Safer Sexual Practices

WSW are generally at very low risk of HIV infection, whereas bisexual women are at higher risk. Sex between two women is not always safe, and WSW are just as vulnerable to certain sexually transmitted infections (STIs) as women who have sex with men. It is important for women to know the risks and how to protect themselves.

HIV transmission

HIV is found in body fluids. It is present in infectious quantities in vaginal secretions, menstrual blood, breast milk, semen and blood. Exposure of these body fluids to mucous membranes (for example oral or vaginal) can potentially lead to HIV infection.

Confirmed female-to-female HIV transmission via sexual contact is rare but there are reports of HIV infection between women who exclusively have sex with women.

Main routes of transmission between women are:

• Sharing sex toys – can be risky if they have vaginal fluids (juice) or blood on them.
• Rough sex – any sexual activity that can lead to bleeding or cuts in the vaginal lining or anus is risky, including ‘fisting’ or certain S&M (sadomasochism) activities.
• Oral sex – the risk of transmitting HIV through oral sex is extremely low. The risk is increased if a woman has sores or cuts in her mouth or if her partner receiving oral sex has sores on her genitals or is menstruating.
• Digital sex (fingering or finger-fucking) – using the same hand when touching yourself and then your partner can put you at risk. Women who are both menstruating are at higher risk.
• Donor insemination – women thinking of using a sperm donor to get pregnant may get infected if the donor is HIV-positive. Always have the donor tested for STIs and HIV.

Prevention of HIV and STIs

• Get tested for HIV – for HIV-positive women this knowledge can help you access treatment early and avoid infecting others. Effective HIV treatment decreases the amount of HIV in your body fluids and reduces the risk of transmission to others.
• Sex toys – wash sex toys with warm water and a good soap before sharing them, or use a new condom on toys for each partner. Ideally have one toy each. Only share clean or covered toys.
• Tips for safer oral sex – avoid oral sex if either of you have any cuts or sores in or around your mouth, or during menstruation.
• Digital sex – ensure there are no sores or cuts on fingers or hands. Keep fingernails short and hands clean. Consider using latex gloves and water-based lubricant if you have cuts or sores on your hands.
• Condom use – condom use and water-based lubricant offer protection for bisexual women having sex with men.