Sexually transmissible bacterial enteric pathogens.

Bacterial enteric pathogens can be transmitted through sexual contact, with gay, bisexual, and other men who have sex with men (gbMSM) being particularly at risk. The factors and dynamics involved in sexual transmission of bacterial enteric pathogens remain incompletely understood. Intestinal pathogens with a low infectious dose, particularly Shigella spp., followed by Campylobacter spp., which has a relatively higher infectious dose, are more likely to spread through sexual contact. Asymptomatic carriers of bacterial enteric pathogens may play a role in transmission through sexual activity. Recommendations for prevention of sexual transmission of bacterial enteric pathogens include engaging in less risky sexual behavior, minimizing oral-anal contact during sexual activity, maintaining good personal hygiene, and using protective measures such as cleaning sex toys. If a partner has diarrhea, it is recommended to avoid sexual contact during active illness and for at least 1 to 2 weeks after the symptoms have resolved. In addition, oral-anal contact should be avoided for 4 to 6 weeks following resolution of symptoms. Increasing awareness of the possible sexual transmission of bacterial enteric pathogens among at-risk groups is essential for encouraging behavioral changes. Similarly, raising awareness among clinicians that care for at-risk groups is essential for providing appropriate counseling and improving patient management.