Zika and Sex - What Should I know?

Since the Zika virus is a new disease to most Americans, and the stories in the media have been confusing, the Centers for Disease Control and Prevention (CDC) updated their recommendations to enable people to make more informed decisions.

According to the CDC, the primary questions people are asking about the Zika virus are as follows:

1. Is there a vaccine for Zika?  The answer is, not at this time. But, there are various vaccine candidates currently in clinical trials.
2. Which medicines can treat Zika?  The answer is, there are not specific medications available to treat Zika. If you are taking medicine for another medical condition, talk to your healthcare provider before taking additional medication to treat the Zika virus.
3. Can infants be affected by Zika?  Yes, when a woman obtains the Zika virus during pregnancy, her infant may have microcephaly and another severe nervous system defects.

The leading Zika questions and answers regarding sex, travel and prevention are also available from the CDC:

• Traveling to an area with known risk of the Zika virus:
  • Pregnant women should NOT travel to areas with risk of Zika. If a pregnant woman must travel to one of these areas, she should talk to her healthcare provider first. Learn more about protecting your pregnancy.
  • If a pregnant woman or her partner travel to an area with risk of Zika, the couple should use condoms from start to finish every time they have sex or not have sex for the entire pregnancy, even if the traveler does not have symptoms of Zika or feel sick.
• What kind of sexual activity puts someone at risk for Zika if their partner is infected?
  • The Zika virus has been detected in semen, vaginal fluids, saliva, urine, and breast milk. However, there is no evidence at present that Zika can be transmitted through saliva during deep kissing.
  • A person with Zika can transmit the virus to his or her partner(s) through vaginal sex, anal sex, and likely, oral sex.
  • There is documented evidence of sexual transmission of Zika from male-to-female, male-to-male, and female-to-male sex partners. Female-to-female sexual transmission has not yet been reported, but is biologically plausible.
• Can infected people have Zika in genital secretions and transmit it to their sex partners?
  • Studies are underway to help us better understand when and under what circumstances Zika can be transmitted sexually. Specifically, scientists are studying semen and vaginal secretions to understand the incidence of viral shedding, the concentrations of virus, and the duration and pattern (e.g., steady decline, intermittent on/off) of viral shedding in genital secretions of symptomatic and asymptomatic individuals.
  • Sexual transmission from an asymptomatically infected male has been reported. People with symptomatic illness have transmitted Zika before they had symptoms, while they had symptoms, and after symptoms resolved. We do not know how long after infection men can no longer transmit Zika sexually.
• How long can Zika be transmitted to sex partners after initial infection?
  • Our knowledge is growing rapidly but we don’t yet know exactly how long infected people can transmit Zika sexually. Detection of Zika virus RNA in semen has been reported up to 188 days after illness onset.
  • It is important to note that the presence of Zika virus RNA does not necessarily represent the presence of an infectious virus. Even so, current evidence suggests a longer precautionary period recommended for men with Zika, taking into consideration that there is evidence of the Zika virus RNA persisting in the semen of infected men after they have recovered from illness.  We don’t yet know how long it takes for an infected man’s semen to clear the virus.
  • And that we don’t have good evidence that Zika illness differs between infected men with symptoms and infected men who never develop symptoms.
• Should people who have been in areas with risk of Zika take precautions to prevent sexual Zika transmission to their partners?
  • Yes, especially if their partner is pregnant. Men and women who have traveled to or live in an area with risk of Zika and who have a pregnant sex partner should use a condom every time they have vaginal, anal, or oral sex or abstain from sex for the duration of the pregnancy.
  • This is important even for those who are asymptomatic. Most people who are infected do not have symptoms and it is possible that an asymptomatic person can transmit Zika through sex.

The CDC recommends people should visit their local healthcare provider with any specific questions related to the Zika virus.

To understand more about Zika virus infection, the CDC established the Zika Pregnancy Registry and is collaborating with state, tribal, local, and territorial health departments to collect information about pregnancy and infant outcomes following laboratory evidence of Zika virus infection during pregnancy.

If you are a healthcare provider with questions about the registry, please call 770-488-7100 and ask for the Zika Pregnancy Hotline.