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Fight with high HIV risk person (multiple scratches)

Question: 

Hi,
I had a fight with a female african escort today , she told me she was high on cocaine.
I am saying she is a high risk cause she's an escort , drug user and as far as I know statistically HIV is more common in people from Africa
The fight lasted for 15 mins since she was so high and would not leave my room.
After the fight , I checked my self and found multiple scratches that were bleeding that I guess were from her nails.
I don't know what happened during the fight or if there was blood from her that got into these scratches
I am worried sick now and I have an appointment with an internal Medicine doctor tomorrow
Is this is a high risk encounter ?
Should I consider PREP?
If I took the RNA test tomorrow would it be accurate ?
Thanks and sorry for the long story

Answer: 

Hello and thanks for reaching out to the AIDS Vancouver Helpline.

It sounds like you are concerned about the likelihood of acquiring HIV through this scenario.

Before I address your question it is important to note that HIV impacts the lives of many throughout the world. When it comes to HIV it is not the individual or population that puts one at risk, but rather the activity that will put one at risk of acquiring HIV.

For HIV transmission to be possible there needs to be a body fluid, an activity such as unprotected anal or vaginal intercourse and a direct access for the virus to enter the bloodstream. This confrontation that you experienced would be considered a No Risk activity even if there was blood from her that may have made contact with the scratches. This is due to the HIV virus being very fragile and once exposed to air it is no longer transmissible. Furthermore, in order for HIV transmission to be possible from an open cut, this cut needs to be very deep and not just a scratch.

No you should not consider PREP as the activity you were engaged in is considered a No Risk activity. PrEP should only be taken if you are considering to engage in any high risk HIV activities.

If you took an RNA test at this given time it would not give you a conclusive result. An HIV test taken at this time would generate a result that would be a good indicator of your current HIV status. Furthermore, official HIV testing guidelines state that at 12 weeks and onwards all HIV tests generate completely conclusive results.

Below I have attached an HIV Transmission Chart, which shows the necessary factors for HIV transmission to be possible.

HIV TRANSMISSION EQUATION

BODY FLUID
+
ACTIVITY
+
DIRECT ACCESS TO BLOODSTREAM
• blood (including menstrual) • unprotected anal or vaginal intercourse • vagina
• semen • sharing needles • anus
• pre-cum • mother to child (in specific cases) • urethra in the penis
• rectal secretions • open cuts and sores (in theory)
• vaginal fluids • other mucosal membranes
• breast milk • points of needle injection

= RISK OF HIV TRANSMISSION

For more information on HIV you can visit HIV and AIDS Basics.

Regards,

Chris, Volunteer

AIDS Vancouver Helpline/Online
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1 844 INFO-HIV (Toll free Canada & U.S.)
helpline@aidsvancouver.org
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