HIV Transmission Between Women; Unlikely But Not Impossible

HIV under electron microscope

HIV under electron microscope

In this week’s publication of Morbidity and Mortality Weekly Report (MMWR), the CDC announced the first case of female-to-female sexual transmission of HIV where both women had not been having sex with men or using intravenous drugs. The woman with newly acquired HIV was in a monogamous relationship with an HIV-positive woman for 6 months, and declared she hadn’t had intercourse with a man in the 10 years prior to the HIV diagnosis in 2012; the women were confirmed to have “virtually identical” forms of the virus. While sex between women has previously been reported to transmit HIV, it is very unlikely, and therefore, HIV transmission between lesbian couples is rare.  This case however, demonstrates that it is not impossible.

The Human Immunodeficiency Virus (HIV) has existed in the U.S. since the mid- to late 1970s, and while a great deal is understood about it and it’s transition into Acquired Immunodeficiency Syndrome (AIDS), there is still no cure. With that, preventative measures is the only way to truly protect ones self from the deadly virus. HIV is present on blood, semen, vaginal secretion, and breast milk. It cannot be exchanged through skin-to-skin contact, and therefore, certain sexual acts are more risky for transmitting disease than others. In male-to-male sex and male-to-female sex, semen often remains in the anus or vagina for an extended period of time, and with the lining of these areas consisting of mucous, transmission easily occurs. For this reason, it isn’t often that lesbian couples contract the virus between one another.

The lesbian couple reported they had been having unprotected sex during their menstruation periods where blood exchange likely occurred, as well as sharing of insertive sex toys without cleaning them in between uses. The woman newly diagnosed ruled out transmission of the HIV from injection drug use, heterosexual sex, tattooing, acupuncture, piercing, sharing sex toys between persons other than a partner, exposure to body fluids of others, and receipt of transplants or transfusion, all of which are the usual suspects for transmission of HIV. This is the first case of woman-to-woman transmission where all these other known risk factors have been ruled out.

While this is a rare circumstance, this demonstrates the importance of having safe sexual practices and having a mutual understanding with your sexual partner. Using a condom to cover sex toys, for example, would be an appropriate measure for lesbian couples to take. Americans often do a better job of remembering to have protected sex when preventing a pregnancy rather than a sexually transmitted disease or infection. Perhaps this rare occurrence will influence more sexually active individuals that it is better to be safe than sorry.

For more information:

CNN Health—CDC: Rare female-to-female HIV Transmission by Ashley Hayes

CDC MMWR Report, March 14, 2014—Likely Female-to-Female Sexual Transmission of HIV — Texas, 2012

This link provides addition sources with information about lesbian sex and HIV transmission

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