Dear Reader,

You're not alone, it's a common misperception that sex between women is without risk. While women who sleep exclusively with women are typically at lower risk for sexually transmitted infections (STIs), including HIV, than their heterosexual and bisexual counterparts, some infections are still common. Because women who sleep with women are at risk for having infections such as HPV, genital herpes, hepatitis, and vaginitis, thinking about safer sex is still a good idea. Here is a summary of information available at the University of Washington's LesbianSTD.com site:  

Infection	Woman to woman transmission possible?	Possible Transmission Route(s)	Prevention
Vaginitis: Bacterial vaginosis (BV), yeast infections, trichomoniasis. Not necessarily considered "STIs," but transmissible infections nonetheless.	Possible, not well documented, studies are underway	Sharing sex toys, genital to genital or mouth contact	Avoid sex if you or your partner has symptoms of vaginitis (itchyness, redness, bad smelling discharge) until after treatment, and/or, Use a barrier on shared sex toys and during oral sex
Genital herpes	Yes	Skin to skin contact, whether through genital to genital contact or oral sex	Steer clear of contact with active cold sores on the mouth or lesions on/near the vulva
HPV (Genital warts)	Yes	Skin to skin contact, possibly sharing sex toys	Avoid touching visible genital warts, and/or, Use a barrier for oral sex and on shared sex toys
Hepatitis (A,B,C)	Hep A – yes Hep B – rarely Hep C – unlikely, not studied	Hep A is transmitted through unprotected oral-anal contact (a.k.a. anilingus or rimming)	Use a barrier for oral-anal contact, and/or, Wash anal area well beforehand with soap
HIV	Rarely, but has been documented	Via oral sex, particularly if the receiving partner has her period and/or the giver has cuts on/inside her mouth	Use a barrier for oral sex, especially if the receiving partner has her period
Chlamydia, Gonorrhea, Syphilis, PID (pelvic inflammatory disease)	Theoretically possible, not yet documented or well studied	More research needed	More research needed

As you can see there are different ways for infections to travel between women. As with heterosexual and bisexual couples, if you and your partner are monogamous and have both been tested, these STIs may be less of a concern for you. However, when you don't know your partner's status, or aren't in a monogamous relationship, there are a few generally applicable safer sex strategies:

• Keep sensitive mucous membranes (vagina, anus, mouth) away from your partner's fluids (particularly vaginal discharge and blood) by using barriers like condoms or dams.
• Don't touch sores like herpes or genital warts.
• Clean sex toys before sharing, or use a new condom on toys for each partner.
• Visit a health care provider if you notice any symptoms or think you have been exposed to get diagnosis and treatment.

Safer sex between two women involves many of the same strategies as for any set of partners, and the ideas below can be part of sex without ruining the mood. The causes of most concern are bodily fluids, including menstrual blood, vaginal juices, breast milk, and secretions from STI sores. If you determine it's time for safer sex, here are some how-tos:

• During oral sex, cover the entire vaginal or anal area with a dam (a square of latex), non-microwaveable plastic wrap, or a cut-open condom or latex glove. Use creative means of keeping the latex or wrap in place, such as a garter belt, to leave your hands free to roam. During vulva-to-vulva sex, a similar latex barrier can be placed over the vaginal area.
• Manual penetration (i.e. fisting) of the vagina and anus can be risky if a partner's fingers or hand have sores or open cuts. If you're concerned about this, use latex gloves, condoms, or finger cots. Always use new "materials" when moving from the anus to the vagina, or between partners.
• If you use sex toys, wash them in hot, soapy water or with a bleach solution before sharing, or use fresh condoms on them for each partner.
• Generally, S&M practices are safe, unless blood or bodily fluids are involved (and they're consensual, of course!). For example, clean any piercing needles with bleach before using them on someone else.
• If you shave one another, use a separate razor for each partner.

Often times, the best protection is having a frank conversation with your partner about STIs, safer sex, and what behaviors you're willing to participate in, and whether you want to get tested. Check out the Related Q&A below for more information and tips on talking about safer sex. And now that you're informed, stock up on the supplies of your choice and enjoy!

Alice

Related Q&As

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