I cast a (somewhat) wide net trying to find out about the risk of HIV transmission through post-SRS vaginal sex. I will post responses as they come in. I posted to the “Ask the Experts” forums on thebody.com and aegis.org, and I sent emails to a few surgeons.
If anyone has read any articles, please let me know where I can find them.
The first response I got was from Dr. Marci Bowers, and this is it:
This is a fascinating subject and something I believe I have heard of previously tho not sure where without a serious wracking of my brain.
As a gynecologist and someone with experience in this area, I can tell you my impression is that it is likely that HIV risk would be higher than in natal born women and for several reasons.
- One, the epithelial lining, although squamous epithelium (excpet in the rarely done colon segment procedures) lines the post-GRS vagina, it is thinner, much thinner than in natal females. There is also less to very little cornification yielding further risk. There is no transudation across the vaginal epithelium altho I do not know how that might affect risk in either direction.
- Secondly, some postops bleed, probably as a result of the thinner epithelium, with penetration, adding obvious risk but also due to other factors such as granulation tissue and vaginal strictures or scarring.
- Finally, I know that some postops still enjoy or opt for rectal penetration, despite the presence of a functional vagina, for whatever reasons.
Are you considering study in this area or what are your thoughts?
Marci Bowers, MD/ http://www.marcibowers.com / San Francisco Office: 66 Bovet Road, Ste. 101, San Mateo, CA 94402 Phone: (877) 439-2244 • FAX: (877) 439-9922/ Seattle Office: 1229 Madison #840 Seattle, WA 98101 Phone: (206) 328-3200 • FAX: (206) 328-4636/ Admin office: P.O. Box 1044, Trinidad, CO 81082 (719) 846-6300