RIS K FACTORS AND BARRIERS TO PREVENTION

RISK FACTORS AND BARRIERS TO PREVENTION

Surveys of behavioral risk factors have been conducted in groups of women who have sex with women (WSW). These surveys generally have been of WSW samples that differ in criteria for participation, location for recruitment, and definition of WSW. As a result, the findings of these surveys cannot be generalized to all WSW. The findings have, however, suggested that some WSW have other behavioral risk factors, such as injection drug use and unprotected vaginal sex with men who have sex with men (MSM) or men who inject drugs.

PREVENTION

Although there are no confirmed cases of female-to-female transmission of HIV, female sexual contact should be considered a possible means of transmission among WSW. These women need to know

• their own and their partner’s HIV serostatus. This knowledge can help women who are not infected to change their behaviors and thus reduce their risk of becoming infected. For women who are infected, this knowledge can help them get early treatment and avoid infecting others.
• the risk for exposure through a mucous membrane. Potentially, HIV can be transmitted through the exposure of a mucous membrane (in the mouth, for example), especially if the tissue is cut or torn, to vaginal secretions and menstrual blood. The potential for transmission is greater during early and late-stage HIV infection, when the amount of virus in the blood is expected to be highest.
• the potential benefits of using condoms. Condoms should be used consistently and correctly during every sexual contact with men or when using sex toys. Sex toys should not be shared. No barrier methods for use during oral sex have been evaluated as effective by the Food and Drug Administration. However, natural rubber latex sheets, dental dams, condoms that have been cut and spread open, or plastic wrap may offer some protection from contact with body fluids during oral sex and thus may reduce the possibility of HIV transmission.

Health care providers need to remember that sexual identity does not necessarily predict behavior and that some women who identify themselves as WSW or lesbian may be at risk for HIV infection through unprotected sex with men.

RISK FACTORS AND BARRIERS TO PREVENTION

Surveys of behavioral risk factors have been conducted in groups of women who have sex with women (WSW). These surveys generally have been of WSW samples that differ in criteria for participation, location for recruitment, and definition of WSW. As a result, the findings of these surveys cannot be generalized to all WSW. The findings have, however, suggested that some WSW have other behavioral risk factors, such as injection drug use and unprotected vaginal sex with men who have sex with men (MSM) or men who inject drugs.

PREVENTION

Although there are no confirmed cases of female-to-female transmission of HIV, female sexual contact should be considered a possible means of transmission among WSW. These women need to know

• their own and their partner’s HIV serostatus. This knowledge can help women who are not infected to change their behaviors and thus reduce their risk of becoming infected. For women who are infected, this knowledge can help them get early treatment and avoid infecting others.
• the risk for exposure through a mucous membrane. Potentially, HIV can be transmitted through the exposure of a mucous membrane (in the mouth, for example), especially if the tissue is cut or torn, to vaginal secretions and menstrual blood. The potential for transmission is greater during early and late-stage HIV infection, when the amount of virus in the blood is expected to be highest.
• the potential benefits of using condoms. Condoms should be used consistently and correctly during every sexual contact with men or when using sex toys. Sex toys should not be shared. No barrier methods for use during oral sex have been evaluated as effective by the Food and Drug Administration. However, natural rubber latex sheets, dental dams, condoms that have been cut and spread open, or plastic wrap may offer some protection from contact with body fluids during oral sex and thus may reduce the possibility of HIV transmission.

Health care providers need to remember that sexual identity does not necessarily predict behavior and that some women who identify themselves as WSW or lesbian may be at risk for HIV infection through unprotected sex with men.