Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the risk of acquiring HIV after engaging in naked frottage. 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 could meet the three components of the Transmission Equation if an HIV-containing fluid (eg. vaginal fluids) was able to gain access to your bloodstream (eg. through your urethra during vigorous frottage). I will answer each of your concerns separately:

1. Frottage is determined to be negligible risk because there is a theoretical possibility of transmission when genitals and the accompanying fluids are rubbed together.

2. Urethral burning and potentially damaged mucosa occurring eight hours after an exposure would not increase your risk of acquiring HIV. If the HIV virus had not already gained access to your bloodstream, it would be inactivated by exposure to oxygen before you had the chance to provide new potential areas of entry.

3. The rate of inactivation of HIV is rapid when exposed to air, leading to a 90-99% reduction in HIV concentration within just a few hours (1). HIV is not instantaneously inactivated when exposed to oxygen, but its ability to cause a new infection declines very quickly due to the decrease in active HIV virus present.

4. Your HIV risk is negligible based off of the information provided in this scenario.

In regards to your symptoms, it does appear as if something is going on. HIV is very unlikely to be transmitted during naked frottage. It is important to note that other sexually transmitted infections (STIs), such as chlamydia, gonorrhoea, or syphilis, are much more easily transmitted. It may be be beneficial to access further STI testing if you have not already done so.

Recommendation: There are no evidence or no documented cases of transmission. Refer to physician for more personalized answers and to inquire about expanded 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 HIV risk associated with fingering someone using a finger that has a cut. 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 typically does not meet the three components of the Transmission Equation because HIV-containing fluids would not have direct access to your bloodstream (1). Superficial cuts on the finger do not provide adequate access to the bloodstream. This scenario is assessed as negligible risk for HIV acquisition only because there is a theoretical possibility that if the cut is large and very fresh, transmission of HIV could occur.

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 the question, you were asking about the risk of HIV transmission in the event that your massage therapist had:

a) Inserted his thumb containing saliva on/in your torn anus

b) Inserted ejaculate/sperm on/in your torn anus, or foot wound

Saliva is not considered to be an avenue for HIV transmission. Saliva contains active enzymes that maintain a volatile environment for HIV to exist. For this reason, there is No Risk (transmission of HIV is not possible in the given scenario) to you if your massage therapist had indeed rubbed spit on or into your torn anus.

Semen is considered to be a method of HIV transmission. If, theoretically, fresh ejaculate had been rubbed onto/into the anus, this would provide a Negligible Risk (there is no evidence or documented cases of transmission). We would consider this to be a Negligible Risk because this encounter does not completely satisfy our HIV Transmission Equation.

In order for there to be an HIV risk, each act requires the combination of HIV positive bodily fluids + a high/low risk activity + direct access to the bloodstream.

Your scenario does not involve a direct access to the bloodstream. The act of rubbing semen onto an open wound or into your anus does not necessarily constitute a high or low HIV risk. When exposed to oxygen or environmental surfaces, HIV is quickly rendered inactive and does not survive long outside of the host (1). HIV outside of the body causes a rapid reduction in HIV concentration within the fluid involved, which significantly reduces the risk of transmission (1). For this reason, although there is the theoretical presence of HIV positive fluids, the lack of direct access to the bloodstream does not warrant a high or low risk, but may be considered a Negligible Risk due to the presence of HIV positive fluid.

In this case, you made a responsible decision in seeking biomedical measures in order to protect yourself from HIV acquisition. PEP can be extremely effective in preventing HIV transmission if taken within the window period, and adhered to correctly. However, it would be wise to seek advice from a physician before you stop taking PEP.

Although we technically deem this theoretical act as a Negligible Risk, it appears as though there was no actual presence of HIV positive fluids (that you know of), making HIV transmission highly unlikely in this case.

It is always wise to know your HIV status, and you may find solace in HIV screening confirmation in this case. Based on our HIV risk assessment, there is no evidence or documented cases of transmission in this case.

For this reason, we recommend you refer to a physician for more personalized answers.

I hope this answers all your questions. Feel free to write to us any time with any additional questions regarding HIV risk.

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 acquring HIV through protected oral sex and protected vaginal sex. 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 containing HIV has direct access to the bloodstream through a high risk activity.

The transmission equation is satisfied through these activities. In this scenario the protected oral sex is deemed to be a Negligible Risk. The protected vaginal sex is determined to be Low Risk. This is due to the possibility of condom misuse or breakage (1). If you ever feel anxiety over possible HIV acquisition the best thing to do for your mental and physical health is to get tested and know your status.

Recommendation: Refer to Physician for HIV test.

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 through fingering where your partner had fingered themselves, and then used the same finger in your anus.

From the information given, this scenario is determined to be Negligible Risk (There is no evidence or documented cases of transmission). This scenario is determined to be Negligible only due to the theoretical risk of HIV transmission that it provides. Fingering is not commonly associated with HIV risk of transmission, unless there is a considerable amount of blood present with open wounds on the finger. Because you are talking about the transfer of possible HIV positive fluid from one person to yourself, there may be a theoretical risk for transmission.

Our HIV Transmission Equation states that in order for HIV transmission to occur, three requirements must be met. These requirements include: presence of HIV positive fluid (semen, pre-cum, vaginal fluid, blood, anal secretion, or breast milk), with direct access to the bloodstream, through a High, Low, or Negligible Risk activity.

In the scenario you have described, each of these are met except the direct access to the bloodstream

By "direct access" we mean that the virus must travel directly from the fluid or bloodstream of another directly into the body of another individual. What you have described is that your partner had fingered themselves, and subsequently fingered you minutes later with the same fingers. This does not satisfy the transmission equation entirely.

When exposed to the environment, HIV positive fluid undergoes a rapid reduction in concentration and quickly becomes rendered inactive. In this case, HIV positive fluid would have had to be transferred directly from one individual to the next, and not traveled via an external tool (their fingers).

For these reasons it is highly unlikely that you are at risk for HIV transmission.

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 specific risk of HIV acquisition given a scenario in which an acne removal lancet and blackhead loop were used on you during a facial procedure.

In a situation such as this, we would responsibly agree that the scenario provided is considered a Negligible Risk (There is no evidence or documented cases of transmission). However, the assumptions that you have made based on research and information you have been given are accurate.

(1) In order for HIV transmission to occur, this scenario would require a large amount of blood, likely comparable to getting a tattoo.

(2) The blades are not hollow, and therefore do not house active HIV in a concealed environment.

Let us add an extra element that hasn't been considered in this encounter.

(3) HIV positive blood that has been exposed to the environment is extremely volatile, and becomes quickly rendered inactive. HIV does not survive long outside of the human host and undergoes a rapid reduction in concentration when exposed to environmental surfaces such as the tool you have described which was used on you.

For these reasons, we agree that this scenario does not provide a significant risk of HIV acquisition to you. We do agree with you in that it is important to know your HIV status, and believe you should not be denied HIV screening for any reason.

However, for the scenario provided there is no need for HIV testing, please refer to a physician for any other health related (ie: Hepatitis C and other) questions.

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 the possibility of HIV transmission given your scratched leg had rubbed against another person with a scratched leg.

From the information given, we would typically determine this scenario to be of Negligible Risk (There is no evidence or no documented cases of transmission). The reason that we would have determined this scenario to be Negligible is due to the theoretical possibility of HIV transmission in the case that each of you was actively bleeding. Our HIV Transmission Equation requires three circumstances to meet in order for the equation to be satisfied. These are: presence of HIV positive fluids (semen, pre-cum, vaginal fluid, rectal secretions, blood, and breast milk), direct access to the bloodstream, and a High Risk, Low Risk, or Negligible Risk activity (unprotected sex, sharing needles, mother to child).

In the scenario you have provided, there does not appear to be actively bleeding wounds that would lead to a direct access to the bloodstream. Superficial cuts do not warrant HIV risk as they do not provide an adequate avenue for direct access to the bloodstream. In order for there to be a significant risk for HIV transmission in this case, you and the person you have encountered would have needed to be actively bleeding, with direct contact to each others blood stream through open cuts or wounds. Your encounter does not appear to satisfy these requirements.

Due to this, we would determine your specific scenario to be of No Risk (HIV transmission is not possible in the given scenario).

Recommendation: No need for HIV test with the scenario provided, refer to a physician for other health related questions.

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 transmission if a one inch bleeding scratch came into contact with a bodily fluid containing HIV. From the information given, this scenario is determined to be Negligible Risk (There are no evidence or no documented cases of transmission).

We have determined this scenario to be of Negligible Risk because even though there are no evidence or no documented cases of transmission, it is a theoretical possibility. What we mean by this, is that there are a lot of undetermined variables within this scenario, IE: How deep is the scratch or cut? How much bodily fluid is present? There are a lot of "what ifs" present as well as other variables to consider, which we will describe below. HIV transmission happens under very specific circumstances, and must meet all requirements of the HIV Transmission Equation(1).

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(1) 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).

Referring to the HIV Transmission Equation(1), we can see that there must be direct access for HIV to enter your bloodstream. In the scenario that you provided, there was most likely no direct access to your bloodstream. The one inch bleeding scratch you described can be categorised as a superficial cut. A superficial cut, likened to that of a paper cut, is simply not deep enough to provide direct access to your bloodstream. In the scenario that you provided, there was also no presence of a risky activity (unprotected anal or vaginal intercourse, sharing needles, mother to child).

HIV does not survive long outside the human body (such as on surfaces), and it cannot reproduce outside a human host(2). Any bodily fluid containing HIV in this scenario had already been outside of the body, exposed to environmental conditions and was unable to transmit HIV to another person.

Many individuals living with HIV today are living with an undetectable viral load. Avert.org explains undetectable as such, "A person living with HIV is considered to have an ‘undetectable’ viral load when antiretroviral treatment has brought the level of virus in their body to such low levels that blood tests cannot detect it. There is no risk of passing on HIV if your doctor has confirmed that you are undetectable (or virally suppressed), you continue taking your treatment and attend regular viral load monitoring appointments. Undetectable = Untransmittable."(3)

Recommendation: No need for HIV test with the scenario provided. Refer to the resources listed below to learn more about HIV and HIV transmission.

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 risk of HIV transmission from touching a person who is living with HIV with a wound (that is assumed to be healing), and the risk of receiving a blowjob from the same individual.

From the information given, this scenario is determined to be of Negligible Risk (There is no evidence or no documented cases of transmission. However, there is a theoretical possibility). This scenario is only determined to be of Negligible Risk due to the receptive oral sex that you had received. Touching the scab or wound of a person living with HIV when you do not have an open or actively bleeding wound is considered to be No Risk (HIV transmission is not possible in given scenario).

In this case, HIV transmission is theoretically possible if your partner had a high viral load and actively bleeding sores or cuts in their mouth. Although, this appears to be highly unlikely in the scenario you provided.

It is important to rememeber that those who are HIV positive and adequately medicated are able to acheive an undetectable viral load, essentially making HIV transmission not possible. For more information on this, you may consider reading more on the Undetectable = Untransmittable campaign, which explains this in more depth.

Recommendation: There is no evidence or no documented cases of transmission, please refer to your health care provider 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 acquiring HIV from vulva to vulva rubbing. From the information given, this scenario is determined to be Negligible Risk (There are no evidence or no documented cases of transmission).

HIV transmission occurs when bodily fluid containing HIV has direct access to the bloodstream of an individual who is of HIV negative status through a high risk activity.

In this scenario the risk is deemed to be Negligible (1). This is because technically the HIV transmission equation is satisfied through the exchange of bodily fluids. Please note that there has been no documented cases of HIV acquisition through this activity. Case reports of female-to-female transmission of HIV are rare (2).

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 avenues in which HIV is transmitted (sexual contact, sharing needles, mother to child). You were also asking about whether you have a chance of HIV acquisition in the event that another individuals blood fell onto cuts or open wounds on your skin, and if blood on bowls, utensils, and cups is also a risk.

From the information given, this scenario is determined to be of Negligible Risk (There is no evidence or no documented cases of transmission, however, there is a theoretical possibility when certain conditions are met). HIV positive blood is considered one of the main avenues for HIV transmission. However, in order for our HIV Transmission Equation to be met, all three requirements for transmission must be present.

These requirements include: HIV positive fluid (blood, semen, pre-cum, vaginal fluid, anal secretions, and breast milk), that must have direct access to the bloodstream, through a High, Low, or Negligible Risk activity. In the first scenario you have provided above, there would need to be a significant amount of blood, with a large open and actively bleeding wound present in the event of transmission. Further, in order for HIV transmission to occur, there must be a direct access to the bloodstream (blood falling from one individual into your wound/drying blood coming into contact with your wound) does not present a significant risk for HIV acquisition in this circumstance.

You are correct in your assumption that HIV is transmitted through certain modes of sexual contact, sharing needles, vertically (mother to child in the womb), and through breast milk. For more information on HIV transmission please refer to our HIV Transmission Equation, which may help educate you further on the ins and outs of transmission.

HIV is not transmitted through sharing bowls, chopsticks, spoons, forks, or cups, or other eating utensils. HIV is also not transmitted through other forms of social contact such as hugging, kissing, shaking hands, and sharing toiettes (1).

Recommendation: There are no evidence or no documented cases of transmission, please refer to health care provider for other health related questions.

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 acquiring HIV from mutual masturbation and receiving unprotected oral sex. From the information given, this scenario is determined to be Negligible Risk (There are no evidence or no documented cases of transmission).

HIV transmission occurs when the three criteria of the HIV transmission equation are satisfied. The criteria include: bodily fluid containing HIV having direct access to the bloodstream through a high risk activity.

The act of mutual masturbation is considered to be a No Risk activity as the bodily fluids involved do not have direct access to the bloodstream in this action. However the act of receiving unprotected oral sex is considered to be negligible because there is an exchange of bodily fluids, but there has there been a confirmed report of transmission through this act (1).

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

Regards,

AIDS Vancouver Helpline/Online, Danielle

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the risk of HIV transmission after you cut yourself quite deep while handling some lumber at work, and a co-worker grabbed that same wrist. The co-worker also had a cut on their hand, and you could not tell it is was bleeding or not. From the information given, this scenario is determined to be Negligible Risk (There are no evidence or no documented cases of transmission. However, there is a theoretical possibility).

The scenario mentioned above does not meet all 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(1) 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 requires the 3 conditions of the HIV transmission equation(1), as listed above, to be met in order for transmission to occur. Your scenario does not satisfy all 3 conditions. HIV does not survive long outside the human body (such as on the surface of the skin), and it cannot reproduce outside a human host(2). Any bodily fluids containing HIV on your co-worker's hand, were already outside of the human body, exposed to environmental conditions and thus, unable to transmit HIV to you.

We are not sure how deep your cut was, generally we say that if it was deep enough to require stitches, then it could theoretically provide direct assess to your bloodstream. From the description provided above, it does not seem that you required stitches, and, the cut on the hand of your co-worker was not gushing blood directly onto your cut. In fact, you state that you could not even tell if your co-worker's cut was bleeding. Superficial cuts, meaning cuts that do not required stitches, are generally not deep enough to provide direct access to the bloodstream. Your co-worker touching your hand with their hand while having a scabbed over cut on it, simply does not provide direct assess to your bloodstream. Casual touch is not a vehicle by which HIV is transmitted. There are a lot of "what-ifs" in this scenario, which is why it has been classified as Negligible Risk, meaning that there are no evidence or documented cases of transmission this way. However, there is a theoretical possibility.

Thanks again for you question. We would encourage you to check out the resources listed below to learn more about HIV and HIV transmission.

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

Regards, AIDS Vancouver Helpline/Online, Hilary

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the risk of acquiring HIV from receiving oral sex from a woman. From the information given, this scenario is determined to be of Negligible Risk. (There are no evidence or no documented cases of transmission. However, there is a theoretical possibility of transmission under certain extenuating circumstances).

Only certain bodily fluids, such as - blood, semen (cum), pre-seminal fluid (pre-cum), rectal fluids, vaginal fluids, and breast milk carry significant viral loads from a person who has HIV. These fluids must come in contact with a mucous membrane (mouth, vagina, penis, anus) or damaged tissue or be directly injected into the bloodstream (from a needle or syringe) for transmission to occur.

Here at AIDS Vancouver we do not assess the individuals involved, but rather the activities that are being engaged in. Although the risk of HIV transmission through oral sex is low, several factors may increase that risk, including sores in the mouth or vagina or on the penis, bleeding gums, oral contact with menstrual blood, and the presence of other sexually transmitted diseases (STDs). Using a barrier like a condom or dental dam during oral sex can further reduce the risk of transmitting HIV, other STDs.

It is also important to continue treatment as prescribed, therefore, PEP should be continued for the full duration of therapy.

Recommendation: There is no evidence or no documented cases of transmission. Please remain adherent to your PEP treatment and take it to completion. Refer to a healthcare professional for more personalized answers.

All the best,

AIDS Vancouver Helpline, Jason

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the risk of acquiring HIV from receiving oral sex and penis on vagina rubbing (Non-insertive). The bodily fluid that could have presented a potential risk is the vaginal fluid being introduced to the penis. From the information given, this scenario is determined to be of Negligible Risk. (There are no evidence or no documented cases of transmission. However, there is a theoretical possibility of transmission under certain extenuating circumstances).

Additionally, the risk of HIV transmission through oral sex is extremely low, several factors may increase that risk, including sores in the mouth or vagina or on the penis, bleeding gums, oral contact with menstrual blood, and the presence of other sexually transmitted diseases (STDs). Using a barrier like a condom or dental dam during oral sex can further reduce the risk of transmitting HIV, other STDs.

It is important that you do not rely on acute HIV symptoms, or "ARS" in any way to indicate whether or not you have HIV. There are no clinically defined symptoms for acute HIV infection that can predict whether or not someone is HIV positive; the symptoms that are observed are only seen in some people, and are very similar to the flu or several other things that can cause similar presentations.

It is also important to continue treatment as prescribed, therefore, PEP should be continued for the full duration of therapy.

Recommendation: There is no evidence or no documented cases of transmission. Please remain adherent to your PEP treatment and take it to completion. Refer to a healthcare professional for more personalized answers.

All the best,

AIDS Vancouver Helpline, Jason

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the HIV testing you accessed after receiving a hand job and engaging in vaginal touching and nipple sucking. The bodily fluid that could have presented a potential risk is the vaginal fluid being introduced to the penis.

From the information given, this is not considered a High Risk or even Low Risk activity - this scenario is determined to be of Negligible Risk (There is no evidence or no documented cases of transmission. However, there is a theoretical possibility of transmission under certain extenuating circumstances).

Since you accessed testing outside of the window period (12 weeks for the 4th Generation test and 3 weeks for the HIV-1 RNA - Qualitative Assay) you can be assured that your negative results are completely conclusive. As long as the index value is below a certain value (depending on the test), the negative result is reliable. It is important that you do not rely on acute HIV symptoms, or "ARS" in any way to indicate whether or not you have HIV. There are no clinically defined symptoms for acute HIV infection that can predict whether or not someone is HIV positive; the symptoms that are seen are only seen in some people, and are very similar to the flu or several other things that can cause similar presentations.

Recommendation: There is no evidence or no documented cases of transmission regarding your scenario. Additionally, with your test results coming back negative after the testing window, you can be assured the test results are accurate. In light of the symptoms you are feeling (painful armpits, neck, thighs) you may want to refer to a healthcare professional for more personalized answers.

All the best,

AIDS Vancouver Helpline, Jason

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the risk of acquiring HIV from receiving oral sex with no visible blood present. From the information given, this scenario is determined to be Negligible Risk (There is no evidence or no documented cases of transmission. However, there is a theoretical possibility of transmission under certain extenuating circumstances).

Although hairy leukoplakia is most common in people with HIV (1), the scenario mentioned above could only rarely meet the three components of the [HIV Transmission Equation]( Transmission equation https://www.aidswindsor.org/healthy-me/hiv-transmission/). To acquire HIV, you need an activity (ex: giving or receiving oral sex), a bodily fluid capable of transmitting HIV (blood, semen, pre-semen, rectal secretions, vaginal fluids, or breast milk), and direct access to your bloodstream. Saliva isn't on that list of bodily fluids. In fact, saliva has an enzyme in it that provides some protection from from HIV. The easiest way to lower the risk of transmitting HIV through performing or receiving oral sex is to use a condom.

In this case, I would listen to the instructions of your Doctor and assume that the white coating you have been experience is fungal.

Recommendation: I would recommend seeing a doctor again to assess whether you have Hairy Leukoplakia, which is easily determined through a physical exam. Further HIV retesting (3rd or 4th generation tests) can be conducted for conclusive HIV results.

Regards, AIDS Vancouver Helpline/Online, (Samantha)

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the risk of acquiring HIV after receiving unprotected oral sex. From the information given, this scenario is determined to be Negligible Risk (there is no evidence or no documented cases of transmission. However, there is a theoretical possibility of transmission under certain extenuating circumstances).

The scenario mentioned above does not meet the three components of the Transmission Equation because saliva is not a bodily fluid that can carry the HIV virus. It is important to note that this scenario is determined to be of negligible risk due to the theoretical possibility that the saliva was mixed with large amounts of blood, which was then able to gain direct access to your bloodstream through the head of your penis.

At 40 days post-exposure the 4th generation test that you accessed is considered to be more than 95% effective (1). Since the activity you engaged in is negligible risk, you do not need to access any further HIV testing.

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

Regards,

AIDS Vancouver Helpline/Online, Marie

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the potential for HIV transmission from an individual's blood into your own wound. From the information given, this scenario is determined to be of Negligible Risk (There is no evidence or no documented cases of transmission. However, there is a theoretical possibility of transmission under certain extenuating circumstances).

It seems you want clarification on whether HIV is transmittable once exposed to air. We are glad to provide some information.

It is correct to say HIV dies once exposed to the air is not transmittable. HIV is a very weak virus and it needs to be in a controlled environment in order to survive. Once HIV is exposed to the air it dies within an extremely short time. As for the precise time when the virus becomes inactivated cannot be given as several variables must be evaluated including, viral content of the fluid, pH of the environment, temperature, etc. If the bodily fluid in question (blood) is exposed to the open environment where there is oxygen it would become inactivated before transmission could occur. Superficial cuts do not provide direct access to the bloodstream that is necessary for the transmission for the virus. Keep in mind, the act of kissing (Direct contact) when two individuals have superficial wounds would be considered a Low Risk activity. Low risk activities warrant HIV testing as this is the only way to be sure if transmission has occurred. In your situation, HIV cannot be transmitted through a superficial cut because for transmission to occur the virus needs direct access to your bloodstream in a tightly sealed environment where no oxygen can interact with the virus. Superficial or small cuts do not provide enough access to the bloodstream, so they do not pose a risk in HIV transmission.

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

Best regards,

AIDS Vancouver Helpline/Online, Jason

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the risk of acquiring HIV after receiving unprotected oral sex followed by 5 days of PEP. From the information given, this scenario is determined to be Negligible Risk (there is no evidence or no documented cases of transmission. However, there is a theoretical possibility of transmission under certain extenuating circumstances).

The scenario mentioned above does not meet the three components of the Transmission Equation because saliva is not a bodily fluid that can carry the HIV virus. It is important to note that this scenario is determined to be of negligible risk due to the theoretical possibility that the saliva was mixed with large amounts of blood, which was then able to gain direct access to your bloodstream through the head of your penis. To prevent any concerns regarding oral sex in the future, make sure to always use a condom to protect both people involved in the activity.

PEP is the most effective when taken immediately after a risky activity as prescribed every day for 28 days (1). Since PEP was stopped on the 5th day it would not be very effective in preventing a possible HIV transmission. It is important to note that your physician was correct to stop PEP, as the person you received oral sex from is negative for HIV and you engaged in a negligible risk activity.

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

Regards,

AIDS Vancouver Helpline/Online, Marie