Can women transmit STIs to other women?

Most discussions of the transmission of STIs tends to focus on heterosexual encounters – women who have sex with men and men who have sex with women.

While this is understandable since they make up the majority of encounters, less attention is paid to the risks and needs of people who have same-sex encounters. Indeed, many researchers have drawn attention to the dearth of research related to STI transmission between women.

One query, which we at Better2Know have come across frequently, is whether women who have sex with women are less likely to contract an STI.

Is this true?

Let’s find out.

Are you worried about STIs? It’s always better to know your sexual health status.

What are STIs?

To understand the female to female STD transmission rate, we need to get a good grasp of what STIs are and how they work.

Sexually transmitted infections (STIs), sometimes called sexually transmitted diseases (STDs), are infections that pass between people during sexual activity. This can include vaginal, anal, and oral sex, and sharing sex toys.

These infections are primarily bacterial, viral, or parasitic infections that enter the body through mucous membranes via infected bodily fluids. These membranes are located in the genitals (penis and vagina), mouth, rectum, and eyes.

While sexual activity is the primary mode of transmission, you can also get some of these infections through other means. Infections like HIV and Hepatitis C can be transmitted through blood-to-blood contact, like through blood transfusions and needle stick injuries. One of the primary methods of transmission for HIV, for example, is through sharing needles for intravenous drug use.

Some infections, like HPV, can be transmitted through simple skin-to-skin contact, like touching the genitals of an infected person.

More on this later.

What’s all this terminology?

When discussing this topic, it’s important to distinguish between your sexual orientation and your choices of sexual partners.

Some people may identify as straight, gay, lesbian, bisexual, trans, or any number of different sexual identities. However, a person’s sexual preference doesn’t necessarily determine who their sexual partners will be. Many people who identify as heterosexual will have sexual encounters with people of the same sex, and vice versa.

So, this is not a conversation about sexual orientation. It is a conversation about the sexual partners people may have had.

Language used in the medical community tries to make this distinction by using certain terms to identify people and their sexual partners. Here is a list of these terms, which we use later in this article:

• Men who have sex with women (MSW)
• Women who have sex with men (WSM)
• Women who have sex with women (WSW)
• Men who have sex with men (MSM)
• Women who have sex with men and women (WSMW)
• Men who have sex with women and men (MSWM)

What do WSW have to know?

There seems to be a general conception that WSW and WSMW are at a lower risk of contracting STIs.

The truth is rather complex.

It is true that, in general, WSW are slightly less likely than WSM to contract an STI. However, simply having sex with women doesn’t necessarily keep a woman safe. WSWM are more likely to be diagnosed with an STI than either of these groups. WSWM also tended to engage in higher levels of risky sexual behaviour than other groups.

So, given the relatively smaller rate of infection, WSW don’t have much to worry about, right?

Wrong.

While women who have female partners may have a slightly lower risk of contracting an STI, they are still at risk, since all sexual activity carries an inherent risk of passing on STIs.

On top of that, 85% of WSW have had male sexual partners in the past, or currently have a male partner, making exposure from STIs from men more likely.

This means that the risk that these women are exposed to in regards to STIS from men, though likely lower than WSM, is not entirely zero. It’s possible that, during a sexual encounter with a man, a woman may contract an STI that they carry and later pass on to another sexual partner.

This is all to say that, while WSW are less likely to be diagnosed with an STI, there is always a risk involved with any sexual activity.

What STIs can be transmitted between women?

Most STIs can be transmitted between women. However, certain STIs are more likely to be transmitted than others.

Chlamydia and Gonorrhoea

Chlamydia, caused by the bacterium Chlamydia trachomatis, is a common STI that can affect various parts of the body, like the genitals, rectum, throat, and eyes. It’s primarily spread through unprotected vaginal, anal, and oral sex.

Symptoms in women can include unusual vaginal discharge, pain during sex and urination, and lower abdominal pain. If left untreated, Chlamydia can lead to serious complications such as pelvic inflammatory disease and infertility.

Gonorrhoea is an STI caused by the bacterium Neisseria gonorrhoeae. Like Chlamydia, it’s primarily transmitted through vaginal, oral, or anal sex. Symptoms in women may include unusual vaginal discharge, pain during sex and urination, and pain in the lower abdomen.

If left untreated, Gonorrhoea can lead to serious health complications such as pelvic inflammatory disease, ectopic pregnancy, and infertility.

Chlamydia and Gonorrhoea infections among WSW are generally considered to be quite low. Studies conducted in the early 2000s found only around 0.3% and 3% of WSW that sought sexual health testing were diagnosed with Chlamydia or Gonorrhoea.

Trichomonas

Trichomonas is an STI caused by a parasite known as Trichomonas vaginalis. Like with Chlamydia and Gonorrhoea, it infects the urinary tract and is primarily spread through sexual activity.

In women, it can cause symptoms such as foul-smelling vaginal discharge, genital itching, and painful urination. If left untreated, Trichomonas can lead to complications such as an increased risk of getting HIV and other STIs, chronic abdominal pain, infertility, and fallopian tube blockage due to scars.

Trichomonas infections are fairly infrequent among WSW, with one study showing around 1.3% of individuals tested showing a positive diagnosis.

HPV

HPV, short for Human Papillomavirus, is the most common STI in the world. There are over 100 types of HPV, with about 30 strains affecting the genital area, including the vulva, vagina, cervix, penis, scrotum, rectum, and anus.

Many strains of HPV are harmless. Most cause no symptoms, while other low-risk strains can cause genital warts – fleshy protuberances that appear in an around the genitals. However, some strains are considered high-risk and can lead to cancers, such as cervical cancer and penile cancer.

Abnormal PAP smears and positive HPV diagnoses are relatively similar for WSW and WSM. However, numbers were significantly higher for HIV-serpositive women, regardless of sexual partners or sexual identity.

Syphilis

Syphilis is a bacterial infection primarily transmitted through sexual contact. It manifests in several stages, each with its own set of symptoms. The first symptom is usually the appearance of a painless chancre on the genitals, rectum, or mouth. Other flu-like symptoms, such as nausea, fever, rashes, muscle aches, and a sore throat, often follow.

If left untreated, Syphilis can enter a latent stage where it can damage several organ systems, including the heart, brain, muscles, bones, and eyes.

Syphilis infections have been shown to be transmissible between WSW through oral-genital sex. While uncommon, it’s also possible to contract Syphilis by touching the chancre of an infected person.

HIV

The Human Immunodeficiency Virus (HIV) is a virus that targets the immune system, specifically the CD4 cells that are crucial in warding off infections and diseases. This makes individuals more prone to other infections and diseases. The main transmission routes of HIV are through unprotected sexual contact or sharing injection drug equipment with an infected person. Without treatment, HIV can advance to AIDS (Acquired Immunodeficiency Syndrome), a severe condition where the immune system is significantly compromised.

HIV tends to be seen as an infection that only affects MSM. However, this is a stereotype. Anyone who engages in unprotected sexual activity with an HIV-positive person who is not undergoing treatment may be at risk of contracting the infection.

It is very rare for WSW to pass on HIV through sexual activity. However, there are recorded cases where this has happened.

Herpes I and II

Herpes Simplex Viruses pass between people through intimate contact. Herpes Simplex Virus Type 1 (HSV1), sometimes known as Oral Herpes, passes between people through physical contact with an infectious cold sore, usually through kissing. This cold sore tends to appear around the mouth.

Herpes Simplex Virus type 2 (HSV2), also known as Genital Herpes, usually passes between people through sexual contact with an infected person’s genitals or rectum where sores tend to appear.

NOTE: While HSV1 infections tend to be located in the mouth and HSV2 infections tend to be located int he genitals, it’s possible to get an HSV1 infection in your genitals, and to get an HSV2 infection in your mouth.

Prevalence of Herpes, especially HSV2, tends to be fairly common among WSW.

Bacterial Vaginosis

Bacterial Vaginosis, often referred to as BV, is a common condition that occurs when there’s an imbalance in the natural bacteria found in the vagina. This imbalance can lead to symptoms such as a foul-smelling vaginal discharge, itching, and a burning sensation during urination.

While it’s not classified as a STI, since the bacteria that causes it naturally occurs in the vagina, the infection can be transmitted between sexual partners.

If left untreated, BV can lead to complications such as an increased risk of contracting other sexually transmitted infections, premature delivery in pregnant women, and pelvic inflammatory disease.

Among all infections that can pass between women who have sex with women, Bacterial Vaginosis (BV) seems to be fairly prevalent and transmissible between WSW.

How can women pass on STIs to other women?

Just like heterosexual sex, sexual practices between women carries risks of spreading STIs. Here’s how it can happen.

Oral sex

The mucous membranes in the back of your throat are susceptible to viruses and bacteria. Performing oral sex on someone who has an infection in their genitals can result in your getting the infection in your throat. This also applies oral-anal stimulation.

It’s fairly common for infections like Chlamydia, Gonhorrhoea, HPV, and Herpes to be passed on in this way.

If you have an infection in your mouth – for instance, if you have an open Herpes sore or a Syphilitic chancre in or around your mouth – it’s possible for the infection to pass from your mouth to your partner’s genitals, although this is fairly rare.

Sharing sex toys

While sex toys don’t have mucous membranes themselves, they can still help transmit infections from one person to another.

Infected bodily fluids can remain on the surface of a sex toy. If one person uses the toy and then another person uses it without cleaning it or covering it with a condom, an infection can be passed on. Certain porous materials used in some sex toys can make transmission more likely.

Skin to skin contact

Skin to skin contact, such a genital touching or digital stimulation, can transmit some STIs.

In the case of digital stimulation, touching infected bodily fluids and then touching mucous membranes, like in your genitals, rectum, or eye, could transmit an infection like HPV. The risk may increase if there are cuts or wounds on your hand.

Other ways women who have sex with women can get STIs

While sexual activity is the main way STIs are transmitted, it’s not the only one.

Here are some other ways that you can get an STI without even having sex.

Blood transfusions

While blood banks and healthcare facilities rigorously screen donated blood for STIs, infections can be missed in rare instances.

STIs that can be passed on in this way include HIV, Hepatitis B, and Hepatitis C.

Needle stick injuries

Needle stick injuries, often overlooked, can be a potential route for transmission. Injuries from needles that are contaminated with blood-borne STIs, such as HIV, Hepatitis B, Hepatitis C, and Syphilis can pose a risk. This is particularly relevant in healthcare settings or places where intravenous drug use occurs. It’s crucial to handle needles with utmost care and follow proper disposal procedures.

Unsterilised tattooing equipment

It’s important to be aware that unsterilised tattooing equipment can transmit STIs. If the equipment has been used on an individual with an STI, particularly blood-borne infections such as HIV, Hepatitis B, and Hepatitis C, and is not properly sterilised before use on another person, there is a risk of transmission.

If you are thinking of getting a tattoo, we strongly recommend attending a professional tattoo parlour that adheres to strict hygiene standards, including the use of sterilised or single-use equipment.

Sharing hygiene products

In rare cases, sharing personal hygiene products can transmit some STIs. Items such as razors or toothbrushes can carry blood and thus, if shared, can pose a risk of transmitting blood-borne infections. Infections like Hepatitis B and Hepatitis C can be passed on in this way.

How to avoid passing on STIs

If you want to protect your sexual health and avoid getting or passing on an STI, there are several effective strategies you can use.

• Practice safe sex: Using barrier methods of contraception, like condoms and dental dams, can greatly reduce the likelihood of contracting an STI. However, infrequent or incorrect usage of contraception can lessen their effectiveness. Condoms and other barrier methods are around 98% effective at preventing transmission.
• Get tested regularly: If you’re sexually active, regular testing will help you get a full view of your sexual health. It will allow you to take action early to cure or treat any infection you have.
• Practice abstinence: Abstinence is the best way to avoid getting an STI. If you’re abstinent, your likelihood of getting an STI is extremely low.
• Get vaccinated: You can get vaccinated against certain STIs that have long-term negative health consequences, like HPV and Hepatitis B.

Final thoughts

There is always a risk of contracting STIs when you engage in sexual activity, regardless of your sexual orientation and preference for sexual partners.

If you’re concerned about STIs, get in touch with Better2know today.

Don’t leave your sexual health to chance. Get tested with Better2Know.

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