Q86) A patient had a closed fist injury at a bar while trying to punch his friend who he later learnt was HIV positive. The patient tells you that there was only an abrasion on his hand and all he noted on his hand was his friend’s saliva. He is very concerned. What is your next step?
A. Give HIV prophylaxis with HAART
B. Clean and debride the wound and reassure that no need for prophylaxis
C. Call surgical consult
D. Close the wound with sutures
E. Check for HIV antibody
Archer USMLE Step 3 Blog 
B
b
a
According to Fischer, bites from an HIV patient constitute ppx
I think its blood only though
B. Only blood and genital secretions include HIV post-exposure Prophylaxis.
The rest of body secretions: saliva, sweat, urine, tears , DO NOT need Tx.
Exposures that may warrant post-exposure prophylaxis include:
• parenteral or mucous membrane exposure (sexual exposure and splashes to the eye, nose or oral cavity); and
• the following bodily fluids may pose a risk of HIV infection: blood, blood-stained saliva, breast-milk, genital secretions and
cerebrospinal, amniotic, rectal, peritoneal, synovial, pericardial or pleural fluids.c
• Exposures that does not require post-exposure prophylaxis include:
• when the exposed individual is already HIV positive;
• when the source is established to be HIV negative; and
• exposure to bodily fluids that does not pose a significant risk: tears, non-blood-stained saliva, urine and sweat
Feces, nasal secretions, saliva, sputum, sweat, tears, urine and vomit are NOT Considerd potential infectious unless they are visibly bloody — the risk for transmission of HIV infection frm these fluids and materials is LOW —B is OK
how can there be a wound if its a closed injury 😉