HIV risk?

[Juliaho90]

I wanted to enquire about an experience I had over the weekend. I was in a. Public restroom and only realised there was a drop of what looks like diluted blood (like menstrual blood in pee) on the toilet seat after I was done using the toilet. I am feeling extremely uncomfortable about this. I am concerned that my private area may have touched it unknowingly. Am I at any HIV risk? I am freaking out right now…

[Sam W]

Hi Juliaho90,

So, even if HIV was present in a drop of blood in this scenario--which is already a pretty big if--HIV needs to be present in a large enough quantity to cause an infection, which you just would not have in this scenario. You also cannot get HIV from touching things like blood or semen with unbroken skin, which is what would have been touching it if it was on the seat.

[Juliaho90]

Thanks Sam. I don’t know if my privates did brush across the blood accidentally when I was sitting down or getting up. And that makes me worry because the vagina is a mucous membrane that allows transmission right?

[Sam W]

Even if that had happened, the first thing I said still applies; HIV would need to be present in large enough quantities to cause infection, which just would not be the case in this scenario. If you want to learn more about what does, and does not, need to be present for HIV to transmit, I'd give this a read: Positively Informed: An HIV/AIDS Roundup

[Juliaho90]

Thanks Sam, I will give it a thorough read. When you say large enough quantity, how would you quantity though? Like how much is large enough?

[Sam W]

It's more about concentration, not just quantity, which if you were seeing blood in a drop of someone else's urine just isn't going to be sufficient. But, I think it would actually be more helpful to pause and think about why your brain went straight to worrying about HIV risk in this scenario and figure out what you could do to address that anxiety.

[Juliaho90]

Hi Sam, I have HIV anxiety and I am seeing a counsellor about it. So this is very difficult for me because whenever I encounter blood, my mind goes straight to “omg I am infected with HIV”

In my situation, can I say based on your answer that there isn’t any risk?

[Juliaho90]

Hi Sam, I have HIV anxiety and I am seeing a counsellor about it. So this is very difficult for me because whenever I encounter blood, my mind goes straight to “omg I am infected with HIV”

In my situation, can I say based on your answer that there isn’t any HIV risk?

[Sofi]

Hi Juliaho90, we can't flat out tell you that for sure there is absolutely NO risk, but the risk here is extremely minimal. Have you told your counselor about this, and if so what did they say about it?

[Juliaho90]

My counsellor’s advice is to stop thinking about it. But with anxiety, there is no such “off button”. How do I stop thinking about it when it is causing me to feel so uncomfortable? Also, she says since the risks are minimal, I should just move on because researching online, and going for tests are feeding the anxiety in the long run.

[Carly]

Hey Juliaho90 -- I know there's some scary unknowns here, which can set anxiety off big time. There's also no real way to stop thinking about it sometimes. The one thing we can assure you is that the risk is not urgent.

In some ways, I think your counselor is right. Researching might get to you, but I wish they didn't shut down the anxiety part of this that isn't directly related to HIV. If I'm recalling correctly from your posts, you also have some regular anxiety about your birth control. Can you pinpoint a reason why sexual and reproductive health might be something that really sticks with you?

[Juliaho90]

Hi there, I don’t think I can explain exactly why I have these anxieties. I have had a trauma in the past involving a needle prick incident and that’s how the HIV anxiety started. So when you say it isn’t urgent, what does it mean? Because to me, everything is amplified, and I don’t know how to take a step back and look at the big picture.

[Sam W]

Hi Juliaho90,

Have you and your counselor done any kind of work around figuring out why your anxieties tend to tack to sexual and reproductive health? If not, we could help you work out how to bring that question into sessions with her.

What Carly meant was what has been reiterated in this thread multiple times: that HIV requires specific conditions to transfer, which simply aren't met by what you've described to us. Even if there was, hypothetically, HIV in the person who left that drop, not only does the concentration of HIV matter, but HIV dies outside of the human body and the blood would have had to come into contact with the inside of your urethra or vagina, which just isn't going to happen when you sit on a toilet seat. Does that make sense?

[Juliaho90]

Hi there, yes that makes sense. Just to clarify, when you say the urethra and vagina, are you referring to deep inside or are the surfaces of the labia also mucous Membranes? Apologies I don’t know the anatomy that well.

I feel like I am really just having problem letting go. My brain is constantly telling me “hey this is important why are you not thinking about it” and it makes it really hard to go about my day. Whenever I have these conversations with my counsellor, she would say use the “stop the thought” process where you literally tell yourself to stop the thoughts, which I found it so hard to do.

[Sam W]

It means inside the vaginal canal, which is different from the external portion (which is the vulva).


Have you told your therapist that the "stop the thought" process isn't working for you?

[Juliaho90]

So is the external portion, the vulva, mucous membrane or is that considered skin?

I told her i found it hard to do but she says I just need practice because my hiv anxiety hasn’t been back for 7 years and it suddenly came back unexpectedly.

[Sam W]

The labia majora is considered skin, while the labia minora is considered a mucous membrane. But, again, I've listed multiple reasons why this doesn't pose an HIV risk, not just one, so I think going forward it will be more effective to focus on figuring out how to work with your therapist to address this fear. For instance, do you two practice the techniques she's telling you you need to work on during the actual sessions?

[Juliaho90]

I did tell her that I found it hard to practise the techniques she asked me to try out because it’s literally telling my self to stop thinking and the more I do that, I feel my brain tells me the exact opposite. But she says I need to keep
Practising and train the brain. Which isn’t totally helpful. And she told me I needed to distract myself but I can’t do that all the time especially when I am at work. So Imm not really doing well right now

[Carly]

I'm so sorry that these techniques haven't been so helpful for you. Have you ever discussed mindfulness/meditation? This can be helpful for some people going through similar anxious thinking and often recommended.

[Juliaho90]

No it doesn’t work as well. And I am not sure why I am finding it so hard to let go.

[Sam W]

One of the tricky things about anxiety is that if we could just let go of it, or stop thinking about the things that make us anxious, anxiety disorders wouldn't really be a thing. I actually wonder if a useful next step would be to look into some of the self-guided resources in this article: Anxiety and Other Mental Health Resources. There may be things in them that you haven't tried, and many of them have a guided component so that you're not stuck navigating them all on your own.

[Juliaho90]

Well I did have a session with my counsellor yesterday and I told her my frustrations. She told me that every time I start thinking about “what if” “I think” “maybe” - it is the anxiety speaking and it’s lying to my brain.

Why am I finding it so hard to let go and move on though? Even though everyone has told me I wasn’t at risk of contracting HIV

[Juliaho90]

I kept trying to recall what exactly happened like step by step but I can’t remember everything.

Which leads to the anxiety and a lot of intrusive thoughts like “what if I did this instead” or “maybe I didn’t do what I thought I did”

[Carly]

Hi Julia -- I wish I had a better answer for why you're so stuck on this even if you're told you weren't at risk. If I had to guess, it would be similar to what I suggested before... there are a lot of unknowns that you are being forced to sit with rather than know exactly what happened. I struggle with anxiety myself, and a lot of that stems from wanting to feel some control in a situation. And sometimes, the way I think I can have control is by knowing exactly what happened or exactly what I did, and knowing that could possibly lead to me having more control over situations in the future. Does that feel accurate?

[Juliaho90]

Yes that is accurate. That is exactly what my mind is trying to do… and recalling that thoughts just makes it more and more fuzzy. And the self doubt continues.

I also realise that my mind plays tricks on me, for example if I had a conversion with my doctor and she says there is no risk, I feel ok for a while but then I think back and wonder if I had misunderstood what she meant. Did she mean I had a risk? How would I know if it’s the anxiety speaking and not reality?