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Female-to-Female Transmission of HIV. Research on female-to-female transmission of HIV has been virtually absent and continues to constitute a gap in the scientific literature on HIV transmission. The only study to date of HIV-serodiscordant lesbian couples (i.e., where one partner is HIV positive and the other HIV negative) was conducted in Italy and found that among the 18 lesbian couples participating in the study there were significant rates of high-risk sexual activities, but there was no evidence of female-to-female transmission of HIV (Raiteri et al., 1994a). Although the validity of these findings has been questioned owing to the small sample size and limited follow-up, they are consistent with the small number of identified cases of potential female-to-female transmission in the United States (Marmor et al., 1986; Monzon and Capellan, 1987; Perry et al., 1989). More systematic attempts to identify cases of female-to-female transmission of HIV are currently underway by the CDC (CDC, 1996). The lack of information about female-to-female transmission of HIV is particularly problematic for serodiscordant couples. Understanding the relationship of self-defined sexual identity, sexual behaviors, and risk of HIV infection is critical for all populations of WSW.
Substance Use Among Lesbians
In the 1996 National Household Survey on Drug Abuse (SAMHSA, 1997) 4.2% of women surveyed reported some illicit drug use during the past month (e.g., marijuana, cocaine, hallucinogens, heroin). About 10% of 15- to 44-year-old pregnant women and women with children in the household reported illicit drug use during the previous year; about 19% of women with no children reported such use. Slightly more than 40% of women aged 15 to 44 reported some previous use of illicit drugs during their lifetime. Alcohol use in the past month was reported by 43.6% of women surveyed; 8.7% reported binge alcohol use, and 1.9% reported heavy alcohol use.
Use of Alcohol Among Lesbians.21 Data on the use of alcohol among lesbians are not available from population-based samples or large-
This section is based largely on the workshop presentation made by Dr. Tonda Hughes.