Do Gay Gals Worry About the Package? Should We?
A Survey of Lesbian Safe-Sex Behavior
I've identified myself as gay since I was very young. I have gone through many phases in my life, from a downwardly mobile, yet elitist women-centered world, to a life surrounded by gay boys, to more balanced acquaintenceship with all bents and genders. The same rules applied regardless of the crowd I was running with: there were certain things you must think/do/feel/be to be a lesbian, dyke, activist, feminist, fag-hag, etc.
When I came out, lesbians were very strident in their definition of a lesbian. Either you were a lesbian, or you weren't. Period. If you were, it meant that you never hung out with or enjoyed the company of men, nor thought about dating or having sex with them. If you were bisexual (I don't remember ever hearing that word until I began working in social services) you were a user and a destroyer of the lesbian community and you would eventually go back to a man, breaking the heart of the poor real lesbian you destroyed.
Lesbians never injected drugs, hurt one another, engaged in sex work, or did anything that would put us at risk of anything besides perhaps a carpentry-related accident. Of course, lesbians were allowed to acknowledge they were at risk of becoming victims of rape, abuse, alcoholism and so on. If anything bad happened to a real lesbian, it wasn't her fault or responsibility.
In the late '80s I fell in with the AIDS-activist crowd in San Francisco and was swept along by the romance and excitement of living the kind of lifestyle wherein I couldn't ride a bus without getting at least one phone number. It was exhilarating. Here I encountered the same expectations I had in the lesbian community a decade before, but with different rules. The Puritanism of the lesbian community in the late '70s was not much different than the gay and AIDS-activist groups I fell in with later.
In politically correct San Francisco, everyone learns the party line and no one strays (or admits it). Amidst the endless meetings, demonstrations and play parties, all I ever heard was that you had to act as if everyone was positive, every time.
What did that mean? Don't be divisive by asking anyone's HIV status. Do engage in safe sex. Don't assess risk. Everything sexual was dangerous but it was our responsibility as queers to have as much sex as possible and remember, if you got infected, it wasn't your partner's fault. And it wasn't your fault, either. It was the government, or the media's lack of representation, or our inability to access information.
Sometimes I followed the rules. I never talked about it when I didn't. It was blasphemous to think there might be a remote possibility that female-to-female sexual transmission was unlikely.
Safely back in Los Angeles now, I can say that taking the potential risk of HIV infection away from the lesbians back then was akin to kicking them out of the sandbox. It seemed as if no one was protecting themselves out of concern for HIV-infection. Honestly: Does anyone think that a finger cot will prevent transmission of HIV? It seemed to me that the dykes were just following the rules because that was the politically correct thing to do.
I don't mess around with the ladies like I used to. I usually know the HIV status of my partners now before I have sex, because I usually know my partners before I have sex. I have decided what I consider safe and what I'm willing to protect. Sometimes I hold myself to my own standards, and sometimes I don't. As a lesbian, I think it's easier for me to relax my standards because I really don't think that female-to-female sexual transmission is likely.
Do lesbians see themselves as being at risk for HIV infection through gal-on-gal sex? To find out, I e-mailed an informal survey to about 15 friends. Some of my friends forwarded the survey to their friends, and so on. I got about 46 responses. I selected comments from those who responded.
Have you ever been tested for HIV? Why or why not?
"Yes, because I foolishly had unsafe sex on multiple occasions with a woman whose history I really didn't know." "No. I give blood on a regular basis and haven't received a notice from them." "Yes, because I met a woman with HIV and had been having unsafe sex with women and a condom slipped with a man I was fucking." "Yes, because my partner at the time was HIV-positive."
I found that of the 79 percent of the respondents who had gotten HIV tests, the only time they considered sexual transmission as an issue was if their partner had engaged in risky behavior. Only 1 respondent stated she had been with an HIV-positive partner.
None of those who responded identified themself as an HIV-positive lesbian. But an overwhelming majority of the respondents claimed to know, or know of, HIV-positive women who identify themselves as lesbians.
Do you feel that you are at risk of getting infected or, if you are positive, infecting your partner(s)? Why or why not?
"Slight risk as I've slept with bisexual women." "I'm not promiscuous, never used IV drugs, not in a high-risk group." "Risks are present in everything that we do, but I do my best to manage them."
Eighty-percent of the respondents felt that they were not at risk of sexually transmitted HIV from their female partners. Only two respondents mentioned that they take precautions.
Are you single/married/other? Did/does the issue of HIV transmission ever come up? How so?
Single-38%; Dating-16%; Partnered/monogamous-46%
"Yes, it came up because my girlfriend was in a relationship with someone who died of AIDS and she used IV drugs with him." "In finding a lover, I bring the topic up and if there's any negative vibes from the potential lover about HIV status I don't bother with them." "Both lesbians and straight men seem to have enormous denial about potential risk, so I need to raise it." "HIV transmission never comes up."
Most of the women who responded bring up the topic of HIV when they begin dating someone new, usually asking their partner if they have been tested. It is notable that more of the respondents ask their partners if they have been tested than actually get tested themselves. It seems that knowing their partner's HIV-status is more critical in making choices about sexual behavior than knowing their own status.
What behaviors do you, as a lesbian, think would put you at risk of HIV infection?
"Contact with blood or other bodily fluids." "Assuming a partner is HIV-negative would be a risk, and then ignoring the issue all together and having unsafe sex would escalate that." "Oral sex without a barrier is possibly risky, although I don't always end up using a barrier even though I believe that." "[Aside from the 'bible' of HIV prevention] I realize that for myself and many other women, practicing safer sex isn't really an option all the time and that although there may be an element of risk in having 'unprotected' sex, I weigh that risk and make independent decisions." "Sex with an infected partner, male or female." "Anything that involves blood or where there is potential to cause bleeding (fisting, anal play, cutting, etc.)."
Only two women mentioned having sex with an HIV-positive woman as being a risk factor. Other risk factors cited were promiscuity, sex with men, injection drug use and sex with women who do any of the afore-mentioned things. The few who mentioned oral sex all stated they thought there was a risk but they chose not to use barriers some or all of the time.
What do you do (if anything) to protect yourself or your partner from HIV infection?
"I take off my rings." "Monogamy." "I keep gloves/dental dams at all times and use them." "I am guilty. I don't take any precautions." "I choose my sexual partners very carefully." "Nothing. We are not at risk."
Monogamy was the overwhelming method of HIV-prevention. That was followed by not using protection whatsoever. Considering the shopping list of things women considered to be risky in their sex lives (see preceding question), only two respondents mentioned latex barriers.
Do you think HIV is an issue in the lesbian community? Why or why not?
"Lesbian community?" "The only reason HIV is an issue in the lesbian community is because lesbians haven't figured out how to make yeast infections an epic tragedy -- yet." "I think it's an issue for anyone who has sex!" "Sure it is. Is alcoholism an issue in the lesbian community? Substance abuse? Ignorance? Anyone who has sex is at risk, period. Anyone who is out of control, has poor judgment derived from a state influenced by any drug substance is at risk (for the obvious reasons of not being responsible, having poor judgment). And more and more lesbians are having sexual interludes with men. Sure it's occasional, but it's there. Plus, it's an issue because there are HIV-positive dykes."
Many women thought HIV should be an issue in the lesbian community despite the fact that they don't see it as much of an issue in their lives. It seems several of the respondents are concerned about the number of lesbians who engage in unprotected sex; looking back on the answers to the previous question, however, a majority of the respondents seem to be in that category themselves.
Have you ever read anything, or seen anything that was about HIV that made you think, "this could happen to me"?
"A girl I slept with died from HIV complications a few years ago." "At a conference on women and HIV years ago, I remember thinking that one of the other dyke activists was really cute, and then she stood up and said she was positive. It made me realize just how close it really could be." "Having an HIV-positive partner certainly makes it up close and personal. I think woman-to-woman transmission is very difficult, but I know it can happen. While we were together, I was always aware I could become infected." "Yes, but it always related to what I had done with men in my past. Nothing I've read ever made me feel I was at a great risk for HIV infection by having sex with exclusively women."
Almost everyone stated they had an experience that personalized HIV for them. This doesn't seem to translate into prevention methods.
Do you think prevention efforts should be directed at the "lesbian community"?
"I think prevention efforts should be directed at the entire population. Education on any level would apply to all communities." "Yes, I do because I don't think the lesbian community has enough concern about any sexually transmitted diseases. I think they need to understand that just because there are no penises involved doesn't mean we are immune." "Yes, some. But without hysteria." "Yes and no. I think our largest risks as lesbian/bisexual women are from injection drug use, and having sex with positive men. I think the 'lesbian community' often defines itself to exclude IDUs, sex workers, and bi women. Perhaps educational efforts would be best focused around us all being part of the same community, or at least that we're having sex with each other. I'm not sure a single-minded focus on 'lesbian safe sex' is the way to go." "We need to focus on issues that affect most lesbians' lives and begin to start a movement based on our total health."
Unprotected sex with women wasn't listed as a possible risk unless the partners in question were IDUs or bisexual (only one respondent mentioned having an HIV positive partner as being a risk). Well, if you believe an IDU or a bisexual could transmit HIV through female-to-female sex, what's to stop a non-IDU or not-perceived-to-be-at-risk lesbian from transmitting HIV (assuming the woman is HIV-positive)? Some things never change: "Pure lesbians are not responsible for anything."
I am not discounting the fact that there are HIV-positive lesbians. On the contrary, because the numbers of women becoming infected are so low, the fact that there are HIV-positive lesbians is indicative to me that transmission via woman-to-woman sexual contact is difficult.
I think a comment from one of the respondents sums it up: "I think health efforts should be directed at the lesbian community. Trying to jump on the HIV train doesn't seem to be the best way to reach most lesbians with our total health issues. Some lesbians have and will get HIV. We must make sure that good information is available to lesbians about how to prevent transmission. I think to raise the HIV banner and demand that lesbians are included puts too much effort on a smaller issue than we need to be addressing. HIV should absolutely be included in messages about lesbian health, but it's the bigger picture that needs dramatic attention, not just this one small piece of the picture. We need to include HIV, not highlight HIV."