ALBUQUERQUE, N.M. (AP) — Three women who were diagnosed with HIV after getting “vampire facial” procedures at an unlicensed New Mexico medical spa are believed to be the first documented cases of people contracting the virus through a cosmetic procedure using needles, federal health officials said.

The Centers for Disease Control and Prevention said in its Morbidity and Mortality Report last week that an investigation into the clinic from 2018 through 2023 showed it apparently reused disposable equipment intended for one-time use.

Although HIV transmission from contaminated blood through unsterile injection is a well-known risk, the report said this is the first documentation of probable infections involving cosmetic services.

Many popular cosmetic treatments are delivered with needles, such as Botox to iron out wrinkles and fillers to plump lips. A “vampire facial,” or platelet-rich plasma microneedling procedure, involves drawing a client’s own blood, separating its components, then using tiny needles to inject plasma into the face to rejuvenate the skin. Tattoos also require needles.

The New Mexico Department of Health began investigating the spa in the summer of 2018 after it was notified that a woman in her 40s had tested positive for HIV even though she had no known risk factors. The woman reported exposure to needles through the procedure at the clinic that spring.

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The spa closed in fall 2018 after the investigation was launched, and its owner was prosecuted for practicing medicine without a license.

The report said the investigation showed how important it is to require infection control practices at businesses that offer cosmetic procedures involving needles.

It also noted that the investigation was slowed by poor record keeping and said businesses providing such services should keep better records in case clients need to be contacted later.