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How Is HIV Transmitted?

Posted on Tue, 29 Apr 2014

Question: 1.) 19 days ago, I purchased a hookah from a shop...the person who was packing the hookah pipe MAY have had a small wound on his hand (not sure)...it took me roughly 30 mins to get back home and prepare the hookah for smoking..before putting the pipe in my mouth..I rubbed it with some hand sanitizer (ethanol) and let it dry out. 2.) Four days later (15 days ago), I shared the hookah pipe with a friend. Unfortunately, I had forgotten that I didnt have any mouth pieces for my frnd..so we ended up sharing the hookah anyways (moved the pipe around to and fro for an hour). But before using the pipe (putting it into my mouth)..I would rub it with hand sanitizer for a few seconds and wipe it with my shirt...and my frnd would do the same. During both instances, I had chapped lips with a visible cut on my lower lip (the kind that looks red but isnt actively bleeding) Now, exactly 1 week after the first incident ( and 3-4 days after the second one)..I developed a mild sore throat with weird underarm pain. The pain has spread to my neck/back/legs. I also have a bad headache, eye pain and stomach ache. My doctor thought that it is a viral infection of some sort and will sort itself out. I am worried that If there was any blood on the pipe which came in contact with my chapped lips..could I get HIV from this. Do I need to test? Im quite stressed out. Pls help PS: yesterday, I was at a temple where the priest used a small steel/metal rod to apply a tikka on my forehead. Now, I have a small non-bleeding cut (its pretty small) on my forehead for the last 3-4 days ...if the metal rod had someone's blood on it..can this lead to transmission? (the rod was immersed in a bowl of red coloured liquid (generally made of water and red powder - artificial or natural). The area where the tikka was put has since become reddish and slightly inflamed (could be due to the heat as well). Pls offer your risk assessment of the above mentioned incidents and advise ASAP. I have taken a DUO test on Saturday (2 days ago) evening and it was negative Thanks

Answered by Dr. Praveen Rodrigues (16 minutes later)

Brief Answer: No risk of HIV in former;Contact dermatitis latter Detailed Answer: Hey there. I chose to answer this question not only because i am a specialist in the field but because i have a hookah at home & well versed with its nuances & empathise with your concerns. As for the first incident, your physician is absolutely spot on..dont lose him/her. It does appear to be an ailment linked to a virus (something like infectious mononucleosis). This is infinitely more plausible than a HIV infection given your history. The risk is less than 0.03% to be more precise..so chill..It is all good as my best friend at work says. It is even more credible that your DUO test was negative & should emphasise the view your physician has that it is a fleeting URTI (upper respiratory tract infection) that will resolve itself in a week; please remember to hydrate yourself well. As for the second incident, it is every bit likely (in my clinical experience of dermatology spanning 2 decades) that you will have developed an 'irritant' or 'contact dermatitis' due to the combination of trauma & the dye/kumkum even if you have not experienced a similar reaction earlier & more so if not earlier as it is possibly a case of 'delayed hypersensitivity'. It simply means dont worry..use a cream called HHFudic if in India (contains a mild cortisone & antibiotic) & if used on the area locally twice daily should resolve the issue in 24-48 hrs or so. I trust this will have cleared both your doubts & given you a clear action plan. Relax, it will all be fine & wish you continued good health in the future. Avoid the hokah for a good 2 weeks or so till issues resolve & then do remember that smoking does damage over a period that is irreversible. Good Luck & Godspeed! Dr Praveen Rodrigues MD

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Praveen Rodrigues (50 minutes later)

Thank you very much Sir, I forgot to add that the symptoms seem to have subsided reasonably in the last 3 days...its only the fact that it came almost immediately after using the hookah that had scared the hell out of me...plus the pain in the glandular areas. Also, can I assume from your reply that the second incident was reasonably risk free? I only asked because I am pretty stressed out and yes my skin is very sensitive and I tend to get my share of skin issues. In any case, can I stop worrying and let this go? (no further testing) Thanks

Answered by Dr. Praveen Rodrigues (4 hours later)

Brief Answer: Dont worry, be happy...all is well..cheers! Detailed Answer: Yes Please. You can stop worrying & let this thing go especially as you say you are feeling much better...that is always a good sign & that I was right in my assessment. Please feel free to close this query & it will give you the necessary closure too! Good Luck & Godspeed! Dr Praveen Rodrigues MD

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Praveen Rodrigues (38 hours later)

Sorry to bother you again Sir. As I told you...I had taken a DUO test 3 days ago on Saturday, 13 days after sharing the hookah pipe with my frnd. I had also taken a Proviral DNA PCR test on the same day with the DUO...the result for which arrived yesterday evening and it is negative. While I understand that testing was not required, from an anxiety relief point of view...is the DNA PCR at 13.5/14 days conclusive??? Thanks

Answered by Dr. Praveen Rodrigues (2 hours later)

Brief Answer: Yes conclusive & RIP (Rest in Peace) :) Detailed Answer: Yes in 2 weeks it should be considered conclusive. You have absolutely nothing to fear. Best Regds. Dr Praveen Rodrigues MD

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Above answer was peer-reviewed by : Dr. Vinay Bhardwaj