Zika virus infection sexual transmission

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Nate Michalak, B.A.; Serge Korjian M.D.; Yamuna Kondapally, M.B.B.S[2]

Overview

Zika can be passed through sex from a person with Zika to his or her partners. The recommended length of time for safer sex practices includes 8 weeks to 6 months in males and 8 weeks in females depending on symptoms.

Sexual transmission

  • Zika can be passed through sex from a person with Zika to his or her partners.[1]
  • Vaginal sex
  • Anal sex
  • Oral sex
  • Sharing of sex toys
  • Zika can be transmitted through sex, even if the infected person does not have symptoms at the time. It can be passed during following periods:
  • Before the symptoms start
  • During the symptomatic period
  • After the symptoms end
  • Infected person without any symptoms at all

Prevention

The recommended length of time for safer sex practices iclude:[2]

  • Asymptomatic males:
    • Asymptomatic males returning from areas with active Zika virus transmission was extended from 8 weeks to 6 months.
  • Symptomatic males:
    • The recommended length of time for safer sex practices for symptomatic males is 6 months.
  • Females:
    • The recommended length of time for safer sex practices for asymptomatic and symptomatic females is 8 weeks.
How Long to Wait Before Attempting to Have a Baby in Zika Endemic areas
Presence of Symptoms Women Men
Zika symptoms At least 8 weeks after symptoms start At least 6 months after symptoms start
No Zika symptoms Talk with doctor or healthcare provider Talk with doctor or healthcare provider

Safe sex practices

Safe sex practices which decreases the risk of transmission of ZIKV include:

  • Condoms
  • Includes male and female condoms
  • To be effective, condoms should be used from start to finish, every time during vaginal, anal, and oral sex and the sharing of sex toys
  • Dental dams (latex or polyurethane sheets) may also be used for certain types of oral sex (mouth to vagina or mouth to anus).
  • Do not share sex toys

Recommendations

WHO recommendations in regions with active Zika virus transmission include:

  • The information on risks of sexual transmission of Zika virus should be provided to all people (male and female) with Zika virus infection and their sexual partners (particularly pregnant women).
  • Men and women are counselled on safer sexual practices.
  • Sexually active men and women are counselled regarding the contraception and to make an informed choice about when to become pregnant, in order to prevent possible adverse pregnancy and fetal outcomes.
  • Women who have had unprotected sex and do not wish to become pregnant due to concerns about Zika virus infection will have access to emergency contraceptive services and counselling.
  • Pregnant women should practice safer sex or abstain from sexual activity for at least the whole duration of the pregnancy.

WHO recommendations in regions with NO active Zika virus transmission:

  • Men and women returning from Zika endemic areas should adopt safer sex practices or consider abstinence for at least 6 months.
  • Couples or women returning from Zika endemic areas who are planning for pregnancy, are advised to wait atleast 6 months.
  • Pregnant women should practice safe sex or abstain from sexual activity for at least the whole duration of the pregnancy.

Read the CDC infographic on prevention of ZIKV through sexual transmission [3]

For People Who Have Traveled to an Area with Zika
If you are pregnant Pregnant women should not travel to areas with Zika. If you must travel to an area with Zika, talk to your healthcare provider.
If your partner is pregnant Use condoms correctly, every time you have vaginal, anal, or oral sex or do not have sex for the entire pregnancy.
If you and your partner are planning a pregnancy Discuss your plans for pregnancy with a healthcare provider to determine your risk and the options available.
If you or your partner are not pregnant and are not planning a pregnancy Men - consider using condoms or not having sex for at least 6 months after travel (if you don’t have symptoms) or for at least 6 months from the start of symptoms (or Zika diagnosis) if you develop Zika.
Women- consider using condoms or not having sex for at least 8 weeks after travel (if you don’t have symptoms) or for at least 8 weeks from the start of symptoms (or Zika diagnosis) if you develop Zika.


For People Living in an Area with Zika
If you or your partner are pregnant Use condoms from start to finish, every time you have vaginal, anal, or oral sex or do not have sex for the entire pregnancy.
It is also very important to see a healthcare provider to discuss your options during pregnancy
If you and your partner are planning a pregnancy Discuss your plans for pregnancy with a healthcare provider to determine your risk and the options available.
If you or your partner are not pregnant and are not planning a pregnancy Consider using condoms or not having sex as long as there is Zika in the area. If either you or your partner develop symptoms of Zika or have concerns, talk to a healthcare provider and follow the guidelines on the left.

Pregnant couples

  • The risk of birth defects is high in ZIKV infected mothers. Pregnant women with partners who live in or traveled to an area with Zika should protect themselves for the entire pregnancy. The precautions to be taken by the partners to prevent ZIKV infection include:
  • Use condoms
  • Do not share sex toys
  • Prevent mosquito bites (travelers should prevent mosquito bites for 3 weeks after returning from Zika-endemic area)
  • Pregnant couples who are concerned that one of them may have Zika should tell their healthcare provider immediately about:
  • Symptoms of Zika
  • Each partner’s travel history
  • How long either partner stayed in an area with Zika
  • If either partner took steps to prevent mosquito bites while in an area with Zika
  • If they had sex without a condom

References

  1. CDC Zika sexual transmission https://www.cdc.gov/zika/prevention/protect-yourself-during-sex.html (October 5, 2016) Accessed on October 6, 2016
  2. Sexual transmission prevention http://apps.who.int/iris/bitstream/10665/204421/1/WHO_ZIKV_MOC_16.1_eng.pdf?ua=1 (September 6, 2016) Accessed on September 21, 2016