Why should lesbians think about HIV?
Generally, lesbians are at low risk of HIV infection, unplanned pregnancy and becoming infected with STDs. However, even though sex between women has a reduced likelihood of transmitting HIV, transmission can still occur. Sex between women is not always safe, and therefore women need to know the risks and how to protect themselves.
HIV and AIDS
Lesbian or bisexual women are not at high risk of becoming infected with HIV through woman-to-woman sex.
However, like many women:
- Some lesbians have unsafe sex with men
- Some lesbians inject drugs and share needles
- Some lesbian sexual practices are risky (see underneath for more details)
- Lesbians wanting to get pregnant face decisions about semen donors
What is ‘safe sex’?
‘Safe sex’ is any activity through which you are at no risk of becoming infected with HIV or a sexually transmitted infection (STI). HIV is found in the blood and the sexual fluids of an infected person, and in the breast-milk of an infected woman. HIV transmission occurs when sufficient of these fluids get inside the body of an uninfected person. Sexual transmission of HIV is most common between men, and between men and women, but it does also happen between women – something that’s often ignored in sexual health information.
So safe sex is sex that doesn’t allow any infected body fluid to enter your body – and doesn’t allow you to infect your partner, either. Activities that are safe include hugging, touch, massage, masturbation. Sex toys, whatever, are fine, too – just put a condom over them, and if you switch them from one person’s body to another’s then change the condom.
What are the risks?
- HIV - the virus that causes AIDS - is in the blood, breast milk, vaginal fluid or semen of someone with HIV, so you are at risk if you get any of these fluids in your bloodstream.
- The risks of sexually transmitting HIV between women are very low. Very few women are known to have passed HIV on to other women sexually.
- The risk of HIV being passed on through oral sex is low - but there is increased risk if a woman has cuts or sores in her mouth, or if her partner receiving oral sex has sores on her genitals or is having her period.
- Oral sex is safer if you use a 'dental dam' (a square of latex or cling film) to stop any vaginal fluid or menstrual blood getting into your mouth. A condom cut open and spread flat can also be used for this.
- Sharing sex toys (for example vibrators) can be risky if they have vaginal fluids (juice), blood or faeces on them. Always clean them well and have one each. This is one area of sex where sharing is a bad idea!
- Any sexual activity that can lead to bleeding or cuts/breaks in the lining of vagina or anus is risky, including 'fisting' or certain S&M activities.
- If you are thinking of donor insemination to get pregnant, be sure you are aware of your possible donor's detailed medical history and any possible risk factors - including drug use and sexual history. If you want to be sure, you may want to suggest your donor takes an HIV test before you go ahead.
Other Sexually transmitted Infections (STIs or STDs)
Although we have seen that lesbian and bisexual women are at low risk of getting HIV from sex with another woman, many other sexually transmitted infections - such as herpes or thrush - are just as common for lesbians as for women who have sex with men.
- Thrush is an overgrowth of yeast causing vaginal itching and soreness, often with a white discharge. It is possibly passed via sex between women, though oral sex is low risk.
- Bacterial Vaginosis/BV or Gardnerella is an overgrowth of vaginal bacteria causing a smelly discharge, which lesbians often experience. There is a possible link with perfumed soaps and bath oils.
- Genital Warts are painless bumps on the vulva, in the vagina, on the cervix or round the anus. They can be passed through contact with the wart, for example by touching, rubbing or sharing sex toys. It is unlikely non-genital warts, such as on hands, can be transferred to the genitals.
- Trichomonas vaginalis (TV) gives a frothy, itchy vaginal discharge and is passed on by contact with the vagina only, for example by touching or sharing sex toys.
- Herpes can cause painful sores on the inside of the vulva/vagina or anus (these are genital herpes) or on the mouth (cold sores). Herpes can be passed on through contact with a sore, for example by touching, fondling or sharing sex toys. Oral sex when a cold sore is present can also transmit the virus. It can be possible to have the herpes virus, be infectious and yet never have had any symptoms.
- Crabs/Pubic Lice cling to pubic and other body hair causing itching and sometimes blood spots from bites. They are spread through naked body/skin contact.
- Chlamydia and Gonorrhea are rare in lesbians but if they are present may be passed on through sharing sex toys or rubbing vulvas together. Often there are no symptoms, though there may be a discharge. The first sign of both infections may be pain in the pelvic region (pelvic inflammatory disease or PID). There is a risk of infertility for women who have had untreated chlamydia.
- Syphilis is very infectious and close skin contact during sex can pass it on.
- Hepatitis B is a viral infection that in its most infectious forms can easily be passed on in sex - for example by touching or sharing sex toys. There are often no symptoms, though it can cause jaundice (yellow skin) or nausea.
Treatment is available for all the sexually transmitted infections mentioned above, often with antibiotics, and most can be cleared up quite rapidly. It is vital you seek help as soon as you notice any symptoms and that you do not have sexual contact that could pass on any infection until it has been dealt with.
Smears
Looking after yourself also means having regular cervical smears, even if you have never had sex with a man, or not for years. The reason for this is because sex between women can transmit HPV, the virus associated with cervical cancer. These tests can detect pre-cancerous cells and early treatment can mean cancer never develops. Your doctor can help with this.
