Needlstick Risk Evaluation

[vipsmith74]

Hello Experts,

I accidently found your forum (a big thank you to maintaining it) by google search.
I am  bit stressed as yesterday had an incidence that prompted bit of my anxiety and wanted to run my risk related to HIV transmission. I have contractor working in my house, he is originally from Mexico, married with kids, though he recently found his wife cheating so is taking divorce (sorry need to give this background for your evaluation). While working in my house today he asked to remove a tool from the pocket of his jacket that was hanging on a door. When I reached into his pocket I removed few objects and one of them to my  horror was used insulin diabetic pen needle (very fine) it had cap on the needle that goes into skin but the other end needle that goes into pen was exposed inside rear cap. I asked him when he had last time he used his pen he said in the morning so it was 3 hrs before I pulled it out of his pocket.

I immediately dropped it and checked my hands for any puncture wounds. I did not find any puncture wound or blood on my hands. but the needle are fine insulin so even if it punctured my skin I would not have know it. Now my questions are below

1. What are my risk for HIV assuming I got stuck by the rear end of this diabetic pen needle?
2. Should I go to ER and ask for PEP?
3. Do I need to test at for HIV and Hep etc?
4. Should I continue unprotected sex with my wife of 20 years of marriage? Dont want to put her at any risk.

Please give me your honest evaluation as even if its slightest risk I would immediately take next steps I am still within 24 hrs of PEP window. AM married happily for 15 years so do not want to RISK my lovely wife.

Thank you

[Jim Allen]

I have contractor working in my house, he is originally from Mexico, married with kids, though he recently found his wife cheating so is taking divorce (sorry need to give this background for your evaluation).

Sorry, but it's irrelevant.

When I reached into his pocket I removed few objects and one of them to my  horror was used insulin diabetic pen needle (very fine) it had cap on the needle that goes into skin but the other end needle that goes into pen was exposed inside rear cap. I asked him when he had last time he used his pen he said in the morning so it was 3 hrs before I pulled it out of his pocket.

I immediately dropped it and checked my hands for any puncture wounds. I did not find any puncture wound or blood on my hands. but the needle are fine insulin so even if it punctured my skin I would not have know it. Now my questions are below

1. What are my risk for HIV assuming I got stuck by the rear end of this diabetic pen needle?
2. Should I go to ER and ask for PEP?
3. Do I need to test at for HIV and Hep etc?

1,2 & 3. Read your post three times, it's not an HIV risk; move on with your life.

Should I continue unprotected sex with my wife of 20 years of marriage?

Nobody here is going to tell you condomless sex is safe in terms of HIV, and HIV doesn't care that you are married or how long you have been married. 

I'll mention the same thing I always do when someone says they are in a relationship; If you engage in condomless sex with your partner, you are obviously at risk of acquiring HIV. In relationships, condomless sex is often based on trust or past test results; however, this does not prevent HIV, so if condomless sex does occur, you should consider testing more frequently.

Here's what you need to know to reduce your HIV risks:
Use condoms for anal or vaginal intercourse correctly and consistently, with no exceptions. Consider talking to your healthcare provider about PrEP as an additional layer of protection against HIV

Keep in mind that some sexual practices described as safe in terms of acquiring HIV still pose a risk for other easier-acquired STIs. So please do get tested at least yearly for STIs, including but not limited to HIV, and more frequently if condomless intercourse occurs.

Also, note that it is possible to have an STI and show no signs or symptoms; testing is the only way to know.

Kind regards

Jim

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[Jim Allen]

Please do not post about this again! Thank you.

[vipsmith74]

Thank you Jim, in your response I find little solace. Can you elaborate more on why its not a risk since i read needlesticks are known risk factors? I am not challenging your evaluation just need more information so I get educated on the topic.

Also since the upper portion of needle was capped would that create some vacuum type environment elevating risk with prick from down side of needle that was exposed?

thanks no more posts from me will appreciate if you can answer my last queries above.

[Jim Allen]

Also since the upper portion of needle was capped would that create some vacuum type environment elevating risk with prick from down side of needle that was exposed?

No, it's not a vacuum; used and stored in a vacuum (if it was your contractor would be dead) or pricked you (it didn't) in a vacuum.

Can you elaborate more on why its not a risk since i read needlesticks are known risk factors?

It's not... Okay in brief, to give some context:

In non-occupational situations, It is an HIV risk when sharing hollow needles (syringes) during drug use due to the volume of fluids containing HIV that are kept within a vacuum, so they are not exposed to the environment that is (re)-injected within a very short time directly into the bloodstream.

However, to give you some context, picking yourself is not injecting; your concerns are also the wrong needle type/usage, and HIV is so fragile that even accidental needle pricks with discarded syringes in community situations have not resulted in a single confirmed case of someone acquiring HIV in 40+ years. So, the needle stick injuries in the community resulting in HIV being acquired or HIV scares are just myths.

You did not get HIV from his diabetic pen, and before you ask, that's no HIV risk regardless of his HIV status, race, nationality, marital status, etc.

However, in occupational settings (Hospitals), needle stick injury is a minor HIV risk as it relates to hollow needles containing still viable HIV directly from the patient to the healthcare worker. However, you did not take a hollow needle from the guy injection site and directly stick it into yourself and inject.

To give some context, in occupational settings, the estimated number of HIV transmissions from occupational needlestick injuries in the US & UK is about 100-120. I last checked the numbers in 2020, and at the time, there were 60 confirmed in the USA since the HIV pandemic started in the 1980s, with only one since 1999 and 5 in the UK. Yet, occupational needlestick injuries are fairly common, with yearly an estimated 3+ million globally occurring in occupational settings with less than 100 HIV cases per year.

Summary:

Needle stick injuries...

1) If you are a healthcare worker and pulling needles out of the patient's arms and directly stabbing yourself, it is a tiny risk, and I mean minuscule.  I blame hysteria and TV for this misunderstanding.

2) Drug use, sharing drug rigs to inject other people's blood with drugs directly into your veins, high risk.

3) There is no risk in non-occupational situations, so contact with discarded or old sharps, including someone's diabetic pen 3 hours later from their pocket, is no HIV risk.

Finally, please don't post again. It's not a HIV risk; you touched a diabetic pen.

If you want to reduce your risks, start using condoms, consider PrEP, and, as you are sexually active, get an HIV & STI screening at least yearly.

Anyone who continues to post excessively, questioning a conclusive negative result or no-risk situation, will be subject to a four week Time Out (a temporary ban from the Forums). If you continue to post excessively after one Time Out, you may be given a second Time Out which will last eight weeks. There is no third Time Out - it is a permanent ban. The purpose of a Time Out is to encourage you to seek the face-to-face help we cannot provide on this forum.