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)

Although blood is listed as a fluid that can transmit HIV, in order for this to happen there must be a large, actively bleeding wound that requires immediate medical attention (eg. deep cut that requires stitches). From the way you describe your wound, as skin being peeled off but not actively bleeding or requiring medical attention. For this reason, it is not a direct access to the bloodstream, and even if it was in contact with someone else's blood on it, there would be no HIV transmission. Additionally, there is no HIV found in the fluid of sweat and negligible amounts in saliva (a bodily fluid that does not carry HIV).

It is worth mentioning that as soon as HIV is exposed to air, the virus is not able to transmit. Therefore, whichever bodily fluid you encountered and rubbed against your wound were exposed to air, therefore they did not contain transmittable HIV.

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

Hi there,

Thank you for your inquiry. From what we gather from the question, you were asking about the possibility of HIV transmission given the event that a few drops of HIV positive blood had come into contact with a hangnail that you had.

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). This scenario is determined to be of Negligible Risk due to the theoretical possibility of transmission. However, this is extremely unlikely. HIV requires direct access to the bloodstream for transmission to occur. In the scenario you have described that you only have a hangnail, which we would not determine to be a wound that is deep enough to allow a direct access to the bloodstream. Although the blood that you had come into contact was supposedly HIV positive, there is a very small chance of actual HIV transmission in this event.

Please also consider the following:

HIV positive fluid that has come into contact with the environment or environmental surfaces becomes quickly rendered inactive, and thus, provides little threat to HIV transmission (1).

For these reasons, you may not need to concern yourself with immediate HIV testing, or PEP, yet, our Recommendation is for you to refer to a healthcare professional for more personalized answers.

All the best,

AIDS Vancouver Online/Helpline, Cody

Hello there, Thank you for your inquiry, from what we gather you were asking about the possibility of HIV transmission from being punctured by sharp object contaminated with HIV positive blood.

From the information given, this scenario is determined to be "Negligible Risk" situation (There is no evidence or no documented cases of transmission. However, there is a theoretical possibility of transmission under certain extenuating circumstances). However, in this scenario you do not specify if the scissors were freshly contaminated with the HIV blood and you were injured immediately afterwards. So given the circumstance, we would consider the situation to be of Negligible Risk. This scenario does not meet the 3 components of our HIV Transmission Equation. It does not meet the equation because there is no direct access to the bloodstream from another individual. In this case, any HIV positive fluid that would have previously been on the scissors that had caused your open wound would have been inadvertently exposed to the environment, causing the HIV positive fluid to become rendered inactive, thus, making transmission very difficult (1). Any exposure to oxygen, or HIV outside of the body causes a rapid reduction in concentration, making transmission of HIV difficult (1).

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

Thank you for contacting AIDS Vancouver Online/Helpline

AIDS Vancouver Helpline, Joseph

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 insertive 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 HIV Transmission Equation. In typical circumstances, receiving oral sex does not satisfy the transmission equation because saliva is not a bodily fluid that can carry the HIV virus. If a large amount of blood is present in the saliva during the activity (from actively bleeding gums, etc.) and that blood gains access to your bloodstream through the head of your penis, then there is a theoretical possibility of HIV transmission when receiving oral sex. This is why it is very important to use protective barriers when engaging in any and all sexual activities.

To briefly address your second question, even if both HIV and gonorrhea were present in the saliva, it would not make it more likely for you to get either infection. Please note that this is not the case if you already have an active gonorrhea infection, since the presence of an active STI increases your risk of acquiring an HIV infection (1). Additionally, it is important to note that you are much more likely to get gonorrhea (and other STIs such as chlamydia) than HIV from receiving oral sex, thus it is imperative that you access STI testing after engaging in sexual 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

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 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).

Although saliva can contain trace amounts of HIV, there is not enough of the virus for sufficient transmission. Saliva contains enzymes that breakdown the virus within the mouth, thus is a protective factor against HIV. 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). However, using a barrier like a condom or dental dam during oral sex can further reduce the risk of transmitting HIV, and other STDs.

In regard to your concern about the incubation period for HIV from your partners previous partner. Signs and symptoms of seroconversion appear to occur from between 40-60 days after transmission has taken place (1). Yet, seroconversion has known to occur starting at two weeks after HIV transmission has taken place. During this incubation period, HIV is characterized by the high viral load in the body of the newly positive individual, making HIV highly transmittable.

In the scenario you have provided above, there appears to be less than a 10 day incubation period in which the theoretical presence of HIV would have little time to increase the viral load to highly infectious levels.

For these reasons, this scenario is determined to be of Negligible Risk to you.

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

Best regards,

AIDS Vancouver Helpline/Online, Jason

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 even that you had a cut finger that had come into contact (through fingering) with rectal fluid.

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). We would consider this to be a Negligible Risk due to the presence of possible HIV positive fluid, with the capacity for direct access to the bloodstream, through a Negligible Risk activity such as anal fingering.

The event described above would only be of significant risk to you in terms of HIV transmission had your cut been fresh, and actively bleeding. The cut you have described above is 1 day old, and has dried blood. Due to this, there is not a significant risk of HIV transmission. We would determine this to be a 'theoretical risk', because, in the event that your cut had re-opened (causing a direct access to the bloodstream), and then subsequently come into contact with the rectal fluid in the anal cavity of another person; there would be a higher risk for HIV acquisition in this case.

From what we have observed, the scenario above does not involve these extenuating circumstances. If you are worried about the risk of HIV transmission in the future when it comes to fingering your partner with a fresh wound, you may consider protective measures such as condoms and PrEP (pre-exposure prophylaxis).

Recommendation: There is no evidence or no documented cases of transmission. Please refer to a healthcare professional 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 whether or not you could acquire HIV from someone else's wound when they are activity bleeding. 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.)

Since HIV becomes inactive when exposed to oxygen, it is likely that the HIV+ person's blood would not be able to transmit the virus once it has left their body. Of course there are extenuating circumstances that may be considered high risk activities. For example, if two people have open bleeding wounds and they rub each others wounds against each other (without any exposure to oxygen in between) and the blood between the two is interchanged from individual to individual, there could be the possibility of transmission.

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, Heidi

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 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).

Although saliva can contain trace amounts of HIV, there is not enough of the virus for sufficient transmission. Saliva contains enzymes that breakdown the virus within the mouth, thus is a protective factor against HIV. 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). However, using a barrier like a condom or dental dam during oral sex can further reduce the risk of transmitting HIV, and other STDs.

To address your other theoretical question, an individual engaging in protected sex with a partner of unknown status can potentially satisfy the transmission equation. Bodily fluid that contains HIV (blood, semen (including pre-ejaculate), vaginal fluids, breast milk, and rectal secretions) can have direct access to the bloodstream through protected sex if improper use of a condom occurs (1). Routine testing (every 3 months) is encouraged if engaging in protected and unprotected sex with individuals of unknown HIV status.

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

Additional Resources:

HIV Transmission Equation (1) (<--clickable link)

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 an individual of unknown HIV status. 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.

Although the risk of HIV transmission through oral sex is very 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). In the future, 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 and/or several other viruses that can cause similar presentations. The only way to be sure is through testing outside of the window period - 6 weeks and 3 months post-exposure for completely conclusive results.

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

All the best,

AIDS Vancouver Helpline, Jason

Hi there,

Thank you for your inquiry. From what we gather from the question, you were asking about whether you should receive further HIV testing beyond the HIV blood test you received 40 days post exposure (given the sexual activities that you have described above).

From the information given, of the activities described above, you appear to have engaged in Negligible Risk activities when it comes to HIV transmission (There is no evidence or no documented cases of transmission. However, there is a theoretical possibility of transmission under certain extenuating circumstances). To clarify, the activities that you engaged in do not warrant a significant risk, unless there were extenuating circumstances involved in one or more of each.

However, official HIV testing guidelines recommend re-testing at approximately 12 weeks post exposure to assure that you have received completely conclusive results (1). For this reason, we Recommend that you seek additional HIV screening on your 3rd month post-exposure, to assure you of 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 transmission 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. The reason there is a theoretical possibility of HIV transmission after receiving unprotected oral sex is if there was a large amount of blood present in the saliva that could have gained access to your bloodstream through the head of your penis. The best way to lower your risk of acquiring HIV is to wear a condom when engaging in any sexual activities.

In regards to your symptoms, an HIV infection is very unlikely to be the cause of your sore throat.

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

Hi there,

Thank you for your inquiry. From what we gather from the question, you were asking about the risk of HIV transmission from wound-to-wound contact of two individuals. From the information given, this scenario is determined to be Negligible Risk, where there is no evidence or no documented cases of transmission, but there exists a theoretical possibility of transmission under certain extenuating circumstances.

In order for this to occur, the HIV Transmission Equation must be fully satisfied. In this case, HIV positive fluid from one individual, must be directly exposed to the bloodstream of another person (such as through broken skin or deep cuts/wounds/sores) (1).

However, in order for HIV transmission to occur in this circumstance, there must be no opportunity for HIV positive fluid to be exposed to oxygen from the outer air/environment, as HIV does not survive outside the body (1). This condition makes it very difficult for HIV transmission to occur in this circumstance. Furthermore, most individuals living with HIV take antiretroviral therapy (ART), which can help one achieve and maintain an undetectable viral load, and therefore no longer able to transmit HIV to another individual (2).

To summarize, there is a Negligible chance of HIV transmission occurring in this situation.

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, Shirromi

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the possibility of HIV transmission through a) cuts on your hands in contact with those on another individual, b) blood into your eye, and c) touching an object that may have been contaminated with another individual's blood. From the information provided, the first and third scenario are determined to be No Risk (HIV transmission is not possible in the given scenario), while the second scenario has a Negligible Risk level (there is no evidence or no documented cases of transmission, however, there is a theoretical possibility of transmission under certain extenuating circumstances).

Addressing the first and last scenarios mentioned, HIV outside of the body (contained in a body fluid like blood) is exposed to oxygen, which causes a rapid reduction in HIV concentration (1). From the CDC, HIV outside of the body that is drying on a surface (in this case being the other individual's hands or inanimate objects like a pen/piece of paper), has a rapid (within several hours) reduction in HIV concentration of 90-99% (1). In addition, small superficial cuts, like the ones on your hands, are not deep enough to permit direct access of blood into your bloodstream. A higher risk of HIV transmission would be present if the cuts on your hands were deeper or larger open wounds. The two scenarios discussed here do not meet the requirements for the HIV Transmission Equation as they do not permit sufficient access to the bloodstream through a High, Low, or Negligible Risk activity.

With regards to the second scenario, the reason why there is a Negligible Risk level here is due to the fact that the Transmission Equation (discussed above) can be satisfied. HIV in a bodily fluid (blood in this example) can theoretically access the bloodstream by travelling through the mucous membranes of your eye. However, as mentioned previously, HIV outside of the body drying on a surface such as your hands undergoes a rapid reduction in HIV concentration over several hours. Furthermore, if the individual that you contacted was indeed living with HIV (and was aware of their status), they would most likely be taking antiretroviral therapy (ART). ART drugs would help them achieve and maintain an undetectable viral load, and no longer able to transmit HIV to other individuals (2). Both of these reasons therefore significantly decrease the likelihood of HIV transmission taking place in this scenario.

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

All the best,

AIDS Vancouver Online/Helpline, Shirley