In March, the Centers for Disease Control and Prevention reported the first confirmed case of HIV transmission between lesbians. While federal health officials have indicated that the case is rare, lesbian couples are advised to take precautions, particularly if one partner is HIV-positive. The case in the CDC’s Morbidity and Mortality Weekly Report offers the strongest evidence yet that HIV can be transmitted sexually between women.
The two women in the case are both in their 40s and were living together in Houston in 2012, when the transmission occurred. Although the infecting partner had previously undergone HIV drug therapy, she’d stopped taking her meds. For about two years, beginning in 2010, she went untreated for HIV. During that time, she engaged in unprotected sex with her female partner. The two were physically intimate during menstruation and shared penetrative sex toys, sometimes using them roughly enough to cause bleeding.
The newly infected partner reported no other sexual contacts for six months prior to infection. She tested negative on an HIV antibody test in March 2012. But antibody tests can have a “window period,” usually one to three months, during which a recently infected person can test negative because HIV antibodies have not yet formed. Ten days later, she went to a hospital emergency room with flulike symptoms that can indicate early HIV infection. Again, she tested negative for HIV antibodies and got sent home with flu medication. Two weeks later, at a blood plasma center, she tested HIV-positive. Genetic testing demonstrated that the virus in both women was virtually identical. This result essentially proves that one partner infected the other, according to the CDC report.
In the thirty years since HIV’s discovery, women who partner exclusively with women have been (unofficially) considered the lowest risk group among sexually active adults. Still, lesbians do get HIV/AIDS. Supermodel Gia Carangi, who died in 1986, is the best-known example. But like Gia, HIV-positive lesbians are usually found to have been exposed through intravenous drug use or unprotected sex with men—not women. In previous studies of suspected woman-to-woman HIV transmission, either genetic testing wasn’t performed, or the newly infected woman reported other means of exposure. It’s possible that there were missed cases of lesbian transmission all along. Something to think about.
So what can we do about our HIV risk? Protection for penetrative sex (condoms, latex gloves, finger cots) and non-penetrative sex (dental dams, plastic wrap) are easy to obtain and use. And if a lesbian is HIV-positive, she should regularly take antiretroviral drugs, which can reduce virus levels in blood and bodily fluids so much that transmission is highly unlikely.