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.

1.
Khumalo NP, Jessop S, Gumedze F, Ehrlich R: Hairdressing and the prevalence of scalp disease in African adults. Br J Dermatol 2007;157:981-988.
2.
Khumalo NP, Gumedze F, Lehloenya R: Folliculitis keloidalis nuchae is associated with the risk for bleeding from haircuts. Int J Dermatol 2011;50:1212-1216.
3.
Khumalo NP, Gantsho N, Gumedze F, Mthebe T: Health risks of the clean-shave chiskop haircut. S Afr Med J 2013;103:489-490.
4.
van Bueren J, Simpson RA, Jacobs P, Cookson BD: Survival of human immunodeficiency virus in suspension and dried onto surfaces. J Clin Microbiol 1994;32:571-574.
5.
Terpstra FG, van den Blink AE, Bos LM, Boots AG, Brinkhuis FH, Gijsen E, van Remmerden Y, Schuitemaker H, van 't Wout AB: Resistance of surface-dried virus to common disinfection procedures. J Hosp Infect 2007;66:332-338.
6.
Arulogun OS, Adesoro MO: Potential risk of HIV transmission in barbering practice among professional barbers in Ibadan, Nigeria. Afr Health Sci 2009;9:19-25.
7.
Khaliq AA, Smego RA: Barber shaving and blood-borne disease transmission in developing countries. S Afr Med J 2005;95:94, 96.
8.
Amodio E, Di Benedetto MA, Gennaro L, Maida CM, Romano N: Knowledge, attitudes and risk of HIV, HBV and HCV infections in hairdressers of Palermo city (South Italy). Eur J Public Health 2010;20:433-437.
9.
Haas C, Hanson E, Bar W, Banemann R, Bento AM, Berti A, et al: mRNA profiling for the identification of blood - results of a collaborative EDNAP exercise. Forensic Sci Int Genet 2011;5:21-26.
10.
Engelbrecht S, van Rensburg EJ: Detection of southern African human immunodeficiency virus type 1 subtypes by polymerase chain reaction: evaluation of different primer pairs and conditions. J Virol Methods 1995;55:391-400.
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