March 13, 2014
2 min read
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Female-to-female sexual transmission likely caused HIV in Texas woman

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A Texas woman with HIV likely acquired the infection through female sexual contact, according to the CDC.

The 46-year-old woman who acquired HIV had a history of heterosexual intercourse, but not within 10 years before the infection. She also reported no injection drug use, tattoos, acupuncture, transfusion, transplants or other HIV risk behavior. She reported three female sexual partners in the preceding 5 years. The woman tested negative for HIV by HIV-1/2 enzyme immunoassay (EIA) serology screening after donating plasma in March 2012.

Ten days after donating plasma, the woman presented to the ED with a sore throat, fever, vomiting, decreased appetite, pain on swallowing, dry cough, frequent diarrhea and muscle cramps. The EIA test was negative at that time and she received treatment for a presumed upper respiratory infection. The woman again attempted to sell plasma 18 days later, when her EIA serology and Western blot test were positive for HIV.

The woman had a virus that was almost genetically identical to her female partner’s virus. The partner had been previously diagnosed with HIV and stopped receiving antiretroviral therapy in 2010. During the 6-month monogamous relationship, the couple had not received any preventive counseling. They reported routinely having unprotected oral and vaginal contact and sharing sex toys. They also described rough sex to the point of bleeding and unprotected sex during menses.

“All persons at risk for HIV, including all discordant couples, should receive information regarding the prevention of HIV and sexually transmitted infections to prevent the HIV-negative partner from acquiring the infection,” the CDC investigators wrote. “Furthermore, all persons identified as infected with HIV should be linked to and retained in medical care. Control of HIV infection with suppression of viral load can result in better health outcomes and a reduced chance of transmitting HIV to partners.”