News and Views on Sexual Health by Dr. Verity Sullivan
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Feb 2016: The Telegraph: Zika Virus

What's it about?

Some Latin American governments have advised pregnant women avoid getting pregnant for up to 2 years in the face of Zika virus. But how is this possible with poor access to contraception, illegal abortion and high rates of sexual assault?

Zika virus outbreak highlights limited women's reproductive rights

You can also see this article at The Telegraph Online

What's it about?

Some Latin American governments have advised pregnant women avoid getting pregnant for up to 2 years in the face of Zika virus. But how is this possible with poor access to contraception, illegal abortion and high rates of sexual assault?

A confirmed case of sexually transmitted Zika virus has been reported in a patient in Texas prompting fresh concerns about the transmission of a disease already predicted to spread ‘explosively’ throughout the Americas. The patient’s partner had recently returned from Venezuela, a Zika-affected area and demonstrates how the virus can spread to people who have not even visited affected countries.

This is not the first time concerns about sexually transmitted Zika have been raised, with a suspected case reported in Senegal in 2008. The virus was also found in the semen of a man with Zika-symptoms during an outbreak in French Polynesia in 2013.The news that the virus may be transmitted in this way has been described by those in the know as “not unexpected”.

Current advice suggests condom use for up to six months after confirmed infection in men.

As of yet, the Centre for Disease Control and Prevention (CDC) has not made formal recommendations about sex and Zika-virus spread. However guidance, particularly for the partners of pregnant women or women trying to conceive, is expected soon.

It is not yet known how long Zika stays in the semen, but current advice suggests condom use for up to six months after confirmed infection. It is also not yet known if the virus can be sexually transmitted from a Zika-infected woman to a man.

Most Zika infections cause little to no symptoms at all but the main concern is its effect on pregnant women. The virus is thought to cross the placenta and lead to microcephaly, a condition causing an abnormally small head and reduced brain development in the developing foetus. The true relationship between the virus and abnormalities in newborns is not yet fully understood but intense research is ongoing to fully determine its effects. As a result, the CDC has issued special precautions for women who are pregnant or trying for pregnancy.

Governments have advised women to avoid pregnancy for up to two years to avoid Zika-related complications.

Zika has also highlighted the more longstanding problems of women’s reproductive rights in Latin America and the fact that abortion remains illegal in most circumstances in 18 countries of the region, including Brazil where Zika is thought to be most prevalent.

Governments of highly conservative countries such as El Salvador have advised women to avoid pregnancy for up to two years to avoid Zika-related complications, but are not addressing the very real issues of poor contraceptive access and strict abortion laws. El Salvador has one of the highest rates of teenage pregnancy in Latin America, with a third of all pregnancies occurring in under-19s and a law that prohibits abortion in all circumstances. Access to contraceptive services is poor due to lack of resources and stigma attached to seeking sexual healthcare. Unsafe abortion remains a serious public health problem and cause of death and news of the “2 year rule” has sparked concerns of a surge of “back alley” abortions.

Campaigners for women’s reproductive rights are calling on the government to address these concerns, including a groups of Brazilian activists who are asking the Brazilian supreme court to permit abortions for pregnant women who have contracted the virus.

So what does the Zika epidemic mean for you?

  • Men with confirmed Zika virus are currently advised to avoid unprotected sex for 6 months after infection
  • Pregnant women, of all trimesters, should consider postponing travel to Zika-affected areas
  • If travel is essential, pregnant women and those trying to conceive should chat with their doctor and follow strict steps to avoid mosquito bites: cover up with long-sleeved/legged clothing, sleep with a mosquito net and use insect repellent. Always check the label to ensure they are safe for use in pregnancy. Be especially vigilant during the day which is when the Aedes mosquito is active
  • Pregnant women with symptoms of Zika, including fever, rash, joint pain or red eyes who have travelled to a Zika-affected area should see their doctor
  • Zika testing in all pregnant women who have visited an affected country is currently not recommended
  • It is thought once the virus is cleared from the blood that Zika won’t pose a threat to future pregnancies. Zika usually remains in the blood for about a week. If you’re contemplating pregnancy and have just visited a Zika-infected area, see your doctor

For further information see:  Centres for Disease Control and Prevention