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Tattoo and Debilitating HIV Concern

Question: 

Hi,

First of all, I'd like to thank you for your work here - you've certainly helped a lot of people.

I had a few concerns and I wanted to know if you could possible relieve some of my anxiety.

I got a tattoo on the 17th of June, 2018, and following that, I spiraled into severe anxiety about contracting HIV although there was no obvious risk. The country I got the tattoo in is unregulated - however, I made sure to go to a parlor that maintains strict sterilization processes - including having an autoclave. Despite all this, I was anxious and got tested twice - both tests turned out negative.

Just last month, I got another tattoo - and the same thing started happening. Once again, I did choose a parlor that maintains strict sterilization processes - as per the employees. The country is, once again, unregulated. However, the parlor does use disposable needles, ink cartridges and ink pots. In addition to that, they say they sterilize all non-disposable equipment (tattoo grip) in a chemical solution and then in special packages in an autoclave. They've mentioned all this on their instagram page.

I have a couple of questions that have been plaguing me.

1. I wasn't paying attention when the tattoo artist set up her station, although she did it in front of me. I did see her setting up the tattoo machine. However, I didn't pay attention as to whether she opened a new needle or not. Although they assured me they always use new needles and would never risk their shop's reputation. If a used needle was used, what are the risks? I believe I was her first customer of the day - and if not, it took her at least an hour to draw and set up. If there were any blood present, would it still be able to infect? I know that tattoo needles aren't a major concern since they are not attached to a barrel.

2. When she was working on my tattoo, the ink ran out and she had to grab the ink bottle to refill the ink pot. I know that you cannot get HIV from surfaces. However, I also know that tattoo artists shouldn't touch anything that isn't wrapped, etc. So, that has sent me into so many "what ifs" - like what if she used used needles. I mean she did touch an unwrapped bottle and then touched my skin.

3. I didn't see any visible blood. So, my question is, can one get infected from microscopic amounts of blood?

4. I know that being tattooed using non-sterilized equipment is low risk - but why is that? If there were blood on a used needle, wouldn't it have been exposed to air before touching my skin?

5. Tattoo needles are solid - as we all know - however, some tattoo needles are actually made up of several smaller needles. Do those pose a higher risk due to blood being held in those spaces?

6. How risky is getting tattooed in terms of HIV infection - I mean, I have a couple of tattoos - and I have never seen any visible blood. Not sure if this is relevant.

Lastly, I would like to apologize for all my questions. However, I won't be able to get tested (for my peace of mind) for the next 2 months - and the country I live in deports you if you are infected with HIV. The tattoo parlor I went to (second tattoo - last month) seems extremely reputable and has at 8,000 followers on instagram and the person who did my tattoo owned the shop. Is it naive to think that she wouldn't risk her shop's reputation and therefore, would always use disposables?

I also want to state that I do live with anxiety and possibly an anxiety disorder - and I do tend to have paranoid thoughts although they have never been this intense and these intense thoughts only seem to revolve around HIV. I know that HIV is not diagnosed based on symptoms, but I am now associating any physical ailment I have with HIV.

I have even reached a point where I looked up the prevalence of HIV in that country. (It's 0.1% by the way)

Thank you so much and once again, I apologize for writing out such a long message, I just didn't want to miss anything and I'm looking forward to hearing your reply. I hope you can alleviate some of my concerns.

Answer: 

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about acquiring HIV from possibly sterilized tattoo equipment. From the information given, this scenario is determined to be Low Risk (Evidence of transmission occurs through these activities when certain conditions are met).

HIV transmission occurs when bodily fluid containing HIV has direct access to the bloodstream through a High Risk Activity.

In this scenario if the tattoo equipment is non professional and non-sterlized then this would cause an opportunity for HIV transmission to occur (1). If unsterlized equipment is used and a needle is being reused there is the possibility that there is a previous customers' blood in the needle. HIV does not survive outside the body. However, it can survive over 40 days in a completely sealed environment such as a syringe/needle (2). If the tattoo artist is unlicensed then this is a Low Risk situation since there is a potential for unsanitary practices that could include sharing needles or ink (1). In regards to grabbing more ink from the bottle as long as the bottle does not have used ink and the artist is only refilling the ink pot then there should not be a concern for you (1).
In the future to help keep your mind at ease make sure the artist is properly licensed and that only new or sterlized needles, ink, and tattoo equipment are used (1). It is a good idea to do research on the artist/tattoo shop you are interested in getting work done and making sure the tattoo shop has proper licensing.

HIV symptoms mimic other illnesses, therefore the only way to be sure if to get tested.

Recommendation: Refer to Physician for HIV test.

Regards,

AIDS Vancouver Helpline/Online, Danielle