HIV serology in artificially inseminated lesbians

The purpose of this investigation was to examine the risks of HIV transmission from artificial insemination in a sample of lesbians residing in California and inseminated between 1979 and 1987. This population was selected because lesbians are considered to be at low risk for HIV infection, and have traditionally used semen from men engaging in high-risk behaviors, namely, homosexual men. Each of the 98 participants had blood drawn for the HIV antibody test (ELISA) and completed a questionnaire inquiring about her sexual, health, and reproductive history, including detailed information about her inseminations (e.g., vaginal vs. uterine, fresh vs. frozen semen, sexual orientation, and antibody status of donor). One-half of the women had homosexual or bisexual donors, many of whom resided in the San Francisco Bay area; most of these inseminations were with fresh semen. The women reported a marked decline in the use of homosexual donors after 1982 and a corresponding increase in the use of donations from sperm banks and health practitioners. Based on the women's reports, as many as 11 women may have received semen from an infected donor. However, none of the 98 women tested seropositive. We attribute our negative findings to the change to low-risk donors in the years when HIV became more prevalent in the population, and to the potentially lower rates of infectivity with artificial insemination than with heterosexual intercourse. Nevertheless, we recommend that women continue to follow the CDC guidelines for screening donors prior to artificial insemination.