Lesbian Sexual Practices - Health Risks

Health Risks

These safer sex recommendations
are generally agreed upon by
public health officials for
women who have sex with women
to avoid sexually transmitted infections (STIs/STDs):

• Avoid contact with a partner’s menstrual blood and with any visible genital lesions.
• Cover sex toys that penetrate more than one person’s vagina or anus with a new condom for each person; consider using different toys for each person.
• Use a barrier (e.g., latex sheet, dental dam, cut-open condom, plastic wrap) during oral sex.
• Use latex or vinyl gloves and lubricant for any manual sex that might cause bleeding.

Like most sexual activity, lesbian sexual activities can carry risks of sexually transmitted infections (STIs/STDs), such as HIV or other pathogenic diseases. When lesbian sexual activity is of a non-penetrative nature, the risk of exchange of bodily fluids is generally lower than for heterosexual sexual intercourse, and the incidence of transmission of such diseases is relatively low, though not eliminated. The use of the same sex toys by more than one person increases the risk of transmitting such diseases.

The Centers for Disease Control (CDC) reported there is little data available regarding the risk of spreading sexually transmitted diseases between women. However, the CDC notes that pathogens such as metronidazole-resistant trichomoniasis, genotype-concordant HIV, human papilloma virus (HPV, which has been linked to nearly all cases of cervical cancer) and syphilis can be spread through sexual contact between women. While the rates of these pathologies is unknown, one study showed 30% of lesbians and bisexual women had medical histories with sexually transmitted diseases. This does not mean sexually active lesbians are exposed to higher health risks than the general population. Health Canada noted "the prevalence of all types of HPV (cancer and non-cancer-causing) in different groups of Canadian women ranges from 20%–33%" and an American university study found 60% of sexually active females were infected with HPV at some time within a three-year period.

The CDC did not recognize female-to-female transmission as a possible method of HIV infection until 1995. It is possible, though less likely, for transmission to occur in female-to-female sexual activity. Although the risk is not as high as for male-to-male and male-to-female transmission, the risk is still present. HIV can be spread through body fluids, such as blood (including menstrual blood), vaginal fluid and breast milk. Transmission can also take place through oral sex if a woman has cuts or sores in her mouth, or poor oral hygiene, especially if her partner is menstruating. HIV can also be spread through the sharing of penetrative sex toys if their use results in broken skin within the vagina or anus.

There "is no good evidence" that using a dental dam reduces STI transmission risks; studies show that using a dental dam as a protection barrier is rarely practiced, and that, among WSW, this may be because the individuals have "limited knowledge about the possibilities of STI transmission or less vulnerable to STIs ".

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