Women Who Have Sex with Women

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Women Who Have Sex with Women
What is the HIV Risk?

Female-to-female transmission of HIV appears to be a very rare occurrence. However, case reports of HIV in women who have sex with women (wsw) indicate that vaginal secretions and menstrual blood are potentially infectious and that mucous membrane (e.g., oral, vaginal) exposure to these secretions has the potential to transmit HIV.

What Does Surveillance Say About HIV Transmission Between Women?
Through 2004, almost 250,000 women were living with HIV. Of these, approximately 7400 were reported to have had sex with women; however, the vast majority had other risks (such as injection drug use, sex with high-risk men, or receipt of blood or blood products). Of the 534 women who were reported to have had sex only with women, 91 percent also had another risk.

What Does Follow-up Surveillance Show?
Follow-up surveillance was done on women whose only reported risk was sex with women. As of December 2004, none of these studies could definitely confirm the possibility of female-to-female HIV transmission. In those women studied, other risks were usually identified or women declined to participate in follow-up interviews. In fact, a separate study of more than 1 million female blood donors found no HIV-infected women whose only risk was sex with women. These findings suggest that female-to-female transmission of HIV is uncommon. However uncommon, these results do not rule out the possibility of female-to-female HIV transmission.

What Behaviors Place WSW at Risk of HIV Infection?
Surveys have shown that many wsw have increased rates of high-risk behaviors such as:

* injection drug use
* unprotected vaginal sex with gay/bisexual men who are injection drug users.

What Can WSW do to Reduce Their Risk of HIV?
While the occurence is rare, women who have sex with women need to realize that the risk of HIV transmission is there. These women need to know:

* that exposure of a mucous membrane(of the mouth) to vaginal secretions and menstrual blood is potentially infectious
* that condoms should be used properly each and every time during sexual contact with men or when using sex toys.
* sex toys should not be shared.
* women can use dental dams, cut-open condoms, or plastic wrap to help protect themselves from contact with body fluids during oral sex.
* to reduce their risk of becoming infected women should know their own HIV status as well as their partner's
* for women who are HIV positive knowing their status early improves their prognosis and helps prevent infecting others.

To accurately assess a women's HIV risk, health professionals also need to remember:

* that sexual identity does not necessarily predict behavior, and that women who identify as lesbian may be at risk for HIV through unprotected sex with men.
* that prevention interventions targeting wsw must address behaviors (injecting drugs and unprotected sex) that put wsw at risk for HIV infection.

Source: Centers for Disease Control, "HIV/AIDS Among Women Who Have Sex With Women"; 1 Jun 2006.