Published August, 2014

Likely Female-to-Female Sexual Transmission of HIV – Texas, 2012, Shirley K. Chan et al., Morbidity and Mortality Weekly Report (MMWR), Centers for Disease Control and Prevention (CDC) (2014)

This report describes a case of HIV transmission likely by sexual contact between female partners. It describes the likely female-to-female transmission of HIV in a lesbian couple who had unprotected sex during a six-month monogamous relationship.

In August 2012, the Houston Department of Health contacted the Centers for Disease Control and Prevention (CDC) regarding the rare transmission of HIV likely by sexual contact between two women. The case was investigated, and laboratory testing confirmed that the woman with newly diagnosed HIV infection had a virus virtually identical to that of her female partner, who was diagnosed previously with HIV and who had stopped receiving antiretroviral treatment in 2010.

Past confirmation of HIV transmission during female-to-female sexual contact has been difficult because other risk factors almost always are present or cannot be ruled out. In this case, other risk factors for HIV transmission were not reported by the newly infected woman, and the viruses infecting the two women were virtually identical. Although rare, female-to-female HIV transmission can occur through unprotected exposure to vaginal and other bodily fluids and to blood from menstruation, or to exposure to blood from trauma during rough sex. The couple described here stated that their sexual contact was at time rough to the point of inducing bleeding in one or both women.

All persons at risk for HIV, including all discordant couples, should receive information regarding the prevention of HIV and sexually transmitted infections to prevent the HIV-negative partner from acquiring the infection. Furthermore, all persons identified as infected with HIV should be linked to and retained in medical care. Control of HIV infection with suppression of viral load can result in better health outcomes and a reduced chance of transmitting HIV to partners.