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healthcare exposure

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pjwrites:
Hello all.
I was exposed to HIV at work. I was cut on a dental instrument. I didn't report the exposure as I was new to the field  and inexperienced. I later found out by accident the paitient was HIV +. I tested at 14 wks neg. The doctor didnt see me, his office just called the test in on Friday and called me with results on the following Tuesday. I have no idea what type of HIV test was used. Everything I have read indicates that healthcare workers who were exposed to hiv should test at 3, 6 and 12 months. My questions are:

1. Does it matter what test was used at 14 wks?
2. is the window period longer for a health care related exposure?
3. does the fact I have adult on set stills disease (an autoamune disease) affect my test results?
pj

Ann:
PJ,

Getting cut on a dental instrument that was used on a positive patient isn't a risk for hiv infection. Hiv is a fragile, difficult to transmit virus and not one that is transmitted outside the human body in the manner you describe. Once hiv finds itself outside the body, it quickly becomes damaged and unable to infect a new host.

Hiv is primarily transmitted INSIDE the human body, as in unprotected anal or vaginal intercourse. For this reason, 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 STIs together. To agree to have unprotected intercourse is to consent to the possibility of being infected with a sexually transmitted infection.

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

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.

The healthcare situations that might need testing past the three month mark involve needle stick injury where PEP (post exposure prophylaxis) has been used. PEP extends the window period by four weeks.

Your situation does not fall into this category as you did not have a risk in the first place. You can consider your fourteen week test to be conclusive.

Ann

pjwrites:
Ann thank you for your response. 

The instrument had his fresh blood on it (we were involvedin a very bloody procedure) and very quickly after using it on him I cut my hand with it leaving a bleeding opening. I washed it as soon as it happened but how is this less risk than a needle stick as needle sticks leave the infected person and travel to the other person as well? Can the HIV be damaged that quickly after leaving the body?

As far as unprotected sex goes I have only had one partner my entire life and we have been together 25 years. Unfortunately we had unprotected sex after this incident before I found out the patient was hiv pos. So now im worried for my husband also.

Ann:
PJ,

Your risk was theoretical at best. However, your fourteen week negative result proves that you did not become infected from this incident and you do not need further testing.

The difference between your accident and a needle stick is that with needle stick, hiv is introduced directly into the body from the inside of a hollow bore needle. There is very little air contact in this type of case. Also, please keep in mind that the incidence of a person becoming infected through needle stick is very, very low, considering how many times this happens in a medical setting. Hiv needs to come into contact with a specific type of cell and these cells are not found in many places in the body.

Relax, you are hiv negative.

Ann

Andy Velez:
PJ, since  I am sure you are still fretting over this, I just want to chime in and tell you that I agree with Ann. No further testing is needed. You're HIV negative. Period.

Take a breath and get on with your life. No kidding.

Cheers,

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