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Home Ask the Experts Ask the Experts Transmission among lesbians

Transmission among lesbians

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I’m a lesbian and I’m aware of the very low risk of female-to-female transmission of HIV. My partner is under the impression that we are at risk for herpes, but I figure it’s the same as HIV—unlikely for us. Is this true?

While the Centers for Disease Control and Prevention (CDC) notes that there are no confirmed cases of female-to-female sexual transmission of HIV in the United States database, there are case reports of female-to-female transmission of HIV.1 While this may mean the risk is low, it does not mean you can measure your risk for herpes by it.
For one, the two are transmitted differently. HIV is primarily transmitted through activities involving sexual fluids (pre-semen, semen and vaginal secretions) and blood. These activities include oral, vaginal, and anal sex, sharing needles and mother-to-child transmission. Genital herpes is transmitted from direct skin-to-skin contact between the contagious area and a mucous membrane (such as penis, vagina or anus) or area of abraded (damaged) skin. Activities where genital transmission may occur include oral sex, genital-to-genital contact, rubbing, or penetration.

Unlike HIV, there are confirmed cases of transmission of herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) among lesbians. In 2003, Marrazzo, et al conducted a study to assess HSV prevalence among lesbians.2 Three hundred ninety-two women participated in the study and of those seventy-eight reported no previous sex with men. Among those, 3% were infected with HSV-2. From this study the researchers found nearly 1 in 10 lesbians have HSV-2, and that neither sexual identity nor prior sex with men were predictors of HSV-2 infection. Researchers also found that genital HSV-1 is quite common in this group because of oral-genital contact. It also held true that within this group, most may not know they are infected with HSV.

The only way you can discount your risk for HSV is if you and your partner are not infected and you are mutually monogamous. If you and your partner are unaware of your HSV status, perhaps you both may want to consider testing for the virus—blood tests can detect HSV by type whether you have symptoms or not.

1. Kwakwa HA, Ghobrial MW. Female to Female Transmission of Human Immunodeficiency Virus. Clin Infect Dis. 2003 Feb 1;36(3):e40-1. Epub 2003 Jan 10.
2. Marrazzo JM, Stine K, Wald A. Prevalence and risk factors for infection with herpes simplex virus type-1 and -2 among lesbians.
Sex Transm Dis. 2003 Dec;30(12):890-5.


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