Date: Fri, 19 May 1995 12:49:14 +0500
From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com
Subject: CDC Nat. AIDS Hotline Train. Bull. #139


           CENTERS FOR DISEASE CONTROL AND PREVENTION
                       HIV/AIDS PREVENTION
           CDC NATIONAL AIDS HOTLINE TRAINING BULLETIN
.................................................................
May 1, 1995                                                 #139

This is an answer from the Centers for Disease Control and
Prevention (CDC) to a question submitted by the CDC National AIDS
Hotline concerning female to female sexual transmission of HIV.

NAH Question:

Female to female sexual transmission--e.g., how many cases have
been reported and/or documented?

CDC Response:

Demographic and other information is obtained on persons reported
with AIDS for surveillance purposes.  One of the most important
sets of questions on the AIDS case report form concerns possible
HIV risk exposures.  Persons who report cases of AIDS in male and
female adolescents and adults are asked if the patient had sexual
contact with a male or with a female after 1977 and preceding the
patient's diagnosis of HIV infection or AIDS.  Therefore,
information is routinely obtained on AIDS cases among women who
are reported to have had sexual contact with other women.

There have been several reports in the medical literature
indicating possible female-to-female sexual transmission of HIV.
AIDS surveillance data indicate that women with AIDS who are
reported to have had sexual contact only with other women have
also been reported to have injected drugs or to have received
blood transfusions or blood components.   Although these risk
factors do not preclude the possibility that the mode of
transmission of HIV for these women was female-to-female sexual
contact, the absence of cases in lesbian women without other
established risk factors is striking.  We interpret this
observation to mean that these women likely acquired their
infection through injection drug use or receipt of blood
transfusion or blood components.

Studies from HIV serosurveys among women attending sexually
transmitted disease clinics and women's health clinics also
suggest that HIV infection in lesbian and bisexual women is
closely associated with injecting drug use or to sexual contact
with men at increased risk for HIV infection.  These data do not
exclude the possibility of female-to-female sexual transmission
of HIV, but they do indicate that it is rare.  However rare such
transmission may be, women who have sexual contact with other
women need to be aware of the potential for infection with HIV,
including the risk behaviors of their sex partners.  Lesbian
women should know that vaginal and cervical secretions and
menstrual blood are potentially infectious and that mucous
membrane (e.g., oral, vaginal) contact with infected blood or
secretions can lead to HIV transmission.

CDC will continue to examine behavioral and other risk factors
for HIV infection among women.


Reference:  Chu SY, Conti L, Schable BA, Diaz T.  Female-to-
female sexual contact and HIV transmission.  [letter]  JAMA
1994;272:433.