way. Even then, the vaginal fluids must already contain HIV for you to acquire HIV. There are a lot of "ifs" in this scenario that must be satisfied for transmission to occur, which leads to a negligible risk assessment. We have included some resources below and encourage you to check them out to learn more about HIV and HIV transmission.

Recommendation: There are no evidence or no documented cases of transmission refer to Physician for more personalised answers.

Regards, AIDS Vancouver Helpline/Online, Hilary

Hi there,

Thank you for your inquiry. From what we gather from the question, you were asking about the possibility of HIV transmission through docking (connecting the head of ones penis into the foreskin of another).

For a risk of HIV transmission to exist, specific HIV+ fluids must come into direct contact with the blood stream of a HIV- person. Only some bodily fluids carry enough HIV to pass the virus sexually such as semen, vaginal fluid and rectal fluid (this includes pre-ejaculate). Further, wet skin such as the urethra of your penis contains mucous membranes susceptible to HIV transmission. In your case, the act of docking between you and your partner, with a considerable amount of pre-cum, does carry a potential for HIV transmission.

Although this act presents a potential for HIV transmission (due to the exchange of bodily fluids, with direct access to the bloodstream through the urethra), there has technically never been a confirmed report of HIV transmission. For this reason, we would consider the scenario provided to be of Negligible Risk (There are no evidence or no documented cases of transmission).

While there has never been a documented report of transmission through this avenue, it still remains important to know your HIV status.

Recommendation: There are no evidence or no documented cases of transmission refer to Physician for more personalized answers.

All the best,

AIDS Vancouver Online/Helpline, Cody

Hello and thank you for contacting us.

We understand that you would like to know if there is a risk of acquiring HIV when your mouth came into contact with a sex worker's vagina.

Normally performing oral sex is classified as a low risk activity, but based on the details you have provided this likely wouldn't be considered oral sex. We will classify this mouth to vagina contact under Negligible Risk, meaning that transmission is theoretically possible because there was a potential exchange of body fluids, however, the amounts, conditions and types of body fluid exchanged greatly diminish the risk. Receiving oral sex is also classified as a negligible risk, with your risk from that activity being reduced by your use of protection.

I am including a link below with some ideas about safer oral sex practices. This article details several different methods, including pros and cons for each. You might consider trying one of these methods to further reduce your risk of acquiring HIV or other STI's.

Recommendation: There are no evidence or no documented cases of transmission. Refer to physician for more personalised answers.

Regards, AIDS Vancouver Helpline Volunteer, Dyson

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the HIV transmission risk associated with sharing a cleaned sex toy. From the information given, this scenario is determined to be Negligible Risk (there are no evidence or no documented cases of transmission).

The scenario mentioned above does not meet the three components of the Transmission Equation. It is important to note that the reason the risk assessment is negligible rather than none is because if the toy was not properly cleaned, then there is a theoretical risk of transmission. Since there were many hours between the shared uses of the toy (exposure to oxygen renders the HIV virus inactive), as well as thorough washes, it is very unlikely that HIV would be transmitted in this scenario.

Recommendation: There are no evidence or no documented cases of transmission. Refer to a physician for more personalized answers.

Regards,

AIDS Vancouver Helpline/Online, Marie

Hi there,

Thank you for your inquiry, from what we gather from your question, you were asking about the risk of HIV transmission from the presence of seminal fluid on the outside of a condom.

From the information you have provided, this scenario is determined to be of Negligible Risk (There are no evidence or no documented cases of transmission). You are correct in your assumption that HIV exposed to oxygen does not pose a risk for HIV transmission. However, although HIV is considered to be extremely volatile when exposed to environmental surfaces (such as the outside of a condom), there is still a theoretical possibility of transmission (1). While HIV does not live long outside of the body and cannot reproduce outside of a human host, the exact time frame for HIV survival is not well studied. For this reason, we maintain that there is a theoretical risk with an extremely low probability rate.

The scenario provided does not technically satisfy our HIV Transmission Equation.

Bodily fluid is present without a direct access to the bloodstream.

Recommendation: There is no evidence or documented cases of transmission. Please refer to a Physician for more personalized answers. It is important to always know your HIV status.

All the best,

AIDS Vancouver Online/Helpline, Cody

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the risk of HIV acquisition in regard to sex toys. From the information given, this scenario is determined to be Low Risk (Evidence of transmission occurs through these activities when certain conditions are met).

HIV transmission occurs when bodily fluid that contains HIV has direct access to the bloodstream through a high risk activity. The following are a few theoretical scenarios that present different levels of risk when it comes to the sharing of sex toys:

The topic of sex toys presents with different risk levels depending on how you prepare your sex toys. If you are using a shared sex toy without properly cleaning them, this is a Low Risk. This is a Low Risk due to sex toy having the ability to store fluids and inserting from one person to another gives the opportunity for transferring fluid with direct access to the bloodstream.

If you are sharing sex toys with the use of a condom, this act would be considered a Negligible Risk due to the possibility of improper usage or breakage of the condom.

If you are not sharing your sex toy, and only using it on yourself, this is a No Risk activity as there are no opportunities for an exchange of bodily fluid from another person.

It is recommended to avoid sharing sex toys and if you do to cover the toy wit ha new condom before each use (1). It is also important to clean your toys between vaginal and anal use (1).

Recommendation: Refer to Physician for HIV test.

Regards,

AIDS Vancouver Helpline/Online, Danielle

Hello, Thank you for your inquiry. From what we gather from the question, you were asking about your risk of acquiring HIV while volunteering in a hospital and helping a individual living with HIV with their meal. From the information given, this scenario is determined to be No Risk (transmission of HIV is not possible in the given scenario).

The scenario mentioned above does not meet the three components of the transmission equation(1). It does not satisfy the equation because:

• For transmission to occur the three components of the HIV Transmission Equation must be met: there must be HIV present in a bodily fluid (ie: in blood, semen or rectal secretions), direct access to the bloodstream (ie: inside of the vagina, anus and other mucous membranes) paired with a high risk activity (ie: unprotected anal or vaginal intercourse, sharing needles, mother to child)(1).

• HIV does not survive long outside the human body (such as on surfaces), and it cannot reproduce outside a human host(2).

• HIV is not transmitted through casual contact. For example, handshakes or hugging or kissing(3).

• Superficial wounds, meaning wounds similar to a paper cut, are not deep enough to provide direct access to the bloodstream.

• Saliva contains enzymes that inhibit the transmission of HIV(3).

In the scenario that you provided, you were helping a individual living with HIV eat their meal during a volunteer shift at a hospital. You are concerned about acquiring HIV through casual touch if blood were present and the individual touched your arm. You are also concerned about your risk of acquiring HIV if you then touched your eyes or mouth. This scenario has been assessed as No Risk for you acquiring HIV. As we learned above, HIV does not survive long outside the human body (such as on the surfaces), and it cannot reproduce outside a human host(2). For you this means that any bodily fluids (ie: blood) that you may have come into contact with, had been outside of the body, exposed to external environmental factors, was not able to reproduce, and was thus unable to transmit to you. HIV is not transmitted through casual contact(3) like that which had while helping an individual with their meal. Simply touching your eyes or mouth does not provide direct access for HIV to enter your bloodstream, and saliva contains enzymes that inhibit the transmission of HIV(3). Remember as well that any bodily fluids on your hand while touching your eye or mouth, have been outside of the body, exposed to external environmental factors and unable to reproduce. You were concerned that if you happened to have a small wound on your arm that this may be a vehicle for you to acquire HIV. The small, open cut that you described we can liken to a 'superficial wound', like that of a paper cut. Superficial wounds are simply not deep enough to provide direct access for HIV to enter your bloodstream. This scenario has been assessed to be No Risk.

As for your question regarding an actively bleeding would of one person touching the actively bleeding wound of another person, or blood splashing into the mouth or eyes, remember that HIV does not survive long outside the human body (such as on surfaces), and it cannot reproduce outside a human host(2). There are many "what ifs" in this hypothetical scenario. For transmission to occur the three components of the HIV Transmission Equation must be met: there must be HIV present in a bodily fluid (ie: in blood, semen or rectal secretions), direct access to the bloodstream (ie: inside of the vagina, anus and other mucous membranes) paired with a high risk activity (ie: unprotected anal or vaginal intercourse, sharing needles, mother to child)(1). We can give this hypothetical scenario a Negligible Risk assessment. This means that there are no evidence or no documented cases of transmission. However, there is a theoretical possibility. We will assume that you are asking about this scenario for if it were to happen within a healthcare setting while you are on shift in your volunteer position. Within a Healthcare setting, "The risk of health care workers being exposed to HIV on the job (occupational exposure) is very low, especially if they use protective practices and personal protective equipment to prevent HIV and other blood-borne infections. For health care workers on the job, the main risk of HIV transmission is from being stuck with an HIV-contaminated needle or other sharp object. However, even this risk is small. Scientists estimate that the risk of HIV infection from being stuck with a needle used on a person with HIV is less than 1%."(3)(4)

We would also like to say thank you for getting involved in your community and taking the time to volunteer at your local hospital. We have linked below some great resources about HIV Transmission, and HIV in Healthcare settings. Individuals living with HIV frequently encounter a certain amount of stigma associated with HIV. This could be a great opportunity for you to meet with your volunteer supervisor, discuss your experience and make a plan to educate other volunteers about HIV transmission and HIV in healthcare settings. Feel free to ask us any questions you may have in the future, or direct other volunteers our way for HIV/AIDS related information that they can trust. Keep up the great work!

Recommendation: No need for HIV test with the scenario provided, refer to the resources we have linked below to learn more about HIV and HIV transmission. Refer to your healthcare professional for other health related questions .

Regards, AIDS Vancouver Helpline/Online, Hilary

Hi there,

Thank you for your inquiry. From what we gather from the question, you were asking about your risk of HIV acquisition from the superficial cuts and scratches you received from an aggressive encounter with another person in which their finger nails damaged the outer layer of your epidermis.

From the information given, this scenario would usually be determined to be of Negligible Risk (There are no evidence or no documented cases of transmission). This scenario would only be determined to be Negligible due to the theoretical possibility of profuse bleeding with direct contact from your aggressor to your face (direct access to the bloodstream from one wound to another). This would only be in an extreme case where your cuts would be considered deeper than what you have previously explained. Due to your detailed explanation of the event that occurred coupled with your diligent research and interpretation of your scenario; we would determine this scenario to be of No Risk (HIV transmission is not possible in the given scenario).

The research you have done and the statements that you have made surrounding this scenario are correct. Your wound is considered superficial and thus does not provide direct access to the bloodstream (one of the requirements for HIV transmission). You do not recall seeing "red" on your aggressors fingers, which leads us to believe there was not enough blood present to warrant a threat of HIV transmission.

In your case, we would recommend there is no need for HIV test with the scenario provided, refer to a physician for other health related questions. If you are continuing to feel anxious or uneasy about an encounter, don't hesitate to visit your local physician for medical advice or HIV screening. It is always important to know your HIV status, and regular screening is important in maintaining good health.

All the best,

AIDS Vancouver Online/Helpline, Cody