Guidance

Zika virus: preventing infection by sexual transmission

Guidance on sexual transmission of the Zika virus and ways to prevent this.

Risk of Zika virus sexual transmission

The greatest likelihood of acquiring Zika virus infection is from travelling to a country with high or moderate Zika virus risk. However, sexual transmission of Zika virus is occasionally reported.

While Zika is usually an asymptomatic or mild illness for the majority of people, it presents the greatest risk to the developing fetus. It is therefore imperative that women who are pregnant take enhanced measures to avoid exposure to Zika virus, including during sexual contact.

Women who are planning a pregnancy and may be exposed to Zika virus (either through travel or from their sexual partner), should also take enhanced precautions during the specified risk periods to prevent pregnancy and exposure to the virus (see below).

Recommendations for prevention

Public Health England (PHE) continues to review the current evidence for sexual transmission of Zika virus, and notes the advice from the WHO which is highly precautionary.

Based on all the available information to date and in line with other international guidance, including from the European Centre for Disease Prevention and Control (ECDC), PHE advises the following risk and evidence-based measures for individuals who may have been exposed to Zika virus (defined as either travellers returning from an area with high or moderate Zika virus risk or individuals who have had unprotected sexual contact with a potentially infectious partner).

Barrier method options recommended for preventing Zika virus transmission include male or female condoms for penetrative sex (including sex toys) and male or female condoms or dental dams for oral-genital or oral-anal sexual contact. Sex toys should not be shared. To increase their effectiveness barrier methods should be used consistently and correctly, for the entire duration of sexual contact.

Individuals with further concerns regarding potential sexual transmission of Zika virus and options for contraception should contact their GP for advice.

Advice on preventing sexual transmission of Zika virus is precautionary and is constantly under review as more information becomes available.

Advice for individuals at greatest Zika virus risk

For detailed advice for specific countries use the A to Z listing and the NaTHNaC country information pages.

Advice for pregnant women and their sexual partners

Travelling to high or moderate risk countries/areas

  • Consistent use of barrier methods (see above) for vaginal, anal and oral sex during and after travel is advised to reduce the risk of the developing fetus being exposed to Zika virus
  • Barrier methods should be continued for the duration of the pregnancy if the couple both travelled, or if just the male partner travelled
  • Couples should use barrier methods even in the absence of Zika symptoms

Travelling to low risk countries/areas

  • No specific precautions required

Advice for couples planning pregnancy

Travelling to high or moderate risk countries/areas

Consistent use of effective contraception and barrier methods (e.g. condoms) for vaginal, anal and oral sex during and after travel is advised to reduce the risk of conception and the developing fetus being exposed to Zika virus

These measures should be used even in the absence of symptoms while travelling and if:

  • Both partners travelled, for 6 months after return or after last possible Zika virus exposure*
  • Male traveller only, for 6 months after return or after last possible Zika virus exposure*
  • Female traveller only, for 8 weeks after return or after last possible Zika virus exposure*

*Last possible Zika virus exposure is defined as the date of leaving an area with high or moderate Zika virus risk, or the date on which unprotected sexual contact with a potentially infectious partner took place.

Travelling to low risk countries/areas

  • No specific precautions required

Further information

Zika virus sexual transmission

Most Zika virus infections are transmitted via Aedes mosquitoes, however, a relatively small number of cases of sexual transmission of Zika virus have been reported. The vast majority of cases have involved men who experienced typical Zika symptoms at or before the estimated time of sexual transmission to their female partners.

Transmission of Zika virus from a female to a male sexual partner, and from a male to a male sexual partner has also been reported but these appear to be very rare events.

Zika virus in the genital tract

Zika virus has been shown to be present in semen and vaginal secretions. The virus persists longer in semen than in the female genital tract, but the viral RNA detected is not necessarily infectious.

Published 26 January 2016
Last updated 6 March 2018 + show all updates
  1. Removed the link to Human Fertilisation and Embryology Authority (HFEA) while HFEA update their website.
  2. Updated to reflect changes in travel and sexual transmission advice and revised Zika virus risk ratings.
  3. Revised advice on the duration of precautions to prevent sexual transmission.
  4. Revision, update and clarification
  5. Added additional advice regarding deferral of pregnancy in recommendations for prevention.
  6. Clarification of modes of sexual transmission
  7. First published.