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Female To Female HIV via threesome?

Aug 18, 2017

Hi there, I am a generally hetero female who engaged in a threesome a few weeks ago. I was tested at two weeks and came back positive for chlamydia. I found out it was the other woman involved who was the carrier as the male had been tested quite recently and was negative for everything. However, now that I know I am positive for chlamydia I am very scared I am also HIV+. I was wondering what the likelihood of HIV being transferred from the other female to me is. In terms of the male being inside of her and then to me. I do not know her status but I am having a very hard time with anxiety and my blood work is not yet in, although I know two weeks is not a conclusive time line for the virus.

Response from Mr. Jacobs

Hi there, I'm sorry to hear that a joyful threesome ended up becoming an anxious event. No one wakes up in the morning hoping to get chlamydia but as you have found, it is a very curable infection.

Let's start with the question at hand: Female-to-female transmission of HIV is extremely unlikely and rare, especially in the scenario you describe. Unlike chlamydia or gonorrhea, HIV dies almost immediately once exposed to air. That is why nearly all transmissions take place with the mucous membranes of one person entering into another, either through sexual acts, IV drug use, or on some occasions, childbirth.

In the one instance of we are aware of where there was a confirmed female-to-female transmission of HIV, it occurred in a context of very rough play and sharing toys while menstruating. (https://www.nytimes.com/2014/03/15/health/in-rare-case-woman-with-hiv-infects-female-sex-partner-cdc-says.html). Of the 70+ million HIV diagnoses over the last 36 years, this is the only one known to have occurred from female-to-female. So the likelihood of you acquiring HIV without having direct contact with her blood or vaginal fluids are zero.

And, from what you described, there is no knowledge or reason to believe she is living with HIV and has a detectable viral load. If someone doesn't have HIV, they cannot transmit HIV. But even if she was carrying a detectable level of HIV, these events you describe would not put you at risk.

You mention being tested two weeks after this encounter, and receiving a diagnosis of chlamydia. But you don't mention if this test included HIV? Although two weeks is a short period of time, some RNA tests only have a window period of 10-14 days, and could quite possibly show positive if you did have HIV in your blood. I would check with your provider to find out if they tested you for HIV, and if so, what was the standard window period for the test they used.

Now, my only concern here is what you're telling us about the male partner in this equation. You say he's "negative" but exactly how do you know that? Perhaps it may help you to discuss with him as well exactly what tests he had done, and what his window period looks like.

I can understand your concern about HIV. The only way you're going to know for sure is to get tested. But honestly, the events you describe are considered relatively low risk. Let's say for the sake of argument that your male partner was living with HIV, didn't know it, and had a detectable viral load. Even in that scenario, your risk of acquiring HIV from him one encounter is less than 1% (https://www.poz.com/article/HIV-risk-25382-5829).

When this is all said and done, I hope you are able to enjoy sexual connections that lead to you experience pleasure and empowerment, instead of fear and dread. Until then, please relax, take care, and get the facts you need in order to make informed decisions about your sexual health.

To learn more about HIV transmission please visit our forum here at The Body.com: http://www.thebody.com/content/30024/hiv-transmission.html?getPage=3#q18



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