Anonymous
I have sex with a sex worker with condom all the time, however the day after I noticed on my shirt two white stain on the bottom part. I had my shirt on during the act. I usually put my shirt under my underwear. What are the risk of hiv transmission in this case? In other words transmission of hiv because using cloths with hiv infected body fluids close to penis (urethra). 
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helpline-volunteer
Hi there, 

Thank you for your inquiry. From what we gather from the information, you were asking about the possibility of HIV transmission in the event that a white stain on your shirt had come into contact with your urethra when tucking in your shirt. 

From the information given, this scenario is determined to be No Risk (transmission of HIV is not possible in the given scenario). This scenario is determined to be No Risk because it does not satisfy the requirements of our HIV Transmission Equation (see below). 

In this case, you had described a white substance on your shirt which may fulfill the requirement of the presence of HIV positive fluid, yet, as you have described, there has been no direct access to the bloodstream through a High, Low, or Negligible Risk activity. 

It sounds as if the white substance on your shirt would have had a significant amount of time to dry. Dry or drying HIV positive fluid is understood to undergo a rapid reduction in HIV concentration when exposed to environmental surfaces (1). 

For this reason, when the dry or drying HIV fluid had the potential to come into contact with your urethra, the fluid itself would have lost a reasonable amount of HIV concentration. Again, transmission in this event would require fresh fluid to have direct access to the bloodstream. 

Now, you had also mentioned you engaged in sex with a condom. Without knowing the details of your encounter, it is important to remember that anal or vaginal penetrative sex is considered to be a Low Risk (evidence of transmission occurs through these activities when certain conditions are met). 

In this context, the exposure of the fluid you mentioned through your shirt is not the main element of risk.

Here at the AIDS Vancouver Online/Helpline, we urge those who are regularly engaging in Low Risk activities to seek regular HIV screening. 

Our official Recommendation for the scenario above is to refer to your health care provider for HIV testing. 

HIV Transmission Equation: 
Helpline Transmission Equation .jpg
All the best, 

AIDS Vancouver Online/Helpline, Cody 

HIV in the Environment  (1)

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