Sunday morning brunch: coffee but HOLD the cream

I’m on call this weekend, which means my answering services calls me all day and all night from patients wanting treatment for one thing or another. Their complaints range from, “I have a cold” to “Hey doc there’s this wart on my foot that’s been bothering me for two months.”

“And you waited until 7:00pm on a Saturday night to call me?”

Being a Chelsea doctor is slightly different. Calls run the gambit from, “Can I get a refill on my Viagra?” to “It says on my medication bottle to take with food. Does a coffee and a cigarette constitute as a meal?”

This morning I woke up to a text message that said, “Out last night and had sex with a guy who is HIV positive. We didn’t do anal, but I got cum in my eye. Don’t be mad.”

I call him immediately because I know how scary it is for patients to think they have been exposed to HIV.

“What happened?” I asked.

“I was performing oral sex and cum got in my eye.”

“Did it burn? Because that is one way to know if the fluid actually came into contact with your conjuctiva.”

“Yes.”

Just as an aside, I know many of you think it’s hot to look up longingly at your partner (alla Jenna Jamison); but if you want my advice, keep your eyes shut!!

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So for the record, here are some facts:

HIV is transmitted through bodily fluid like, semen and blood.

Even some sexually transmitted diseases can affect your eye like Chlamydia which causes Trachoma.

The risk of getting HIV is highest through unprotected recipient anal sex. That means you are the bottom.

There are reported cases of men contracting HIV as the top or insertive partner and through performing oral sex, especially if you swallow.

If you have open sores – herpes or cold sores – they can act as portals to allow entry for HIV.

In a case where someone, who is HIV positive, gets his ejaculatory fluid in your eye, wash your eye ASAP, do not rub them, and contact your doctor or go to the emergency room immediately.
Getting semen in the eye certainly poses a risk for transmission. Blood getting into the eyes can also be risky, which is why healthcare workers (like dentists) wear eye goggles when performing procedures that have a likelihood of this happening.

The linings of the eyes are made of mucous membranes. HIV can easily pass through mucous membranes. When something gets into the eye, the first thing that people naturally do is rub their eyes. This can easily cause microscopic cuts and abrasions in the mucous membranes lining the eyes. Since semen contains high concentrations of HIV, and since there is a distinct possibility of HIV getting into the bloodstream through the eyes (especially if you rub them), it would not be surprising for HIV to be transmitted in this way. Transmission of HIV is possible but is considered low risk in this scenario.

Post-Exposure Prophylaxis or PEP is taking antiretroviral drugs – the same drugs we use to treat HIV – for a period of 28 days after exposure. PEP should be instituted as soon as possible, preferably within 36 hours. Taking PEP has been shown to substantially reduce the risk of acquiring HIV.

If you think you have been exposed to HIV, go to the emergency room or call your doctor immediately (even if it is Sunday morning.)

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One Comment

  1. Larry Flick
    Posted November 23, 2008 at 8:59 pm | Permalink

    Gee, we gay-lads really DO have our own unique problems, don’t we? You have many lucky patients (like me) who don’t always realize how hard you work for all of us.

    If I had your job, I think I’d be in danger of setting all of Chelsea on fire every other day. 🙂


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