I don't understand my "risk"

[Vario]

Hello dear Experts!
First of all I want to emphasize that I am not paranoid and that I'm not gonna spam you with irrational requests but there is one aspect of exposure I really don't understand because everybody out there- even doctors seem to dispread misinformation or contradict themselves...

I don't want to annoy you with another eye question, but I realls tried to understand this on my own before posting here!
My situation: I accidantly hit someone with my elbow in a crowded subway. He started bleeding out of his nose. I felt sorry for him and gave him facial tissues. When he cleaned his face he sneezed - and I felt 2 veeery tiny droplets hit my chin and eye. Well actually I am not sure if it was saliva or blood, but the fact that he WAS bleeding makes it a bit more likely that it was blood.
The droplet in my eye was really small it was too small being lachrymatory, the dot on my chin was actually red...but how do I distinguish (in the meantime) dried blood from other red substances?

1) So - is there really a 1:1000 risk, what doctors say? Or is that just a number regardless of the amount? Would such a tiny droplet be enough for an infection? Or does one have to hold his eye into a fountain of arterial blood to have a risk?

2)What about the fact that the virus dies in such tiny droplets really quick? Are there just very few seconds enough?

3)Does the eye contain cells, that can absorb the virus or doesn't it host such cells? (I read again different infos).

4) What about the tear fluid everyone has? Is it enough for thinning the virus and are there enzymes comparable to saliva that inactivate the virus, too?

5) And sometimes it says there is a theoretical risk? What does this mean? I mean there is still a risk then, right?

Why do doctors recommend PEP after ocular contact if there haven't been really documented cases?

I'd be very happy if you could clear up these different infos for me! I hope I can forget this incident after being educated :-). I wanna know if I have to get tested, I don't want to put my boyfriend at risk - we have unprotected sex (after we had an HIV test together :-) )

[RapidRod]

Hello dear Experts!
First of all I want to emphasize that I am not paranoid and that I'm not gonna spam you with irrational requests but there is one aspect of exposure I really don't understand because everybody out there- even doctors seem to dispread misinformation or contradict themselves...

I don't want to annoy you with another eye question, but I realls tried to understand this on my own before posting here!
My situation: I accidantly hit someone with my elbow in a crowded subway. He started bleeding out of his nose. I felt sorry for him and gave him facial tissues. When he cleaned his face he sneezed - and I felt 2 veeery tiny droplets hit my chin and eye. Well actually I am not sure if it was saliva or blood, but the fact that he WAS bleeding makes it a bit more likely that it was blood.
The droplet in my eye was really small it was too small being lachrymatory, the dot on my chin was actually red...but how do I distinguish (in the meantime) dried blood from other red substances?

1) So - is there really a 1:1000 risk, what doctors say? Or is that just a number regardless of the amount? Would such a tiny droplet be enough for an infection? Or does one have to hold his eye into a fountain of arterial blood to have a risk?

2)What about the fact that the virus dies in such tiny droplets really quick? Are there just very few seconds enough?

3)Does the eye contain cells, that can absorb the virus or doesn't it host such cells? (I read again different infos).

4) What about the tear fluid everyone has? Is it enough for thinning the virus and are there enzymes comparable to saliva that inactivate the virus, too?

5) And sometimes it says there is a theoretical risk? What does this mean? I mean there is still a risk then, right?

Why do doctors recommend PEP after ocular contact if there haven't been really documented cases?

I'd be very happy if you could clear up these different infos for me! I hope I can forget this incident after being educated :-). I wanna know if I have to get tested, I don't want to put my boyfriend at risk - we have unprotected sex (after we had an HIV test together :-) )

You don't have an HIV concern. HIV is not airborne transmitted. HIV is unable to reproduce outside its living host (unlike many bacteria or fungi, which may do so under suitable conditions), except under laboratory conditions; therefore, it does not spread or maintain infectiousness outside its host. If you had a doctor recommend nPEP I suggest you find a doctor that is educated in HIV.

[Vario]

Thanks RapidRod!
I thought that refers to objects. I did not know that just a second of air exposure would e enough to make HIV unable to cause infectiousness.

Do you know medelp.org? I am not a member but there the doctors said that the risk was very low..but not zero. They even talked about a risk of semen into the eye which is less infectious than blood. And everything more than zero would be too much for me because I also have a responsibility for my boyfriend, not only for me.

I hope you can understand my confusion and why I posted s many questions. I don't want to end up like other persons with their OCD :-). This is why I preferred seeking help here immediately before making up scenarios in my head :-).

I've not yet told him because he's a soldier currently helping in Kosovo. And if there is no risk in reality I am not gonna tell him, he has a lot concerns on his own.

[Ann]

Vario,

You haven't had a risk so don't bother telling your boyfriend about this non-event.

1. Don't pay attention to the 1:whatever numbers you may see elsewhere regarding the risks of hiv infection. The study that produced those numbers was discredited years ago - they basically pulled the numbers out of thin air.

But yes, only something like an arterial blood spray where you got a huge amount of blood directly into your eye would be a theoretical risk. I've never been able to find any verified, documented cases of transmission happening via blood in the eye and yes, I've looked many times over the years.

About theoretical risks - it's also a theoretical risk that you'll be struck down by a meteorite falling to earth the next time you step outside, but do you worry about it? I sure hope you don't. It could happen, yes, but it's not going to.

2. Hiv is very fragile. Small changes in temperature, and pH and moisture levels all quickly damage the virus and render it unable to infect. Yes, it happens VERY quickly.

3. No, the type of cells that hiv can latch onto and infect are not found in abundance in the eye.

4. Tears are not a bodily fluid that hiv can survive in.

5. see above.

6. PEP is only recommended for ocular transmission in a medical setting where huge amounts of arterial spray has gotten into the eye. This is purely a "cover your ass" situation on the part of the hospital - and ONLY done when the patient tests hiv positive. You do NOT need PEP. You have NOT had a risk!

As an adult, the only ways you might put yourself at risk is through sharing needles to inject drugs or through having unprotected anal or vaginal intercourse.

Here's what you need to know in order to avoid hiv infection:

You need to be using condoms for anal or vaginal intercourse, every time, no exceptions until such time as you are in a securely monogamous relationship where you have both tested for ALL sexually transmitted infections together.

To agree to have unprotected intercourse is to consent to the possibility of being infected with an STI. Sex without a condom lasts only a matter of minutes, but hiv is forever.

Have a look through the condom and lube links in my signature line so you can use condoms with confidence.

ALTHOUGH YOU DO NOT NEED TO TEST OVER THIS SNEEZING INCIDENT, anyone who is sexually active should be having a full sexual health care check-up, including but not limited to hiv testing, at least once a year and more often if unprotected intercourse occurs.

If you aren't already having regular, routine check-ups, now is the time to start. As long as you make sure condoms are being used for intercourse, you can fully expect your routine hiv tests to return with negative results.

Don't forget to always get checked for all the other sexually transmitted infections as well, because they are MUCH easier to transmit than hiv.

Use condoms for anal or vaginal intercourse, correctly and consistently, and you will avoid hiv infection. It really is that simple!

Ann

[Vario]

Thank you Ann, you're great for answering all my questions!
I've also looked, but in contrast I am not able to distinguish good from bad information - which you can with expertise. The only thing I found strange on my own is a case study from a droplet serum to the eyes which lead to HIV infection where not even the specimen was registrated. There was just a similarity between the two viruses from a patient and the health care worker. But well, that's no proof :-). I bet there are a lot of persons with similar viruses.
I live in a monogamous relationship and our last HIV test was 1 moth ago - we are donating blood regularly. I was afraid of having a "bad" surprise when donating the next time. But now my fears are detached, thanks again!

[Ann]

Vario,

You're welcome. Keep doing what you're already doing and you'll be just fine where hiv is concerned.

Ann