Can sexually transmitted infections (STIs) be transmitted during sex between women?

Dear Reader,

Regardless of gender, sexual orientation, or with whom someone chooses to be intimate, if one partner has a sexually transmitted infection (STI), known or unknown, it is possible to pass it during sexual activity, and indeed, research and experience tell us that it is possible for STIs to pass from woman to woman. The tricky thing with STIs — especially HPV and herpes — is that many who are infected do not have any symptoms even though it is possible for them to transmit the infection. In fact, the most common symptom of an STI is none at all. This means that people may not know that they have an STI. This is why you hear health professionals going on all the time about taking safer sex precautions, whether a person has symptoms or not.

HPV is human papillomavirus, the virus that causes genital warts. HPV is the most common STI in the United States, with 30 different strains of the virus that can infect the genital area. Some of these strains cause warts that are visible on the male and female genitals. Others cause warts on a woman's cervix that, in some cases, especially when left undiagnosed, can lead to cervical cancer.

It is only natural that you are curious about your possible exposure to this virus. During woman-to-woman sex, HPV is most likely to be transmitted from an infected person to her partner through skin-to-skin contact with an infected area. Less likely possible routes of sexual transmission are:

• Contact with vaginal fluids, including menstrual blood, that can enter a partner's body through cuts in the skin or tears in mucous membranes, such as the vagina, anus, and mouth.
• Sharing of sex toys.
• Unprotected oral sex.

If you are diagnosed with HPV, it is possible that any of your three past sexual partners could have transmitted the virus to you through any of the above-mentioned sexual behaviors. Some cases of HPV, however, are not sexually transmitted. For example, HPV can be transmitted from mother to child through vaginal birth and via inanimate objects (e.g., towels), but these are quite rare.

Some people talk with their partners about STIs before they are sexually active (and it’s a great idea). Communicating about sexual history or potential risk for STIs provides an opportunity for partners to talk about to what they've been exposed. However, since sometimes a person isn't aware that s/he has been exposed to an STI, even an honest conversation may not provide 100 percent certainty. As a result, many people choose to be tested for STIs, either independently or with their partners, before getting intimately involved with a new person.

Whether you do or do not have HPV, it can be helpful to learn from this experience by having safer sex in the future. This can include:

• Using dams or unlubricated condoms cut into a rectangular sheet during oral sex.
• Avoiding sharing sex toys or washing them thoroughly after using them (or using a new condom or other latex barrier on the toy for each partner).
• Wearing latex gloves or finger cots during sexual activity, and being conscious of not exchanging body fluids.

These precautions can significantly reduce the chances of spreading any kind of infection if one or both partners are affected.

While HPV can't be "cured," if your biopsy results are positive for HPV, it is likely that your health care provider can treat the symptoms. Some people who are exposed may have only one outbreak or abnormal Pap smear in their lifetime, while others may have recurring episodes. You may want to take some time and talk about what living with HPV may be like with a health professional or process some of your feelings with a mental health professional.  Additionally, discussing your treatment options with your health care provider can help you manage the diagnosis and feel more comfortable communicating about it in your future sexual experiences.