Can women give other women STDs? Yes.

There is a misconception among health care providers and women themselves that lesbian and bisexual women have little or no risk for sexually transmitted diseases (STD). This myth is fueled by the lack of reliable studies of STD transmission in these communities.

In fact, the risk of STD transmission between women varies significantly depending on the STD. Herpes, HPV (genital wart virus), and bacterial vaginosis are transmitted fairly easily between women during sex. HIV, hepatitis B, gonorrhea, and chlamydia are much less likely to be transmitted--the risk is low but it is still possible.

The majority of lesbian and bisexual women have (or have had) sex with men, and all STDs are easily transmitted from men to women during intercourse. Often STD do not have symptoms, so it is possible for a woman to have become infected years ago and to still harbor the infection.

It is important that you share your particular sexual history with a GLBT-friendly health care provider who can advise you of the appropriate STD screening tests for you. All women, including lesbian and bisexual women, need to receive regular Pap tests.

HIV

Often people worry more about HIV (the virus that causes AIDS) than about any other STD. HIV is transmitted when infected sexual fluids or blood enter another person's bloodstream.

There are little research specifically concerning woman-to-woman transmission of HIV. It has been documented in several studies that women who have had sex only with other women, and have not used intravenous drugs, are at low risk for HIV. Although there are case reports of woman-to-woman transmission through oral sex or shared sex toys, this is an uncommon transmission route. The risk of exposure to HIV in menstrual blood is not known, but could provide another means of transmission between women.

Women who have had sexual contact with men, which includes the majority of women who identify as lesbian, have a higher risk for HIV. Women who have had unprotected sex with gay or bisexual men, or men who have injected drugs, are at an especially high risk.

Herpes and HPV

Genital herpes and the human papillomavirus (HPV) are more likely to be transmitted between women than HIV is because they can be transmitted by skin-to-skin, genital-to-genital, or mouth-to-genital contact.

In addition, because these viruses are not curable and stay in the body, a woman could acquire herpes or HPV from a male partner and later pass it on to a female partner. Case studies and recent research support this possibility. As HPV can lead to cervical cancer, lesbians and bisexual women need Pap tests on a regular basis, just as heterosexual women do.

Bacterial STDs

While chlamydia, gonorrhea and syphilis are less likely to be transmitted between women, it does happen rarely. One study found that four of 241 lesbians had one of these infections. An April 2000 article in the Journal of Obstetrics and Gynecology reports of two lesbians diagnosed with pelvic inflammatory disease (PID) which is usually caused by untreated chlamydia or gonorrhea. These studies show that lesbians are at a low, but not nonexistant risk for bacterial STDs, reinforcing the need for providers to obtain full and complete sexual histories.

Bacterial Vaginosis

Researchers are especially interested in bacterial vaginosis (BV) in women who have sex with women both because it occurs frequently among lesbians and because the cause and transmission of BV is not clearly understood. In one study over half of the lesbians had BV and BV was diagnosed even in the absence of sexual activity with a man in the previous year. Additionally, there was a high likelihood that if one partner in a monogamous couple had BV her partner would as well.

It is important for both providers and lesbian and bisexual women to remember that orientation and identity are not enough to assess risk of STDs. A woman's history--particularly her sexual activity with men--and her sexual behaviors are more reliable and comprehensive indicators of risk.

Cervical Cancer

Click here to visit the GLBT Cervical Cancer webpage

RESOURCES:

• Lesbian STD website
  Provides information and resources regarding STDs in women who have sex with women and research advancing the knowledge of lesbian health. The site is created by researchers at the University of Washington, and includes an overview of STDs and their transmission between women, a question & answer forum where you get your questions answered, a listing of lesbian health research studies currently enrolling and research data from our current studies.
  
  
• Public Health - Seattle & King County HIV/STD Program