Lesbian safer sex

Safer sex: An important issue for lesbians too

Sexual health is an important part of your well-being, regardless of who you love and with whom you are intimate. Safer sex is often associated primarily with heterosexual relationships or men who have sex with men. Safer sex refers to techniques that significantly reduce the risk of HIV infection. HIV transmission during lesbian sex is so rare that some people describe lesbian sex as safer sex. However, it is also important for women who have sex with women to be informed and to take care of their own sexual health.

Disclaimer: This text is intended for lesbian or other (cis) women who have sex with (cis) women.

Which sexually transmitted infections can be transmitted during sexual activity between women?

There are various pathogens that can also be transmitted during sex between women. Here is an overview for your information, which should help you to take care of yourself and your partners in a self-determined way:

Viral infections

Human papillomavirus (HPV): HPV is a very common viral infection that is transmitted through skin contact, including during oral sex, manual stimulation, and genital contact. Some types of HPV can cause genital warts, while others increase the risk of cervical cancer. The safest protection is provided by vaccination with a nine-valent vaccine. In Germany, all statutory health insurance companies pay for the vaccination up to the age of 18, and most up to the age of 25. If you are older, you will unfortunately have to pay for the vaccination yourself, but it is the only protection against HPV transmission, the best protection against genital warts, and an effective cancer screening measure. Cancer screening also includes regular cervical smears (Pap smears).

In Germany, Pap smears are offered as part of the statutory cancer screening program for women aged 20 and over and are covered by health insurance. Recommendations and intervals vary depending on age group. These Pap smears are important for all people with a cervix, regardless of sexual orientation. So, don't forget your preventive care appointments—they are an important part of your health! You can find more information about HPV at FP-Beratung, for example, in their article on HPV infections. At s.a.m health, we deliberately do not offer HPV testing, as it only makes sense in the context of cancer screening. Don't let other providers who recommend regular HPV home tests unsettle you.

Herpes (HSV-1 and HSV-2): Herpes is transmitted through contact between mucous membranes and fluid from herpes blisters, including oral, genital, and anal contact, as well as through shared sex toys. Both oral and genital herpes (HSV-1 and HSV-2) can be transmitted during sexual activity between women. If you currently have active cold sores, tell your partner that you cannot kiss or lick right now because a primary infection, especially in the vaginal area, is very painful. HSV tests only make sense for diagnostic confirmation if your doctor is unsure whether the vaginal burning sensation you are experiencing is herpes. 

Bacterial infections:

Chlamydia and gonorrhea: These bacterial infections are transmitted through direct (cunnilingus) or indirect (hands, shared sex toys) mucous membrane contact. These infections often have no symptoms. If you want to be sure that you cannot pass on chlamydia or gonorrhea, you can get tested by your gynecologist or through s.a.m health.

Syphilis: Syphilis is transmitted through direct contact with infected areas, which can occur during oral, vaginal, or anal sex. Although syphilis is very rare in the context of lesbian sex, transmission is possible and should not be forgotten, as undetected syphilis can have serious consequences. That is why it is also included in the range of services offered by s.a.m health.

Parasitic infections

Trichomoniasis: Trichomoniasis is caused by a tiny parasite called Trichomonas vaginalis and is transmitted during sexual intercourse; from mucous membrane to mucous membrane, through the shared use of vaginally inserted sex toys, fingering, etc. Whether regular testing is advisable is a matter of controversy. s.a.m health tends to believe that it is not necessary. Trichomoniasis often has no symptoms. In the event of unusual discharge (often yellowish-green, foamy, and foul-smelling), itching, burning, redness, or swelling of the vulva, or pain during urination or sex, we consider a diagnosis in a medical context to be appropriate.

HIV: The transmission of HIV between women is very rare, but it is possible through the exchange of bodily fluids such as menstrual blood or vaginal secretions, as well as through shared sex toys. Non-sexual risk factors such as sharing needles should also be taken into account. For those who have frequently changing sexual partners, pre-exposure prophylaxis (PrEP) could be an effective method of HIV prevention. Your doctor can tell you more about this. Regular testing helps you to know your HIV status. Even though transmission is very rare, it is good to be aware that it is possible in certain situations, especially for women who also have sex with men. 

Safer sex practices for lesbian sex

Safer sex refers to techniques that significantly reduce the risk of HIV infection. HIV transmission during lesbian sex is so rare that some people consider lesbian sex to be safer sex in itself. 
If you want to further reduce the risk of transmitting sexually transmitted diseases during sexual activities between women, you can use the following barrier methods.

Barrier methods

• Dental dams: A dental dam is a thin, rectangular piece of latex or polyurethane foil that can be used as a barrier during oral sex on the vulva or anus. It prevents direct contact with bacterial pathogens. If you decide to use one, use a new dental dam for each partner and each sexual act.
• Condoms for sex toys: Use condoms for sex toys, especially if they are shared or used for anal intercourse before vaginal intercourse. Change condoms between partners and clean your toys according to the manufacturer's instructions.
• Gloves/finger cots: If you have bleeding injuries on your hands or fingers, latex gloves or finger cots may be useful when manually stimulating the genitals or anus. Use sufficient amounts of suitable lubricant.

Open communication

• Talk openly with your partner about sexual health and sexually transmitted diseases.
• Get tested regularly for sexually transmitted diseases, especially with new partners. For lesbian women, chlamydia and, if necessary, gonorrhea are significant.
• Discuss safer sex practices and, if applicable, other sexual partners. Open and honest communication about your desires and needs is the basis for a relaxed sex life.

Hygiene and caution

• Washing your hands before and after sex helps.
• Avoid sexual contact if your partner has open wounds in the vaginal area or symptoms of a sexually transmitted disease.
• Use lubricant to minimize the risk of tears and irritation.

Organizations and resources for further information and support

Here you will find further contact points and information on the topic of lesbian safer sex that can support you:

• Deutsche Aidshilfe (DAH): On the German AIDS Federation website, you can find comprehensive information about HIV/AIDS and other STIs for all genders and sexual orientations.
• Local AIDS support organizations: Often offer specific counseling services and testing. You can find the partner checkpoints of samhealth.de on our website.
• Federal Institute for Public Health (BIÖG): The BIÖG is an important source of information and resources in the field of public health, including sexual health.
• Health departments: Usually offer free and anonymous STI testing and counseling that is accessible to everyone.
• Doctors: Gynecologists and family doctors can give you detailed advice on sexual health and perform tests, regardless of your sexual orientation. It is important to find doctors who you feel comfortable with and who understand your needs. Community-based doctors or practices that are known for their openness towards queer patients can be particularly helpful here.
• Queermed: Queermed is a directory that lists queer-friendly healthcare professionals and can help you access non-discriminatory care. It helps you find practices and therapists who are knowledgeable and sensitive about sexual orientation and gender identity.
• LGBTQ+ organizations: Many organizations offer information and support on health issues.