Rare Case of HIV Transmission between Lesbians

Sharing of sex toys may be the cause

An extremely rare case of female-to-female sexual transmission of HIV has been reported in the U.S. The report concerns a 46-year-old woman who appears to have acquired HIV during a six-month monogamous serodiscordant sexual relationship with a 43-year-old woman. The case is reported in the March 14 edition of the Center for Disease Control & Prevention’s (CDC) Morbidity and Mortality Weekly Report.

The patient’s female partner was diagnosed with HIV in 2008. The partner started antiretroviral therapy in February 2009 but stopped in November 2010, dropping out of HIV care in January 2011.

The newly diagnosed woman had no other recent risk factors for HIV. Nor were any identified in her past. That her current female sexual partner was the likely source of her HIV infection was confirmed by a technique called phylogenetic analysis, which showed that the genetic sequences of the viruses infecting the two women were highly related.

The latest case was reported to the CDC in August 2012. The woman who acquired HIV regularly sold plasma to supplement her income and had a negative HIV antibody screen when donating plasma in March 2012. However, 18 days later, an attempt by the patient to donate plasma was refused because HIV antibodies were detected. She also reported experiencing symptoms of serconversion—fever, vomiting, other flu-like symptoms. Repeat testing confirmed the woman had HIV.

Confirmed cases of female-to-female transmission of HIV via sexual contact are extremely rare. However, possible modes of female-to-female transmission during sex include exposure to vaginal or other body fluids, blood from menstruation, or blood from damage sustained during rougher sex. Another rare case a decade ago was reportedly attributed to sharing of sex toys.

The couple reported routinely having unprotected (using no barrier precautions) oral and vaginal contact and using insertive sex toys that were shared between them but were not shared with any other persons. They described their sexual contact as at times rough to the point of inducing bleeding in either woman. They also reported having unprotected sexual contact during the menses of either partner.

“This report describes likely female-to-female transmission of HIV-1 supported by phylogenetic analysis in a WSW [women who have sex with women] couple who had unprotected sex during a six-month monogamous relationship,” conclude the authors. “Although rare, HIV transmission between WSW can occur. All persons at risk of HIV, including all discordant couples, should receive information regarding the prevention of HIV.”

The newly infected woman’s partner had a viral load of 69,000 copies/ml, a level that is known to be infectious. The authors therefore believe the case underscores the importance of retaining patients with diagnosed infection in long-term care, as “control of HIV infection with suppression of viral load can result in better health outcomes and a reduced chance of transmitting HIV to partners.”


April 10 Is National Youth HIV/AIDS Awareness Day

National Youth HIV & AIDS Awareness Day is an annual observance that takes place on April 10 to educate the public about the impact of HIV and AIDS on young people and to highlight the work young people are doing across the country to respond to the epidemic.

Advocates for Youth is the lead for planning the observance day.

In 2014, the theme is “Engaging Youth Voices in the HIV & AIDS Response.”
Here are some ways to get involved:

Blog about HIV among young adults. Or comment on an AIDS.gov blog post or on other blogs.

Read and share the new media declaration.

Help promote National Youth HIV and AIDS Awareness Day. Post the logo: