Sexually Transmitted Infections (STIs/STDs) in the Lesbian Community

There appears to be a misconception among the lesbian community and their health care providers that lesbians have little or no risk for sexually transmitted diseases (STD) or what they are now calling Sexually Transmitted Infections (STI). But your sexual orientation does not make you immune to sexually transmitted infections. In fact, in a recent survey of 504 lesbian and bisexual respondents, 26% of women reported having been previously diagnosed with an STI (Reuters Health, 1/26). That's one in four women. The truth is, the risk of STI transmission between lesbians is very real. STI's such as Genital Herpes , Genital Herpes and Bacterial Vaginosis are easily transmitted between women during sex. HIV , Hepatitis B, Gonorrhea , and Chlamydia are less likely to be transmitted, although still possible.

An additional risk that tends to get overlooked is that many lesbians have had sex with men at some point in their lives. And since all STIs are easily transmitted from men to women during sex, the risks are higher then some may realize. Many STIs do not have symptoms, so it is possible that a woman could have been infected years ago and still carry the infection in their body without knowing it.

It is extremely important to share your sexual history with your health care provider who can advise you of the appropriate STI screening tests for you. All women, including lesbian, should be receiving Pap tests on a regular basis.

Safer Sex Safer sex and STI prevention are important practices for anyone who is sexually active. It is essential for partners to discuss their sexual and STI history prior to having sex. Safer sex means learning and practicing behaviors that decrease the chance of contracting or transmitting an STI. The best means for avoiding STIs is a barrier. Latex gloves and condoms can be used for genital and anal stimulation with the fingers or with sex toys (dildos, vibrators, etc.). A dental dam (flat, latex barrier), non microwavable plastic wrap, or a condom cut lengthwise and placed over the vagina is advisable for oral-genital sex. It is advisable to avoid sex when genital herpes or genital warts are active until all lesions have cleared up.


The following STIs can be transmitted during sex between women:

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

Candida vaginitis
Yeast infections cause vaginal itching, burning, and pain. A genital yeast infection generally is not considered to be a sexually transmitted disease, however transmission through sex is very common, especially between women.

Chlamydia
Chlamydia is caused by bacteria that is transmitted to the vagina or rectum by contact with infected genital fluids. Chlamydia can infect the cervix, rectum or urethra (the passage through which urine exits the body) in women.

Genital Herpes
Genital herpes is transmitted when an active herpes lesion or its secretion comes into direct contact with a break in the skin or the moist membranes of the mouth, penis, vagina, urethra, anus, or cervix Genital herpes is highly contagious when sores are present. Patients can re-infect themselves by touching an active herpes sore and scratching or rubbing another area of broken skin on the body.

Genital Warts & HPV
Genital HPV infection is a sexually transmitted Infection that is caused by human papillomavirus (HPV). Human papillomavirus is the name of a group of viruses that includes more than 100 different strains or types and is transmitted through vaginal, oral, and anal sex. More than 30 of these viruses are sexually transmitted, and they can infect the genital area women including the skin of the vulva (area outside the vagina), or anus, and the linings of the vagina, cervix, or rectum. Most people who become infected with HPV will not have any symptoms and will clear the infection on their own.

Gonorrhea
Gonorrhea, also known as "the clap", is caused by bacteria transmitted to the vagina, throat or rectum by exchanging infected genital fluids during sex. It is possible to spread this sexually transmitted infection from one part of the body to another via touch. Symptoms for women may include abnormal bleeding, irritability in outer portions of vagina, vaginal discharge, and burring during urination.

Hepatitis
An inflammation of the liver with various causes, and symptoms including yellow skin and eyes, nausea, loss of appetite, tiredness and stomach pain. Hepatitis is considered a STI because it can be contracted and spread through intercourse, contact with genitals and the anus, semen, vaginal fluids, and saliva. It is over 100 times more infectious than HIV.

There are three main hepatitis viruses. Hepatitis A is found in fecal matter, such as contaminated food and oral-anal contact. Transmission between women has been known.

Hepatitis B is spread by an exchange of blood and other body fluids. This includes touching an open cut if you have broken skin and sharing toothbrushes, nail clippers or razors. It takes very little blood or fluid to transmit, but cannot be contracted through food, drink or casual contact.

Hepatitis C is spread mainly through contact with infected blood, and sexual transmission is relatively rare.

HIV
HIV is the virus that causes AIDS and is found in the blood, breast milk, vaginal fluid or semen of someone with HIV, so you are at risk if you get any of these fluids in your bloodstream.

Although the risk of sexually transmitting HIV between women is low, if one or more of your past partners have slept with men, then you can be at risk.

Syphilis
Syphilis is transmitted through direct contact with a sore. Syphilis is found in areas of the anus, genitals, rectum, vagina, cervix, and mouth. It is sometimes hard to detect because the sores that appear seem to clear up on their own; however it stays in the body damaging internal organs

Trichomoniasis “Trich”
Trichomoniasis is caused by a parasite that can be passed from one person to another during sexual contact. It can also be picked up from contact with damp, moist objects such as towels or wet clothing. Trich is spread through sexual contact with an infected person. Signs include yellow, green, or gray vaginal discharge (often foamy) with a strong odor; discomfort during sex and when urinating; irritation and itching of the genital area; and lower abdominal pain in rare cases. To tell if you have trich, your doctor or nurse will do a pelvic exam and lab test. A pelvic exam can show small red sores, or ulcerations, on the wall of the vagina or on the cervix. Trich is treated with antibiotics.

RESOURCES:

Center for Disease Control
Sexual Health Channel
Lesbian STD website