The first confirmed case of lesbian transmission of HIV was reported this week by federal health officials, who said the event was rare but nonetheless advised lesbian couples in which one partner is infected to take precautions.
Genetic tests showed that the virus in the two women was more than 98 percent identical, all but proving that one had infected the other, according to the Morbidity and Mortality Weekly Report issued Thursday by the Centers for Disease Control and Prevention (CDC).
In many previous studies of women who thought they might have been infected by other women, either no genetic testing was done or the newly infected women reported other activity that could have been the cause, such as recent sex with men, drug injection or blood transfusions.
The women in the new case, both in their 40s, lived in Houston when the transmission took place in 2012. The infected partner had been on treatment for HIV from early 2009 to late 2010, but had stopped taking the drugs. The women reported having sex during their periods and using sex toys, sometimes so roughly that bleeding occurred.
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The newly infected woman reported no other sex partners for six months before infection; she tested negative on an HIV antibody test when she sold blood plasma in March 2012. Antibody tests can have a “window period,” usually one to three months, during which a newly infected person can test negative because antibodies to the virus have not formed.
Ten days later, the woman went to a hospital emergency room with flulike symptoms that sometimes indicate an early HIV infection. She again was negative on an antibody test and was given antibiotics on the assumption that she had a cold or flu. Eighteen days later, again at a blood-plasma center, she tested positive.
While barrier methods for nonpenile sex, such as dental dams, exist, they are impractical for use with insertive toys and not popular for oral sex. In an editorial, CDC officials advised that all infected people having sex with uninfected ones stay on daily antiretroviral drugs, which can reduce virus levels in blood and bodily fluids so much that transmission is highly unlikely.