Rammrub
Last night I was helping a family member draw up testosterone from a multi dose glass vial. I pierced the vial once or twice withdrew meds in and out of the syringe several times until it was the right dose. When going to recap the needle I poked myself ever so slightly. But I immediately washed my hands  and applied alcohol to it. I didn’t bleed and no blood came out when I squeezed but I could see a very tiny sort of superficial prick. The family member’s not a reliable source since they’re alcoholic and probable drug use. I asked if the needle was clean to which they stated yes, however it was not in a package when he brought it just came capped. Apparently they reused they syringe but change the needle. I then headed to the urgent care to which they drew blood and am waiting on results. The doctor barely looked at my finger and thought that there was little risk. However I’m going out of my mind with worry since I have a 3 month old I have to breastfeed. Do I need to take PEP based on these details? Should I seek a second opinion? Please please please help!!!
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helpline-volunteer
Hi there,

Thank you for your inquiry. From what we gather from the question, you were asking about the possibility of HIV transmission in the event that you had pierced the skin with a needle that had previously been used on another individual. In this scenario, you describe that the family member claims the needle to be unused, but the syringe to be previously used. 

For the purpose of clarity, it is our interpretation that you had pricked yourself with the needle immediately after drawing liquid from a multi-dose glass vial in which the needle has been attached to a previously used needle chamber. 

From the information given, this scenario is determined to be High Risk (there is evidence of transmission through these activities and are the majority of cases of transmission).

For needle injuries, the type of needle is important. As you have described, the needle used in this event is a hypodermic needle. The risk of HIV transmission is higher in this case than with a non-hollow needle (such as a sewing needle) (1). The risk of acquiring HIV from a hypodermic needle with blood containing the virus is between 0.2%-0.5% (1). The risk increases with the amount of blood introduced and the concentration of virus in the blood (2). The size of the needle, depth of penetration, and injection of blood are also important considerations (1). 

In your post, you describe the needle to be new, but the syringe to have been used. Transmission is still considered to be possible, and the act still considered to be of High Risk. Although the needle has been replaced, the syringe has not. In this event, there is a likelihood that the syringe could act as a vacuum-sealed chamber, allowing HIV positive fluid (blood) to remain intact. Theoretically, blood containing HIV, in this case, may have entered your bloodstream through the needle-prick injury.

It appears as though you had received HIV screening immediately after this event occurred. For High Risk events like the one you have described, we typically would recommend you seek PEP within 72 hours post-exposure, as well as HIV screening.

From what you have described, you have taken the necessary steps we would recommend in this case. If your doctor has not recommended PEP, and you are still within the 72-hour post-exposure period, we would recommend you do ask to inquire about your PEP your options.



Helpline Transmission Equation  (1).jpg

Recommendation:
Refer to a health care provider for more questions regarding PEP.

Regards,

AIDS Vancouver Helpline/Online, Cody

 

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1.) Risk of HIV Transmission associated with Needle-Stick Injuries.
2.) Case Control Study of HIV Transmission After Needle-Stick Injury.

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