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The investigators note that this is the "first reported case of female-to-female sexual transmission of HIV supported by identification of similar HIV genotypes in the source patient and the recipient".Risk factors which have been suggested in sex between women include: This content was checked for accuracy at the time it was written.All of these women had other risk factors: either injecting drug use or vaginal intercourse with men.

The couple’s sexual practices included the sharing of sex toys, and oral sex.

These activities did not occur during menstruation, but sex toys had occasionally been used vigorously enough to draw blood.

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The woman had been in a monogamous lesbian relationship for the past two years, and denied having had any other sexual partners, male or female.

She had never injected drugs or received blood products, and had no tattoos or body piercings.

Doctors suggest the woman may have been infected through sharing sex toys after drug-resistance tests found striking similarities between the genotypes of the woman and her female HIV-positive partner.

The case concerns a 20-year-old woman, from Philadelphia, who presented with HIV infection having had a negative HIV test result six months earlier.

A medical examination established that the woman was in good health with no evidence of injecting drug use, or nasal damage from cocaine snorting.

The woman also had good oral health, which physicians took to mean that oral transmission could be ruled out.

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