Can Lesbians Get HIV or AIDS?
Are Lesbians at Risk of HIV?ByKathy Belge About.com Guide
I
often hear, are lesbians really at risk for HIV and AIDS? What is the
likelihood of transmission of the HIV virus from one female to another?
Do lesbians really need to worry about safer sex?
Let's
start with the basics. Anyone who is sexually active is at risk for
HIV. Yes, female-to-female transmission of HIV is possible and it has
happened. Unfortunately, to date there have not been many studies that
have examined lesbian sexual acts and the transmission of HIV.
First: Who are Lesbians?
What
makes a lesbian? Lesbians are women who have sex with other women. But
does that mean they do not have sex with men? Remember, women can
identify as lesbian and still have sex with men, use drugs, have sex for
money, be victims of rape or abuse or have
, all of which can put them at risk for HIV.
What is the Risk of HIV for Lesbians?
According
to the Centers for Disease Control, documented cases of
female-to-female transmission of HIV appears to be a rare occurrence.
The CDC reports there are case reports of female-to-female transmission
of HIV, but it does not specify how many. From the CDC web site: "The
well documented risk of female-to-male transmission of HIV shows that
vaginal secretions and menstrual blood may contain the virus and that
mucous membrane (e.g., oral, vaginal) exposure to these secretions has
the potential to lead to HIV infection."
Why are the Reported Cases of Lesbians with HIV rare?
To
understand why there have been so few cases of female-female HIV
reported, you must understand how the CDC documents transmission. If a
woman has sex with another woman and has other risk factors, such as
drug use, the CDC would traditionally classify the transmission under
one of those factors or as “undetermined.” Under the CDC guidelines,
heterosexual sex is not ruled out as a risk factor unless a woman hasn’t
had sex with a man since 1978.
Sexism is a Factor
It
took more than 10 years for the CDC to expand it’s definition of AIDS
to include opportunistic infections that affected females. A saying from
the late 1980s was, “Women don’t get AIDS, they just die from it.”
From the CDC’s website: Through
December 1998, 109,311 women were reported with AIDS. Of these, 2,220
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 347 (out of 2,220) women who
were reported to have had sex only with women, 98% also had another
risk-- injection drug use in most cases.
Note: information on
whether a woman had sex with women is missing in half of the 109,311
case reports, possibly because the physician did not elicit the
information or the woman did not volunteer it.
Documented Cases of Transmission
According
to Selfhelp Magazine, the first suspected case of transmission from one
woman to another was in 1984. Other cases soon followed in 1986, 1987
and 1993.
In 2003 a
20-year-old African American lesbian from Philadelphia contracted HIV
from her female partner. Most likely she was infected from the use of
sex toys, "used vigorously enough to cause exchange of blood-tinged body
fluids," according to the journal Clinical Infectious Diseases.
This young woman had no other risk factors: she did not use intravenous
drugs, had never had sex with a man, never had a blood transfusion, had
no tattoos or piercings and only had sex with her partner for the
previous two years.
Lesbians with HIV/AIDS
In
1992 the Lesbian AIDS project was started in New York City. It started
with a caseload of 30 women and by the end of two years had jumped to
400 HIV positive lesbians. Currently the Lesbian AIDS project serves
more than 1,000 HIV positive lesbians.
These
are the known cases of lesbians with HIV or AIDS. Other studies have
shown that there is reason to believe lesbians may be at a higher risk
than the CDC is willing to admit.
Injection Drug Use
According
to the Center for AIDS Prevention Studies at University of California,
San Francisco, among injection drug users, women who have sex with other
women have higher HIV rates than do women who have sex with men only. A
study of female injection drug users in 14 US cities found that,
compared to heterosexual women, women who had a female sex partner were
more likely to share syringes, to exchange sex for drugs or money, to be
homeless and to seroconvert.
Lesbians and Bisexual Women who have Sex with Men
Women
who identify as lesbian or bisexual and have sex with men may be at
higher risk for HIV than heterosexual women. Lesbians and bisexual women
may have sex with gay or bisexual men and not use condoms.
A
1996 study published in the American Journal of Public Health found
that 81% of lesbians and bisexual women in San Francisco reported sex
with men in the past three years. Of those women, 39% reported unprotected vaginal sex. 11% reported unprotected anal sex. A study of lesbian and bisexual women in 16 small cities in the US found that 39% reported sex with gay/bisexual men. 20% reported sex with an intravenous drug user.
What is Lesbian Sex?
Lesbians have different sexual practices, which have different levels
of risk for HIV. Oral sex is thought to pose a relatively low risk. Acts
such as sharing sex toys, hand play with long fingernails or cuts pose
higher risk.
Lesbian Youth and AIDS
Young lesbians and bisexual women just coming out often experiment
sexually with their gay male friends. Societal pressure and negative
attitudes about homosexuality may increase young lesbians risk for
contracting HIV. A study in San Francisco found that young lesbians
engaged in high rates of alcohol and drug use, unprotected sex with men
and sexual experimentation with young gay men as a way of coping with
homophobia and societal pressures.
What does it all mean? Just
because there have not been adequate studies of lesbians and AIDS does
not mean that lesbians are not at risk or HIV and AIDS. The fact is,
homophobia and lesbian invisibility exist. Lesbians who have HIV may not
be honest with their health care providers for fear of discrimination.
My guess is, there are more lesbians with AIDS than we know about.
Wouldn’t your rather be safe than sorry?
