Doctors Report Female-To-Female HIV Transmission

Doctors Report Female-To-Female HIV Transmission

By Alan Mozes

NEW YORK (Reuters Health) - Based on genetic analysis, two US researchers report a case of HIV infection that resulted from sexual contact between two females.

"I think that we touched the tip of an iceberg, in the sense that the general thought is that this doesn't happen at all," said Dr. Helena A. Kwakwa of the Jonathan Lax Treatment Center, an AIDS clinic in Philadelphia. "But I still think that although this is an uncommon event it's something that we should all be aware of."

In the current issue of Clinical Infectious Diseases, Kwakwa and her colleague Dr. M. W. Ghobrial report the recent case of a 20-year-old woman who became infected with HIV.

The patient indicated she had had sexual relations exclusively with an HIV infected woman for the prior two years, and that she had been aware of her partner's infection status.

Sexual relations with her partner involved oral contact and the sharing of sex toys. The patient said that although she and her partner had never had sex during menstruation, on occasion a small amount of bleeding occurred during sex. The infected partner was openly bisexual, and reported using condoms whenever engaging in heterosexual sex.

Kwakwa and Ghobrial ruled out alternative explanations, confirming the patient had never shared razors or toothbrushes with her infected partner. As well, she had no history of injection drug use, had never received blood transfusions, had no known exposure to body fluids, had never engaged in heterosexual sex, had healthy gums and teeth, and had no tattoos or body piercings.

The researchers determined that the HIV genotypes in both women were a close match.

They concluded that the patient may have become infected as a result of sexual contact with her infected partner. The authors suggested that infection probably resulted from the drawing of blood in conjunction with the shared use of sex toys.

Kwakwa and Ghobrial note that there have been several reported cases of female to female transmission, but those cases were not confirmed with genotype testing.

"I think it's a wake-up call, because the other reports to date have really been based on a history of no other known risk factors," Kwakwa told Reuters Health. "So I think this gives a little more support to the existence of female to female transmission of HIV."

She added that women having sex with women could do a number of things to protect themselves from HIV.

"The barrier method of prevention helps," she noted. "Using dental damns, plastic wraps, and avoiding the sharing of sexual toys--at least without washing with soap and water and bleach."

Ronald Johnson, associate executive director of the Gay Men's Health Crisis in New York, also supported safer sex for women having sex with either men or women.

"The risk of transmission from women to women is very rare," he told Reuters Health. "But, as this study shows, it exists, and there certainly needs to be more information and research on women to women transmission. The sad reality is that we still know too little about this...and more information is needed."

SOURCE: Clinical Infectious Diseases 2003;36:e40-e41.