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Am I at Risk?

Question: 

When I was at Costco today, a lady was taking items out of my cart and putting them on the belt. I thought I saw dark blood at the base of her fingernail. I didn't ask her about it, but when I got home I decided to wipe off my items before putting them away. When I was wiping off a bag of frozen shrimp, there must have been an ice chip on it because I sliced my finger open and was bleeding. My question is should I be concerned about this and be tested?

Also do you have recommendations for becoming less afraid of contracting the virus? I have this real fear. My brother in law has aids and i always worry when we are together. In my mind I know it is not transmitted through casual contact. I just can't get beyond the worry and really want to. I don't like living like this. Thank you.

Answer: 

Hello and thank you for your inquiry.

We understand that you are asking if you might have acquired HIV from the lady who checked out in front of you in a grocery store, given that she may have had blood on her finger, and you later cut your own finger at home. This scenario is determined to carry No Risk for transmission of HIV, meaning that HIV is not possible in the given scenario.

In order for HIV transmission to occur between two people, the following three conditions must be met:

  1. There must be HIV present in a bodily fluid. (1) In this case the presence of a bodily fluid is in question since you "thought you saw" blood. In the case that you did see blood, the HIV status of the stranger in front of you at Cosco is unknown.

  2. The bodily fluid containing HIV must have direct access to the bloodstream. (1) At no point in the circumstances you described did the blood on the other customer's finger have direct contact with any part of your body, and certainly did not have direct contact with your bloodstream.

  3. Transmission occurs through a risky activity in which the first two conditions are met. (unprotected sex, sharing needles, etc) (1) This condition does not exist in your situation.

Furthermore, scientists and medical authorities agree that HIV does not survive well in the environment, making the possibility of environmental transmission remote. To obtain data on the survival of HIV, laboratory studies have required the use of artificially high concentrations of laboratory-grown virus. Although these unnatural concentrations of HIV can be kept alive for days or even weeks under precisely controlled and limited laboratory conditions, CDC studies have shown that drying of even these high concentrations of HIV reduces the amount of infectious virus by 90 to 99 percent within several hours. Since the HIV concentrations used in laboratory studies are much higher than those actually found in blood or other specimens, drying of HIV infected human blood or other body fluids reduces the risk of environmental transmission to that which has been observed — essentially zero. (2)

At AIDS Vancouver, we believe that the fear of HIV can be reduced through education and information. This is in fact one of the purposes of the helpline. You might consider reading through some of our previous posts which were flagged as "high risk", to give you an idea of what type of situations carry a real risk of transmission. It might also help to know that people who are receiving treatment for HIV and have suppressed their viral load to undetectable cannot transmit HIV to another person. (a person can only know whether he or she is virally suppressed by taking a viral load test.) (3) Think of HIV as a public health concern, rather than a personal threat, and take appropriate, fact-based measures to reduce its spread in your community (condom use, clean needles etc.). You might find that this approach helps you to get past your anxiety, and can also reduce the stigma faced by people like your brother in law who are living with HIV.

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

Regards, AIDS Vancouver Helpline/Online, Dyson