How can I deal with my fears of getting HIV?

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Mila_92

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Hi there 🙂
First of all, I'm from Europe but stumbled over this forum and since it has so many members I'd like to ask about your opinion.

since I'm 13 years old, I kind of have a HIV-phobia which has gotten worse now. I'm currently doing an internship at the psychiatric station and some patients are HIV+.

Now everytime I have to take blood I get extremely nervous.
Also yesterday a patient with unknown serostatus was standing right next to me, when he turned towards me and coughed all over me.. like really bad.
and again, I'm very worried. I know the risk is quite low, but it's not zero. I also feel like that I always meet the weirdest patients, and coughing all over me is something I really hate. Will it ever get better?

How can I deal better with my fears?
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Mila_92 said:
Hi there 🙂
First of all, I'm from Europe but stumbled over this forum and since it has so many members I'd like to ask about your opinion.

since I'm 13 years old, I kind of have a HIV-phobia which has gotten worse now. I'm currently doing an internship at the psychiatric station and some patients are HIV+.

Now everytime I have to take blood I get extremely nervous.
Also yesterday a patient with unknown serostatus was standing right next to me, when he turned towards me and coughed all over me.. like really bad.
and again, I'm very worried. I know the risk is quite low, but it's not zero. I also feel like that I always meet the weirdest patients, and coughing all over me is something I really hate. Will it ever get better?

How can I deal better with my fears?
Click to expand...
You can't get HIV from a cough. Unless you have sex or share blood with someone that is HIV+ then you're good so just be cautious when you're drawing their blood so that you don't stick yourself with the needle. If that were to happen, talk to you supervisor right away and they should give you prophylactic antiretroviral medication. Aside from that, I'm not sure about what else you could do to alleviate those fears..
 
Mila_92 said:
Hi there 🙂
...since I'm 13 years old, I kind of have a HIV-phobia which has gotten worse now. I'm currently doing an internship at the psychiatric station and some patients are HIV+.

Now everytime I have to take blood I get extremely nervous.
A
Click to expand...

You draw blood at 13 years old??? from psych Patients??? :thinking::thinking::thinking:


...I'm hoping there's a grammatical error in there and you really meant that you've had an HIV-phobia since you were 13.
 
Last edited:
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There is always PEP for you in case of occupational exposure:

1) Tenofovir-emtricitabine (300/200 mg once daily) plus dolutegravir (50 mg once daily)
or
2) Tenofovir-emtricitabine (300/200 mg once daily) plus raltegravir (400 mg twice daily)
 
This appears to be a legitimate phobia that will eventually interfere with your ability to be a doctor. I suggest you seek out a good counselor who is specialized in anxiety disorders and a psychiatrist to help with the bridging medication.
 
Yes I feel like it's gonna interfere with my plans. I know that PEP exists but I've heard a lot about people not finishing the treatment due to the severe side effects. So I'd rather be safe in the first place.. :-/
 
Mila_92 said:
Yes I feel like it's gonna interfere with my plans. I know that PEP exists but I've heard a lot about people not finishing the treatment due to the severe side effects. So I'd rather be safe in the first place.. :-/
Click to expand...
You can take Truvada for pre-exposure prophylaxis indefinitely as well.
 
This thread is veering fairly close to providing medical advice, which should be avoided. OP, I recommend that you seek the advice of a physician or your supervisor for your concerns. It sounds like you would benefit from learning more about absolute risk and mechanisms of infection. The CDC has a summary for healthcare workers at https://www.cdc.gov/hiv/pdf/workplace/cdc-hiv-healthcareworkers.pdf .
 
Dude the best thing you can do is educate yourself. You cannot get HIV for kissing, coughing, sneezing, hugging or touching anyone. You can't even get HIV from oral sex (okay, well its possible but EXTREMELY unlikely). The only small risk factor you have is from a needle stick, but even then HIV virus does not live for very long outside of a host. It isn't even super likely to transmit if you're sharing needles with someone who is HIV positive (but Hep C is very transmissible).

You need to figure out your phobia so that you don't alienate the people you are working to HELP. Your fears are irrational and also have potential to further stigmatize and marginalize the people you're working with. They're the ones in a tough spot, not you.

edit: sorry if that was a little abrasive but I am really passionate about this one...
 
From the CDC link I posted above:
"Only 58 cases of confirmed occupational transmission of HIV to health care workers have occurred in the United States. The proper use of gloves and goggles, along with safety devices to prevent injuries from sharp medical devices, can help minimize the risk of exposure to HIV in the course of caring for patients with HIV. When workers are exposed, the Centers for Disease Control and Prevention (CDC) recommends immediate treatment with a short course of antiretroviral drugs to prevent infection.
The Numbers
As of December 31, 2013, 58 confirmed occupational transmissions of HIV and 150 possible transmissions had been reported in the United States. Of these, only one confirmed case has been reported since 1999. Underreporting of cases to CDC is possible, however, because case reporting is voluntary. Health care workers who are exposed to a needlestick involving HIV-infected blood at work have a 0.23% risk of becoming infected. In other words, 2.3 of every 1,000 such injuries, if untreated, will result in infection. Risk of exposure due to splashes with body fluids is thought to be near zero even if the fluids are overtly bloody. Fluid splashes to intact skin or mucous membranes are considered to be extremely low risk of HIV transmission, whether or not blood is involved."
 
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To quote Dr. Cox...

"You're a doctor. You might get sick. Get over it."

latest
 
Heh you should go work in one of the South African township ERs.

About 50% of the patients have HIV including many with full blown AIDS. After treating a few gunshots and stabbings you end up covered in HIV blood since they don't have the money for disposable caps and gowns. Just remember to wash your hands between patients. 😉
 
Mila_92 said:
How can I deal better with my fears?
Click to expand...

#1 Ignore the assh0le choir above they all have Zika.

#2 As long as you have gloves , mask and if you must glasses you will be fine.

#3 Prophylaxis goes a long way , especially when you must deal with uncooperative patients.

#4 Your fear is perfectly normal as long as it doesn't prevent you from working - just focus of keeping your stress level under control.

#5 Good luck.
 
The best way for you to get over your phobia is to educate yourself on HIV.

If you read about it, learned the facts and knew the science, you would realize your fears are unfounded. As someone who spent 2 years researching HIV, learned about it in school, and is a certified HIV/HCV tester and counselor - I can safely say that your fears are not based in reality.
 
Thanks for your answers so far. 🙂

I know my fears are irrational, very. But I just can't really get over them. I'm always careful drawing blood.. but situations like the junkie that coughed on me pretty bad are sometimes inevitable I think (?, or does that only happen to me..) I know every statistics about hiv and how unlikely it is to get infected.

After a needlestick I'd probably always get PEP; but would I even be able to receive it if an hiv+ patient coughed on me with blood in his mouth? Probably not. Chance of contracting is 0.1%. Still scary for me.. but I'll try to work on that! I'm for some reason not concerned about hep C or TB..
 
Mila_92 said:
Thanks for your answers so far. 🙂

I know my fears are irrational, very. But I just can't really get over them. I'm always careful drawing blood.. but situations like the junkie that coughed on me pretty bad are sometimes inevitable I think (?, or does that only happen to me..) I know every statistics about hiv and how unlikely it is to get infected.

After a needlestick I'd probably always get PEP; but would I even be able to receive it if an hiv+ patient coughed on me with blood in his mouth? Probably not. Chance of contracting is 0.1%. Still scary for me.. but I'll try to work on that! I'm for some reason not concerned about hep C or TB..
Click to expand...
0.1% is the in range of risk for some of the legitimate exposures. Coughing in your face is probably thousands to millions of times less likely than 0.1%
 
Sounds more like OCD-type worry where he knows his fears are irrational. In this case, "educating" himself about HIV transmission will be of no value. The only thing you can do with irrational worries like this are the very things you are afraid of, and learn to cope with the anxiety of "possible HIV exposure" without reassurance-seeking.

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cbrons said:
Sounds more like OCD-type worry where he knows his fears are irrational. In this case, "educating" himself about HIV transmission will be of no value. The only thing you can do with irrational worries like this are the very things you are afraid of, and learn to cope with the anxiety of "possible HIV exposure" without reassurance-seeking.

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Click to expand...
Doesn't sound like OCD but I agree.
 
Yeah you might be right. It might be a mix of OCD and anxiety. Cause I usually obsess over diseases, but not as much as I do over hiv. I know everything about it, yet I fear situations where there was hardly any exposure. So I guess I should seek some help, it can't become worse.
but before, I'll get tested for hiv, so my mind can rest..
I just don't think I can go to a test every 2 weeks when I'm a doctor and handling blood all the time, I gotta find a way. 🙂
 
I think your fears are very legitimate.
You have to practice being exceptionally thoughtful and responsible with all possible sharps. Never lose attention, never get lazy, never be tired, always be aware. There is nothing in medicine worth getting ill over.
 
There has not been a documented case of HIV transmission with a suture type needle in the history of medicine.

Only a few cases of seroconversion with bore-type needles.

It is literally damn near impossible to contract HIV unless you are sharing drug needles. Not an embellishment.

Say no to drugs.
 
I've had a needle stick. HIV isn't the one to worry about. Hep C is after a needle stick 😛 HIV has a extremely low transmission rate after prophylactic medications. Hep C has no prophylactic medications and has a decent 1-3% transmission rate.
 
cyanide12345678 said:
I've had a needle stick. HIV isn't the one to worry about. Hep C is after a needle stick HIV has a extremely low transmission rate after prophylactic medications. Hep C has no prophylactic medications and has a decent 1-3% transmission rate.
Click to expand...
HCV is curable though, in 8-12 weeks of treatment for most.

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JeanJ said:
HCV is curable though, in 8-12 weeks of treatment for most.

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Click to expand...

There are a few different types of Hep C virus. Type 1 which is 60-70% of all infections is the one that Harvoni and Sovaldi can treat. The rest are still life long. Also, Insurance can be a bit*h about covering for those 100k meds so that's probably a painful experience as well.

HIV might be the worse disease, but you're just far less likely to get it especially with the antivirals. Hep C is scary because it can realistically happen.
 
cyanide12345678 said:
There are a few different types of Hep C virus. Type 1 which is 60-70% of all infections is the one that Harvoni and Sovaldi can treat.
Click to expand...

Type 2 , Type 3 and Type 4 are also treatable with sofosbuvir + velpatasvir + ledipasvir.

Type 5 & 6 are in the works and it's only a matter of time until complete eradication. I believe Merk or Astra Zeneca have some drug in trials.
 
Spectre of Ockham said:
Type 2 , Type 3 and Type 4 are also treatable with sofosbuvir + velpatasvir + ledipasvir.

Type 5 & 6 are in the works and it's only a matter of time until complete eradication. I believe Merk or Astra Zeneca have some drug in trials.
Click to expand...

Exactly, guess my "for most" was missed in my initial post. And I believe a pan-genotypic version will be approved and available this fall.

And private insurers are beginning to cover much more broadly, particularly if no hx of substance use (although arguably that's the community that should be prioritized if elimination is the goal). Public insurers were beginning to come around (and are not paying $100k), but with so much uncertainty on health care policy broadly, this is definitely a barrier.
 
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