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According to the CDC, although HIV diagnoses among women have declined in recent years, more than 7,000 women received an HIV diagnosis in 2016, representing about 18% of all new infections across the United States. African Americana women are disproportionately affected by HIV, compared with women of other races/ethnicities. Of the total number of women living with diagnosed HIV at the end of 2015, 59% (137,998) were African American, 19% (43,086) were Hispanic/Latina, and 17% (38,992) were white.

HIV/AIDS and Women in New York City

According to the New York City Department of Health and Mental Hygiene, in 2017, women comprised about 18% (394 out of 2,157) of all new HIV diagnoses in New York City, and there were more than 33,300 women living with HIV/AIDS in New York City, representing 26.5% of all people living with HIV/AIDS in the city.

Am I at risk for HIV transmission?

Because of biological and societal factors ALL women are at risk for HIV infection. In the U.S., if you are a woman of color (particularly African-American and Hispanic) you have a greater risk for HIV infection.

What are the most common routes of HIV transmission for women?

  • Unprotected sex with men (vaginal and anal)
  • Injection Drug Use (IDU)
  • Pregnancy, labor, delivery, or breast-feeding accounts for 91% of mother to child transmission of HIV in the United States. The best way to prevent mother to child transmission remains early prenatal care and HIV counseling and testing during pregnancy.

I am not sexually active and I don't use drugs. Am I at risk?

For some women, refraining from all sexual activity is the preferred method of HIV and other STD prevention. In these situations, your risk is not biological exposure but social. All women, regardless of sexual activity, are at risk for HIV transmission from sexual violence (rape, incest, and sexual abuse). Once you decide to become sexually active, it will be important to know your partner's status to ensure that you stay negative. 

Abstinence is defined in various ways. For some, abstinence means refraining from some types of sexual activity but not all. For example, some choose to refrain from vaginal penetration but not from oral sex. Some women refrain from vaginal but not anal sex. However, if you plan to engage in any sexual activity, it is important to know the level of risk for HIV transmission for that activity.

Lesbians & HIV

Historical CDC data on woman-to-woman (WTW) transmission of HIV show that it is rare. Of the 109,311 cases of AIDS reported among women through 1998, 2,220 reported having sex with women. However, the majority of these women also reported other high-risk behaviors such as drug use and unprotected sex with high-risk men (gay and bisexual men). Of these cases, 347 women reported having sex only with women.

In February 2003, reported a rare case of female-to-female transmission from the Clinical Infectious Disease Journal. The case refers to HIV transmission in a serodiscordant couple in which one of the females was HIV positive. The HIV-positive partner was also having sex with men, and while she used protection with her male partners, she did not use any barriers with her female partner. The report postulates that HIV transmission could have occurred as a result of blood transferred from sex toys.

Can lesbians get HIV?

YES. Sexual orientation is not the same as sexual behavior. Many women who identify as either heterosexual or lesbian have sex with men for a variety of reasons that run the gamut from pleasure to cultural expectations and taboos to committed relationships (including marriage). A woman's sexual behavior (i.e., the partners she chooses) may not be consistent with her stated sexual orientation.

What are the behaviors that place lesbians at risk?

Primarily, the behaviors that put lesbians at risk are:

  • Unprotected sex (anal and vaginal) with men (gay, bisexual, heterosexual)
  • Injection Drug use
  • Exposure of mucous membranes to vaginal secretions and menstrual blood in woman to woman sex

Can I get HIV from having unprotected sex with only women?

If your partner is HIV positive, HIV will be in her vaginal secretions and menstrual blood. Exposure to these secretions through the mucous membranes (mouth and vagina) could lead to HIV transmission. For this reason, the CDC contends that WTW sexual contact is a possible means of HIV transmission. There is still much we don't know about HIV transmission between women. In part, this is due to the wide range of sexual practices between women. However, there are documented cases of HIV transmission between women whose only risk is unprotected sex with another woman. The decisions you make about HIV and STD risk are best discussed with your partner. If you can't discuss it with your partner or you don't have a regular sexual partner, it is important to educate yourself about levels of risk and take appropriate steps to reduce the potential of HIV transmission.

What can I do to reduce the risk of woman-to-woman HIV transmission?

  • High-risk behaviors include direct contact with menstrual blood and vaginal secretions, unprotected sex with high-risk men, and intravenous drug use
  • Medium-risk behaviors include oral sex, assuming your partner does not have sexually transmitted infections and your partner is not menstruating
  • Lower-risk behaviors include any activity that does not come into direct contact with menstrual blood and vaginal secretions

Resources: United States Centers for Disease Control and Prevention,, Lesbian AIDS Project Safer Sex Brochure

The National Institute of Health (NIH) has a helpful guide about why women are so susceptible to HIV infection, and what they can do to help protect themselves and their partners.




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