Invisible Bleeding from Clean-Shave Haircuts: Detection with Blood Specific RNA Markers

Abstract

Background: ‘Haircut-associated bleeding' is a newly recognized entity that affects at least a quarter of African men who wear shiny clean-shave (‘chiskop') haircuts. Aim: This pilot study aimed to elucidate whether invisible haircut-associated bleeding was detectable using blood specific RNA markers (16 participants, 5 with unknown HIV status) and whether surface virus could be detected using PCR from scalp swabs (of 11 known HIV-positive participants). Methods: Haircuts were performed professionally and scalps examined by a dermatologist to exclude injury. Serum samples for viral loads were also collected at the same time. Results: In all, 6/16 (37%) samples tested positive (>100 relative fluorescent units) for hemoglobin beta and albumin, confirming evidence of blood; of these, only 1/11 was HIV-positive but had an undetectable serum viral load. No surface HIV was detected from any scalp samples. Conclusions: This study confirms the entity of haircut-associated bleeding but goes further to show for the first time that invisible bleeding from clean-shave haircuts is also common. Both a high serum viral load and evidence of bleeding should ideally be present prior to surface HIV detection. Future investigations for potential HIV (and hepatitis B) transmission through clean-shave haircuts are warranted but should not delay public education for disease prevention.

Blood and virus detection on barber clippers

“…[5,6] Invisible bleeding was recently detected from scalp swabs after professional clean-shave haircuts (with no visible injury on the scalp when examined by a dermatologist) in 37% of participants using genetic testing for bloodspecific RNA markers (albumin and haemoglobin beta (HBB)). [7] The potential transmission of blood-borne viruses such as hepatitis B (HBV) and HIV is most concerning. A study in Ethiopia reported that sharing shaving equipment in barber shops is common practice, [8] and an accidental scratch by sharp equipment in barber shops may create an opportunity for HIV and other blood-borne pathogens to enter the body.…”

The Marketing Mix and Hygienic Barbershop Use: A Formative Study

“…To offset the psychological price of relinquishing amenities of using barbershop services (e.g., practical convenience or/and feeling well-groomed), social marketers should encourage purchasing and taking personal shaving kits to barbers. Research has suggested that the practice of using private shaving kits seems to coincide with lower HIV prevalence (3.6%) in Nigeria, a country that is three times more populous than South Africa but whose HIV prevalence is 17.8% (Arulogun & Adesoro, 2009; Khumalo, Gantsho, Gumedze, Mthebe, 2013; Salami et al, 2006).…”

“…As stipulated by the fundamental assumptions of the IMB model, successful promotion of hygienic hair care is predicated on whether relevant players (i.e., barbershop users, policy makers) are sufficiently motivated. Beliefs underlying the construct of relational motivation suggest that public health risks associated with barbershop use are ambivalently acknowledged as people seem torn between health risks observable in barbershops (see Arulogun & Adesoro, 2009; Khumalo, et al, 2013; Ngoboka, 2015) and the motivation to protect social relationships (Anangwe, 2009; Hornik, 2002; Pillaud et al, 2013). For such situations, Hornik (2002) outlines mechanisms through which exposure (through multiple communication channels) can foster publicity, social support and relevant partnerships (e.g., media and policy makers).…”

“…The aforementioned beliefs underlying the IMB model were then hypothesized to predict close-shave frequency, which is represented by various cutaneous indications of a non-intact skin, such as feeling bruised/cut, stinging or burning (the American Osteopathic College of Dermatology (n.d.); Arulogun & Adesoro, 2009; Howard, 2016; Khumalo, et al, 2013; Ngoboka, 2015). Thus, one can posit that close-shave frequency is a function of informational heuristics regarding disinfection and hygiene in barbershops, relational motivation between barbers and customers as well as negotiation skills.…”

“…Such frequent use may increase risks associated with close-shave practices (American Osteopathic College of Dermatology (n.d.); Arulogun & Adesoro, 2009; Biadgelegn et al, 2012; Howard, 2016; Khumalo, 2012; Khumalo, et al, 2013; Ngoboka, 2015). The close-shave hair styles may cause skin abrasions because they are executed “by pressing the metal of the electric hair clipper directly and firmly onto the scalp without using the manufacturer-supplied clipper combs that determine hair length; the result is similar to that achieved with razor blades” (Khumalo, et al, 2013, p. 197).…”