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Searched Archives...Can't find woman to woman transmission
Jun 4, 2007

Dr. Bob,

Thank you for your wonderful work that you do. You are an inspiration to all of us.

Here is our story:

We are a normal, hard working, conservative couple with a child. We both have been tested before and we are monogomous. We don't get to go out a lot because we are always so busy. This past weekend we decided to get out and cut loose a bit. We ended up going to a swingers club out of curiousity where my wife and I had sex with each other in a room filled with other people having sex. There was a couple having sex next to us and my wife and the other female began touching each other. My wife then stopped having sex with me and the other female stopped having sex with her partner and my wife and her began to make out. There was no oral and no kissing. Just mainly touching. My wife sucked on her tits and she sucked on my wifes. My wife was masturbating herself and the other woman was doing the same to herself. The other woman then began to masturbate my wife and my wife began to masturbate her. Our concern arises from the fact that maybe the other woman had some of her own vaginal fluids or some of her partners semen on her fingers when she began to masturbate my wife. Also, my wife masturbated this woman and then masturbated herself again. We are concerned that some of this fluid may have come in contact with my wifes vagina. We have read all of the responses regarding mutual masturbation but most of them are either male/male or male/female. Is this another case of no risk mutual masturbation or is this something more. We are extremely nervous that we have messed up the wonderful life that we had by one stupid night of curiousity. We have vowed never to do this again and are hoping that we have dodged the bullet. We have read that HIV does not last long outside of the body but we are still nervous. We called the CDC and they gave us the usual run of the mill CYA "if fluids were exchanged then you are at risk" answer. Dr. Bob we respect your opinion. What was the real risk from this incident? Are we talking about no risk here? Does this warrant testing? If a test is warranted would you recommend a PCR DNA test at 28 days. Please help us. We don't want to have to stress for the next 12 weeks before we she can get tested. We are also concerned that if she has it that it can be passed on to our young child.

Your help is greatly appreciated. We know that you get tons of email but we hope that you will select ours due to the unusual (female/female) circumstances surrounding our situation.

Thank you

Scared in FLA

Response from Dr. Frascino

Hello Scared in FLA,

I just love it when a "normal, hardworking, conservative monogamous couple with a child" decides to get curious on the weekend and wind up in an orgy room for some lesbian lovin'!!!

Generally speaking the HIV risk from the gal-on-gal action you describe would carry a minimal HIV risk. I would recommend a single HIV rapid test at the three-month mark to put your fears permanently to rest. I do not recommend PCR testing for routine HIV screening due to cost, the rate of false-positives and other technical considerations. As for passing HIV on to your youngster, relax. HIV is not spread by casual contact.

For completeness I'll post a few girl-on-girl posts below. Even though most refer to oral sex, hopefully they will be helpful for our readers.

Good luck.

Dr. Bob

Lesbians, Vaginal Secretions and HIV Risk Aug 25, 2003

Greetings Dr. Bob,

I have yet to come across a post made by a lesbian to this board, so here's my contribution. On December 27, 2002, I had contact with a woman (ok, a stripper!) of unknown HIV status. While I did use my finger to explore her clitorial region, I did not penetrate her vagina. There was a small amount of vaginal fluid on my index finger, which I then wiped on her nipple and licked off. We also french kissed a couple of times.

Being something of a closet hypochrondriac, I decided to be tested for HIV, which I did at 77 days (11 weeks) post-exposure. My test was negative, but here's my question: Assuming this woman is HIV positive, what are the chances that I could have tested negative one week short of the definitive 84-day timeframe? The counselor told me that given my low-risk exposure, I didn't need to retest at 6 months.

What is your opinion on this? And I might add, that it's nice to have an intelligent, witty and compassionate physician such as yourself in the "family."

We dykes seem to be missing on the radar screen in the HIV risk discussions. How difficult is it, theoretically speaking, for a HIV+ lesbian to transmit the virus to a negative lesbian performing oral sex on her?

Thanks for yout time, and stay well, Dr. Bob.

Lezzie in Cali

Response from Dr. Frascino

Hi Lezzie,

Yeah, where are all the women? My girlfriends read the site, but I hardly ever get any questions. Maybe your question will spark some interest; although, the answer is really rather straightforward. Your risk of HIV transmission from the finger play, and a vaginal fluid coated nipple nosh, is essentially nonexistent. Even a "closet hypochondriac" can't contract HIV this way. Your 77-day test confirms this. You're negative, and no further testing is warranted.

As for your other question oral sex on an HIV-positive woman this, of course, would be the same for both men and women. (My girlfriends, however, tell me they know how to do it much better than men.) The risk would be extremely low. Certainly, there could be extenuating circumstances cuts in the mouth coming into contact with menstrual blood, etc. But overall, the risk remains very low. If someone is concerned about a possible exposure, a test in 3 months is now considered to be definitive.

Stay well. Thanks for writing.

Dr. Bob

Can you contact HIV going down on a girl? Jun 3, 2007

Ok, I went down on a girl I have liked for awhile... not relizing that she was a slammer. Later on hearing she was slamming dope with a girl who was HIV positive. I am getting tested to be sure but I am stressted. I am married and I am afriad I have givin this to my husband..! Please help a scared as hell first time house wife!

Response from Dr. Frascino

Hello,

Oral sex in general carries a very low risk for HIV transmission. Cunnilingus, guy-on-gal or gal-on-gal, carries an extremely minimal risk, barring extenuating circumstances, such as menstrual blood, oral or vaginal sores or cuts, etc. (See below.) My advice would be to level with your husband and get an HIV rapid test at the three-month mark.

Good luck!

Dr. Bob

Lesbians and HIV Feb 6, 2004

Hi there,

My partner is HIV-pos and living with AIDS. She tested positive before we got together and has always been honest with me about it. I am in love and we practice the safest sex we know, but are frustrated about the facts. I went to get tested (I'm neg) and the woman at the clinic basically told me that lesbians don't transmit HIV to other women. HELLO! Am I right to think this is incredably ignorant? There just is not enough information about female partners and HIV. Any advice about what is "safe" and what is not?

Response from Dr. Frascino

Hello,

Refer the woman at the clinic to a recent article by Kwakwa et al., "Female-to-female transmission of human immunodeficiency virus" in Clinical Infectious Diseases, 36, 1 February 2003. It provides evidence of female-to-female transmission to a 20-year-old woman from Philadelphia in a monogamous lesbian relationship. The couple's sexual practices included sharing sex toys and oral sex. These activities did not occur during menstruation, but the sex toys had occasionally been used vigorously enough to draw blood. The authors suggest the infection occurred via sharing these sex toys. The newly infected woman had a negative HIV test six months prior to her first positive test. The genotype of her newly acquired virus was strikingly similar to her HIV-positive partner's viral genotype.

We do know that female-to-female sexual practices are generally associated with lower risk of HIV transmission, but cases such as the one published above have been reported. The exact incidence is difficult to determine, due to other possible risky behaviors intravenous drug use, unprotected sex with men, etc. The CDC doesn't track lesbian HIV statistics accurately. For instance, if a lesbian is diagnosed as HIV-positive, but has ever had sex with a man, the case is counted as "heterosexual."

The bottom line here is that lesbian and bisexual women can and do get HIV and other STD's. As for what is safe and not safe, the same rules apply. Oral sex, for instance, has a low, but not completely nonexistent risk for HIV transmission. "Dental dams" (a square piece of latex) can make cunnilingus even safer, but the taste is far from Julia Childs (her cooking, not the lady herself). Alternatively, plastic wrap is more readily available than dental dams, has essentially no rubbery taste, and has the added benefit of being see-through! Whenever I'm at the local supermarket, I always look to see who's buying the plastic wrap and wonder if it will wind up in the bedroom or kitchen. I never thought it worked all that well in the kitchen!

Hope that helps.

Dr. Bob

Oral Sex question...Pls Pls answer!! (CUNNILINGUS) Apr 24, 2007

Hello Dr. Bob,

About 3 months ago I asked you a question and you responded, which was awesome! I feel like I am talking to a celebrity. I really admire you and all that you do. I know I said I was going to send a donation and I will I promise as soon as I get back to the states next month.

Anyways, my question is regarding HIV and oral sex. I know by reading in the archives that it is a low risk but for some reason I keep on worrying.

Here is what happened. I was with a Romanian sex worker. We had protected intercourse and at the end I performed unprotected oral on her. I didnt notice any open sores or anything unsual down there. After the act I checked my mouth for any open sores and I dont recall seeing any. I also washed my mouth out and when I got back I brushed my teeth. However, I did notice two small canker sores, one on the side of my tongue and the other at the bottom of the inside of my lip. Could any HIV-infected fluids gotten in there?

I assume she was HIV negative. Before and after the act she washed both hers and mine genitals and seemed to be really cautious. As for transmission, is the risk of getting HIV from vaginal fluids lower than from Semen? Does it have to be an open sore in the mouth to get infected? I know blood is the riskiest way as is unprotected anal and vaginal intercourse. Also, does saliva contain agents that help kill the virus?

I would really appreciate it if you could answer this one question for me, I promise this is the last time you will get a question from this worried well. Take care and god bless!

Mikey the Sailor

Response from Dr. Frascino

Hey Sailor-Boy Mikey,

The risk of HIV transmission from cunnilingus is extremely low. (See below.) Even with your two small canker sores, I would put your HIV risk in the remote-to-nonexistent category. Certainly if you're worried, get a rapid HIV test at the three-month mark to put your residual fears permanently to rest. Undoubtedly the result will be negative, but just to be extra sure, I'm sending you my best good-luck karma, OK?

Regarding saliva, yes, there are substances in salivary secretions that inhibit HIV. As for the infectivity of vaginal fluids versus semen, that depends on viral load, viral strain and many other factors.

Be well, Mikey.

Dr. Bob

Tested today. Alone and need some one to talk too. (CUNNILINGUS) Mar 5, 2007

Hey bob, your the best! Well i finally did it, went today and was tested for all sti's including HIV. Im studying in another country and have no one to share the stress of this with. Heres my story...... A few of months ago i performed unprotected cunnilingus. Stupid now i know but i thought this was a safe practice at the time. It lasted for a mere 45 seconds at most. A couple of days later, i came down with chills,which subsided within a day or so. I also had a chesty cough and swollen glands under my chin, which lasted for a week at most. I thought nothing of it at the time as i had just started college and everyone i knew was down with the flu. Then 2 weeks ago (a few months after my exposure) i had some unusual white discharge after urination. This got me worried about gonorrhea and chlamydia, ive been to the toilet several times since and nothing! Anyways today i went to my local clinic in order to put my fears at rest. I honestly didnt think they would test for HIV, but they said i should, so i went along with it. This has got me rather spooked to say the least. My questions are- 1-What do you think my chances of catching HIV from this one off brief exposure? What are my chances of dodging the HIV bullet Dr Bob? Secondly do you think the one episode of discharge indicates gonorrhea or chlamydia? Can symptoms appear month later and only occur the once? Im making a donation to your wonderful cause, will you please send me your goodluck karma in return! Thank you, stay well, Ewan

Response from Dr. Frascino

Hello Ewan,

I'll proceed directly to your specific questions:

1. Negligible (see below).

2. Excellent.

3. Probably not, but you're getting tested anyway, so you'll have a definitive answer very soon.

4. Extremely unlikely.

5. Good luck karma signed, sealed and sent.

Be well. Stay well!

Dr. Bob

Tonsils and Oral Sex (CUNNILINGUS) Sep 30, 2006

Dr. Frascino,

You are definitely a person admirable character. I have just donated $50 to your wonderful foundation. I wish I could afford more at this time, but money is very tight on my end with my graduate school studies. Like everyone else, I have a question for you.

I performed unprotected oral sex on a woman of unknown status about 2 weeks ago. I purposely avoided unprotected intercourse because of its risk. However, I am know concerned about this oral sex episode. I have recently developed enlarged tonsils and my tests for sterp have been negative. I have a sore throat which is understandable, but no other symptoms. I have tried to use your past answers of similar exposures to help ease my anxiety. But there is just something about hearing it directly from you.

Have you ever seen a person with whose only exposure was unprotected oral sex on a woman test positive for HIV?

I hope that your good health will continue to remain. I promise I shall make another donation later on this year.

Thank you,

Kenny

Response from Dr. Frascino

Hello Kenny,

Unprotected cunnilingus on a woman of unknown HIV serostatus carries only a negligible risk for HIV transmission. (See below.)

To answer your specific question, nope!

Thanks for your kind comments and donation.

Stop worrying! If you can't stop worrying, get tested at the three-month mark, but do realize the primary reason to do so would be to put your unwarranted fears permanently to rest, OK?

Good luck. Stay well.

Dr. Bob

Oral Sex and HIV

Feb 18, 2006

i have just stumbled on this site, and would like your opinion, on jan 1st 2006 i had protected vaginal sex with a prostitute, but i performed unprotected oral sex on her, before i performed she whiped her virgina and when performing oral sex i could taste no secretion or menstural blood, immediately afterwards i realised what a rediculous thing i had done and became increasingly paranoid about the possibility of HIV infection, on the 3rd of Jan i started on 28 PEP course, what do you think my chances of having HIV are, alot of other sites i have been on say Cunnilingus is Low risk, some say no risk, quantatively what is this risk? i am due to go for an HIV test at the end of march and am petrified of the result, many thanks

Ben C

Response from Dr. Frascino

Hello Ben,

She "whiped her virgina?" Would that be "whiped" as in whipped or "whiped" as in wiped? And would that be "virgina" as in Virginia or "virgina" as in vagina? I would assume "whipped" and "Virginia" are out, because nothing kinky ever happens in that state. The risk of HIV transmission from cunnilingus is extremely low. I'll post a question from the recent archives that addresses this problem. (See below.)

I do not believe PEP was warranted for your potential exposure. There is no reason to be "petrified" of your HIV test results. I see nothing but good news heading in your direction. I suggest you begin practicing your WOO-HOOs!

Good luck.

Dr. Bob

Cunnilingus - no blood, good oral healt Jan 12, 2006

Dear Dr. Bob,

Just sent a donation of 200 dollares - thanks fo you help - people need it and now i feel i need too

You had answered a number of questions related to the risk of cunnilingus. I was engaged in one 2 months ago but no blood was involved and my oral helth is ok. The experience was with the mistress and when i asked her afterwards she told me she is DD free .What concerns me that you mentioned once that the probability of getting HIV in this case 0.5 per 10000 cases. doest it mean that there is 1 possible transmission in 20000 cases. a number of cunnilinguses given is much more then that and there are no documented cases so far. How do these 2 things reconcile?

I am still concerned although i understand i should not be....you know...

How is it possible generally to get HIV via giving cunnilingus in case when there is no blood and my oral health seems to be in order. Appreciate your reply.

I have another general question re the symptoms...

It seems that in case there are symptoms there are ususally more then one should be present based on the statistics you posted earlier.

Appreciate your reply

Thanks for the help

Response from Dr. Frascino

Hello,

The estimated statistical per-episode risk of 0.5 per 10,000 exposures for unprotected oral intercourse refers to fellatio (oral sex performed on a man), not cunnilingus. The cunnilingus figure would be much less. In fact, it's so small it's difficult to quantitate. There are only very few cases of HIV transmission resulting from performing oral sex on a woman that have been reported to the CDC. Considering we've been monitoring this epidemic for over two decades, that alone is excellent evidence that the HIV-transmission risk through cunnilingus is extremely low. There are a number of scientific hypotheses as to why this is true, but the bottom line remains the same: it's an extremely low-risk activity. (Note: the risk increases if the woman is menstruating and/or the person performing cunnilingus has oral mucous membrane sores, abrasions or inflammation.)

Regarding your second question, ARS can be quite variable in scope, number and severity of symptoms. However, yes, generally more than a single symptom is present.

Thanks for your generous donation!

Stay well.

Dr. Bob

Update from Tonsils and Oral Sex (Cunnilingus) Dec 14, 2006

Dr. Bob,

Thanks for responding to my previous question entitled Tonsils and Oral Sex (CUNNILINGUS). May I woohoo based on the following tests and events:

Week 2: Oraquick Negative Week 7: Oraquick Negative Week 9: Oraquick Negative Night after test, fever of 101.3 and horrible earache Week 12 (86 days): Oraquick Negative

I have not had any other exposures since my unprotected cunnilingus episode. So I will ask again. Do I have your blessing on woohooing?

Happy Holidays!!!

Kenny

P.S. I plan on sending a donation to your organization once I get paid at the end of this week.

Response from Dr. Frascino

Hey Kenny,

Your week 2, 7 and 9 tests were encouraging, but not WOO-HOOable. However, your negative week-12 OraQuick allows you a full-throated, ferociously committed, screaming-banshee-type WOOOOO-HOOOOO!

Thanks for your donation (www.concertedeffort.org).

Happy WOO-HOOing Holidays to you, too!

Dr. Bob



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