More HIV questions...

[Questions11]

I have severe OCD and I used to think I was pretty educated on HIV and did not lose my mind fearing it the way I have now. Please keep in mind before reading and responding that these fears are really impacting my life as I can't stop thinking about this. What makes it worse is that I can't seem to find many answers.

 

Here is what happened: I read about a dentist and some other medical offices that weren't following universal precautions and were putting people at rick for HIV and HEP C. This triggered my OCD and I decided to get test. At this point however, given that needles and syringes were my reason for getting tested, I wasn't capable to do a regular blood draw. So I took 3 oral swab, oraquick HIV tests.

 

 

I did not worry about the tests initially, although I found that they weren't that reliable, but then my brain started going all over the place with "what if" scenarios...and now I am stuck and feel like I know nothing about HIV, and basically am afraid I could be at risk for simply taking these tests.

 

I keep thinking "What if someone isolated the virus, put it on some clear chemicals and put a preservative in it so the virus could survive?" Is this even POSSIBLE to do inside a test stick or on a cotton test pad? I used the test pad to swab my upper and lower gums. Where does "reality" end and where does my "ocd" start because right now I am seriously losing my mind. I hope someone can help!!

[StringJunky]

Go and get a HIV test done by a medical professional.

[Questions11]

What do you mean get a test done by a medical professional? I had 2 tests done at a clinic. Do you mean get a blood test done? Is there anyone that can please answer me this question about the oral swab? I did not see blood on the swab but I didn't thoroughly check either. Is there anyway the virus could have been there with some clear liquid? Or is there any way the virus could have been inside the test stick? The tests I took were the Oraquick oral swab. And yes, I know- getting more tests would end my questions about these tests but because I have OCD, I fear needles intensely (which is why I did the oral swab test). Now, I am doubting if the oral swab test is safe. Is it my OCD causing me to doubt the possibility of the test being infected or is there some real science validity behind this? I know that scientists can isolate the hiv virus in labs under certain conditions. What are those conditions and can those conditions be replicated? I mean the test is an immonoessay later flow test and I know the test itself is safe but assuming someone tampered with it, could I be at risk? This is really making it hard for me to function. Please someone answer!

[Arete]

You cannot get HIV from a cheek swab

[Questions11]

Arete, I understand that but I'm asking is it possible for someone to have placed the virus in the swab or in the test stick, which would allow the virus to fall to the swab when I used it? This is very distressing for me. Can someone isolate hiv and put it in clear fluid so that I wouldn't have noticed? I want to know if this test is safe to reuse.

[Endy0816]

With the amount of time involved(packaging, shipping, use) it is unrealistic to think that any could have survived.

 

It is something of a weakling as far as viruses are concerned. Focus on getting the basics right and you'll be fine.

Edited April 28, 2016 by Endy0816

[StringJunky]

Arete, I understand that but I'm asking is it possible for someone to have placed the virus in the swab or in the test stick, which would allow the virus to fall to the swab when I used it? This is very distressing for me. Can someone isolate hiv and put it in clear fluid so that I wouldn't have noticed? I want to know if this test is safe to reuse.

If someone were to maliciously contaminate something it would be on something that penetrates the body, like a needle or inside a syringe barrel.

 

From the Centers of Disease Control (US) website:

 

How well does HIV survive outside the body?

HIV does not survive long outside the human body (such as on surfaces), and it cannot reproduce outside a human host. It is not spread by

• Mosquitoes, ticks, or other insects.
• Saliva, tears, or sweat that is not mixed with the blood of an HIV-positive person.
• Hugging, shaking hands, sharing toilets, sharing dishes, or closed-mouth or “social” kissing with someone who is HIV-positive.
• Other sexual activities that don’t involve the exchange of body fluids (for example, touching).

http://www.cdc.gov/hiv/basics/transmission.html

 

Extrapolate that to your situation and the answer is no... just like Arete said.

[Arete]

Arete, I understand that but I'm asking is it possible for someone to have placed the virus in the swab or in the test stick, which would allow the virus to fall to the swab when I used it?

 

Even if the swab was contaminated with HIV, you would need a break in the skin of your mouth for any appreciable risk of transmission.

 

Generally speaking it's SOP for a clinician to open any sterile swabs/needles/dressings in front of the patient, so you would have likely seen the swab come out of the sterile package it was in. As previously stated HIV has low viability outside of a host, so any contamination would have to occur immediately prior to you coming into contact with it. It's not like a malicious or negligent person could contaminate a swab, package it up at the factory and have it infect a patient days/weeks later.

 

Any risk of HIV infection from a cheek swab is extremely negligible, even in a worst case scenario - even the risk of an infection following a needlestick with a needle known to be contaminated with HIV + blood is 0.32%

[Questions11]

I got this from the website. It is regarding their test kit controls (which are used to determine if a test is working or not):

 

Each Kit Control box contains a package insert and three vials (one HIV-1 positive control, one HIV-2 positive control and one negative control) as described below:

1. HIV-1 Positive Control One black-capped vial containing 0.2 mL of photo chemically inactivated human plasma positive for antibodies to HIV-1, diluted in a defibrinated pool of normal human plasma. Preservative: ProClin 5000. Negative for Hepatitis B surface antigen and Hepatitis C antibody.

2. HIV-2 Positive Control One red-capped vial containing 0.2 mL of photo chemically inactivated human plasma positive for antibodies to HIV-2, diluted in a defibrinated pool of normal human plasma. Preservative: ProClin 5000. Negative for Hepatitis B surface antigen and Hepatitis C antibody.

3. Negative Control One white-capped vial containing 0.2 mL of defibrinated pool of normal human plasma negative for antibodies to HIV-1 and HIV-2. Preservative: ProClin 5000. Negative for Hepatitis B surface antigen and Hepatitis C antibody.

 

 

What does this mean??? It also says how it is stored in a "clear liquid"....

[Questions11]

Can someone please answer my last question? I'm really going through a lot.

And is the information here correct? I thought the virus became inactivated upon contact with air...

 

http://www.aidsmap.com/Survival-outside-the-body/page/1321278/

[Arete]

The key word is "antibodies". The positive control contains antibodies to hiv. Not the virus itself. It is therefore non infectious.

[Questions11]

Can someone please answer my last question? I'm really going through a lot.

And is the information here correct? I thought the virus became inactivated upon contact with air...

 

http://www.aidsmap.com/Survival-outside-the-body/page/1321278/

How about this link that says the virus can live on the environment for days??? I always thought when it hit the air it became inactive...I am so confused now. Can it stay active on dental equipment??

[Arete]

How about this link that says the virus can live on the environment for days??? I always thought when it hit the air it became inactive...I am so confused now. Can it stay active on dental equipment??

 

HIV is a relatively fragile virus, but is viable for short periods (usually measured in hours) outside the body. Other bloodborne pathogens (e.g. Hepatitis) are much more resilient and thus more of an indirect transmission concern.

 

Yes, HIV could be conceivably transmitted by improperly sterilized medical and dental equipment. Proper autoclaving and aseptic technique reduces the risk to a negligible level.

[Questions11]

 

HIV is a relatively fragile virus, but is viable for short periods (usually measured in hours) outside the body. Other bloodborne pathogens (e.g. Hepatitis) are much more resilient and thus more of an indirect transmission concern.

 

Yes, HIV could be conceivably transmitted by improperly sterilized medical and dental equipment. Proper autoclaving and aseptic technique reduces the risk to a negligible level.

 

WOW! HOURS???? I was told that "hiv dies within seconds/minutes at most when it hits the air/leaves the host"...I'm aware that viruses aren't alive but it's the terminology most people use.... So, how would one know if the equipment was properly sterilized? Also, does this mean that if the woman at the clinic placed hiv contaminated plasma on the oral swab before I used it, that I could be at risk???? This is terrifying me!!!!

[Endy0816]

You have about the same odds of being infected via a swab as you do of having a jet engine crash into your bedroom.

 

I'm not sure there is any information we can give you will put you totally at ease. Many things are hypothetically possible, but incredibly improbable. What you are describing falls into that category.

 

I can't say what I would do, but I advise working on the OCD instead if you wish to find a measure of peace.

[Arete]

WOW! HOURS???? I was told that "hiv dies within seconds/minutes at most when it hits the air/leaves the host"...

 

That's incorrect. Viability of the virus is dependent on a number of variables, but usually for HIV, hours is a good measure.

 

So, how would one know if the equipment was properly sterilized?

 

Virtually all modern medical implements are either disposable or autoclavable. If you're going to a licensed clinician who is practicing in a legal fashion, in a developed nation, you're very safe from HIV infection.

 

does this mean that if the woman at the clinic placed hiv contaminated plasma on the oral swab before I used it, that I could be at risk????

 

No. If you had no open wound in your mouth at the time, there is no risk of transmission.

[Questions11]

It is hard to work on my OCD when I hear that these are REAL possible ways of transmission. I am having terrible anxiety over all this. I don't even trust the oral swab tests anymore and know I need a blood test done but I can't seem to find the courage to go anymore.

 

I have not had OCD regarding HIV for 7 years and now I am learning that the things that helped me aren't even TRUE.

 

1. First, let's please clarify the whole "hiv can still infect hours after being in the environment" thing. Does this mean that if there is hiv+ blood on the toilet and you sit on it 2 hours later and have a cut, that you can possibly become infected? Or that if it is in instruments at the dentist and he/she drills your teeth that you can get infected? So, it really is not that fragile after all??? Why do all the hiv hotlines and prevention forums online keep saying that "the virus is inactive when it hits the air due to temperature and ph level change"?. This is very confusing! Can you please clarify this?

 

2. How much blood is needed to infect? What are the odds of infection if the dental equipment wasn't cleaned? How about if a new anesthesia syringe wasn't used? And last but not least, I am very scared of blood draws and needles. What are the chances of infection if a used butterfly needle was used to draw your blood? Would the blood from the previous person clot the needle? Would it be enough to infect? It would be a direct transmission to the vein so this really scares me.

 

How do all of you manage to go to the dentist and doctors without being as terrified as I am??? I don't know where all this came from. I used to be able to go prior to my ocd starting and then I read articles about some messed up people in the field that were not properly sterilizing equipment and reusing needles/syringes. I don't know how to get through this as it is ruining me!

[StringJunky]

It is hard to work on my OCD when I hear that these are REAL possible ways of transmission. I am having terrible anxiety over all this. I don't even trust the oral swab tests anymore and know I need a blood test done but I can't seem to find the courage to go anymore.

 

I have not had OCD regarding HIV for 7 years and now I am learning that the things that helped me aren't even TRUE.

 

1. First, let's please clarify the whole "hiv can still infect hours after being in the environment" thing. Does this mean that if there is hiv+ blood on the toilet and you sit on it 2 hours later and have a cut, that you can possibly become infected? Or that if it is in instruments at the dentist and he/she drills your teeth that you can get infected? So, it really is not that fragile after all??? Why do all the hiv hotlines and prevention forums online keep saying that "the virus is inactive when it hits the air due to temperature and ph level change"?. This is very confusing! Can you please clarify this?

 

2. How much blood is needed to infect? What are the odds of infection if the dental equipment wasn't cleaned? How about if a new anesthesia syringe wasn't used? And last but not least, I am very scared of blood draws and needles. What are the chances of infection if a used butterfly needle was used to draw your blood? Would the blood from the previous person clot the needle? Would it be enough to infect? It would be a direct transmission to the vein so this really scares me.

 

How do all of you manage to go to the dentist and doctors without being as terrified as I am??? I don't know where all this came from. I used to be able to go prior to my ocd starting and then I read articles about some messed up people in the field that were not properly sterilizing equipment and reusing needles/syringes. I don't know how to get through this as it is ruining me!

I don't think think anything anyone one says here will convince you. You need to go and get test tested. Or see your doctor.,

[Questions11]

I don't think think anything anyone one says here will convince you. You need to go and get test tested. Or see your doctor.,

StringJunky,

What people have said here has caused my OCD to skyrocket. It can live in the environment for hours?? Why the conflicting information from different sources? Some say minutes and some say hours. If it can live in the environment for hours, how can one even eat out at restaurants? What helped me with my OCD about hiv years ago was learning that it was not infectious once it hit the air. Now, are you guys telling me this is wrong and that it can remain infectious for HOURS??

 

This isn't just about getting tested. It is about many things. I am trying to overcome my fears of going to the dentist and having needles or dental equipment in me and I am asking you guys for help and advice. I read a few articles about dentists that weren't following protocol and this has created this whole mess. How do I know that the equipment they use has been properly sterilized? Do you just "assume" they have? Do I need to get tested every time I go to the dentist now? I live in the U.S but it is still hard to be sure. Do I ask to watch as they sterilize the equipment before it is used on me? How does one make sure universal precautions are being implemented?

Edited May 5, 2016 by Questions11

[CharonY]

The problem is that in order to overcome your fear you want assurance that something has zero likelihood. In truth there are many non-zero risks, for example a military transporter getting of course, having a malfunction and accidentally dropping a tank on your head. However, these chances are so ridiculously low that it does not really make sense to think of them as likely options. I am pretty sure you are more likely to choke on your own toothbrush, for example.

 

If you go to a science board you will have to expect that people try not to lie to you in order to make you feel better. Rather the only difference that you need to do to overcome your fear is trying to obtain a rational perspective of things. As you mentioned repeatedly, your OCD (assuming it has been diagnosed as such) prevents you from doing so. Based on that there is little one can do to assuage your fears. Of course you can ask the medical staff whether they follow proper procedure which any reputable medical provider will do. However, if you do not believe them, there is little one can do (though some may have experience with this situation and may even be willing to show it to you).

[StringJunky]

"The CDC (Centre for Disease Control) writes:

 

"Scientists and medical authorities agree that HIV does not survive well outside the body, making the possibility of environmental transmission remote. HIV is found in varying concentrations or amounts in blood, semen, vaginal fluid, breast milk, saliva, and tears. To obtain data on the survival of HIV, laboratory studies have required the use of artificially high concentrations of laboratory-grown virus. Although these unnatural concentrations of HIV can be kept alive for days or even weeks under precisely controlled and limited laboratory conditions, CDC studies have shown that drying of even these high concentrations of HIV reduces the amount of infectious virus by 90 to 99 percent within several hours. Since the HIV concentrations used in laboratory studies are much higher than those actually found in blood or other specimens, drying of HIV-infected human blood or other body fluids reduces the theoretical risk of environmental transmission to that which has been observed–essentially zero. Incorrect interpretations of conclusions drawn from laboratory studies have in some instances caused unnecessary alarm.

Results from laboratory studies should not be used to assess specific personal risk of infection because (1) the amount of virus studied is not found in human specimens or elsewhere in nature, and (2) no one has been identified as infected with HIV due to contact with an environmental surface. Additionally, HIV is unable to reproduce outside its living host (unlike many bacteria or fungi, which may do so under suitable conditions), except under laboratory conditions; therefore, it does not spread or maintain infectiousness outside its host."

To summarize, HIV needs really specific conditions to survive outside the body. Typically air tight and climate controlled. As far as inanimate objects, needles are found to be one place the virus can survive a bit longer. This is due to the airtight space between the needle tip and the plunger also known as the "sweet spot"."

 

http://helpline.aidsvancouver.org/what-we-do/helpline/online/how-much-seconds-or-minutes-exactly-hiv-virus-remains-alive-outside-human

Edited May 5, 2016 by StringJunky

[Questions11]

Thanks for the info!

[StringJunky]

Thanks for the info!

No problem. I hope you are reassured now.

 

For those seeking to reassure others with the same problem I think it is important to stress that the oft-published test samples for the survivability of HIV outside the body has a much higher population density than exists in the wild, as per the CDC article I quoted.

Edited May 12, 2016 by StringJunky

[Questions11]

Yes, I feel better about the environmental risks but still worried about other things. Currently I am worried about the oral tests I took. I know that they use an antigen on the test and that if you have antibodies, it will bind to these antigens...My questions are: (and I'm hoping someone can help as I can't find these answers anywhere)

 

1. How are these antigens created to be placed on the test? Do laboratories grow an artificial virus or can they synthetically create antigens?

2. How do they then transfer these antigens to all these tests? Is it a machine that creates the tests or are they hand made?

3. Where on the test are the antigens located?

4. If someone maliciously or mistakenly put viruses on the test, what are the odds of getting infected through it? (this is the ultimate question that has been driving me crazy)

[Raider5678]

4. If someone maliciously or mistakenly put viruses on the test, what are the odds of getting infected through it? (this is the ultimate question that has been driving me crazy)

Well, considering that most of the time the cotton swabs are sterilized, it has a low chance of being infected, even if it was on purpose. And to answer your question, there is no chemical that can keep HIV alive for more than a few hours without specific lab conditions. Since the swab was probably packaged for days before you ever even saw it, ANY Hiv in it would have died. Furthermore, if it somehow did have trace amounts of hiv it wouldn't be enough to give you hiv unless you had a actively bleeding cut in your mouth at the time which you probably didn't considering you wouldn't have done the test with your OCD if you did, because that's the way most people with OCD as major as your case would do. Even if you didn't actively think about the cut, your subconscious probably would have never scheduled the appointment, or even canceled it if you had a cut. So your near the 99.9999995% chance of safety. And I actually calculated this just for you, so it better make you feel better.