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Information for Sexually Active People

two gay or bisexual men standing together

Gay, bisexual, and other men who have sex with men (MSM) are at risk for Shigella infections.

Shigella germs are found in the stool (poop) of sick people when they have diarrhea and for up to two weeks after the diarrhea has gone away. Shigella infection is spread when people put something (for example, a finger, food, or objects) in their mouths or swallow something that has come into contact with stool of someone sick with shigellosis. This includes exposure to stool through sexual contact. Men who have sex with men (MSM) are more likely than others to get infected with Shigella that is resistant to antibiotics commonly used to treat adults who have shigellosis 1-6. Please see the Antibiotic Resistance page for more information.

Practice Safer Sex

The following recommendations can help prevent the spread of Shigella germs during sex.

Sick people may have Shigella germs on their skin in the anal and genital areas, including the thighs and buttocks. You cannot tell if someone has Shigella germs in these areas just by looking at them.  To protect yourself and your partners from Shigella, follow these steps:

  • Wait to have sex (vaginal, anal, and oral) for one week after you no longer have diarrhea. Because Shigella germs may be in stool for several weeks, follow safe sex practices, or ideally avoid having sex, for several weeks after you or your partner have recovered.
  • Reduce your contact with poop during sex by:
    • Washing your hands, genitals, and anus with soap and water before and after sexual activity.
    • Using barrier methods during sex. Barrier methods include condoms, dental dams, and cut-open condoms. Sex includes oral (mouth-to-penis, mouth-to-vagina, mouth-to-anus), anal (penis-to-anus), and vaginal (penis-to-vagina) sex. Using latex gloves during anal fingering or fisting.
    • Using condoms the right way, every time you have anal and vaginal sex, which will also help prevent other sexually transmitted infections.
    • Washing your hands with soap and water immediately after touching a used condom or other barrier method.
    • Washing sex toys with soap and water after each use, and washing hands after touching used sex toys.

The term “men who have sex with men” is used in CDC surveillance systems because it indicates men who engage in behaviors that may transmit Shigella infection, rather than how someone identifies their sexuality.

More Information

The following resources provide information about Shigella infections for sexually active people and their healthcare provider.

References
  1. Gaudreau C, Barkati S, Leduc JM, Pilon PA, Favreau J, Bekal S. Shigella spp. with reduced azithromycin susceptibility, Quebec, Canada, 2012-2013. Emerg Infect Dis. 2014;20(5): 854–6.
  2. Gaudreau C, Ratnayake R, Pilon PA, Gagnon S, Roger M, Levesque S. Ciprofloxacin-resistant Shigella sonnei among men who have sex with men, Canada, 2010. Emerg Infect Dis. 2011;17(9):1747-50.
  3. Hoffmann C, Sahly H, Jessen A, Ingiliz P, Stellbrink HJ, Neifer S, Schewe K, Dupke S, Baumgarten A, Kuschel A, Krznaric I. High rates of quinolone-resistant strains of Shigella sonnei in HIV-infected MSM. [PDF – 5 pages] Infection. 2013;41(5):999-1003.
  4. Heiman KE, Karlsson M, Grass J, Howie B, Kirkcaldy RD, Mahon B, Brooks J, Bowen A. Notes from the field: Shigella with decreased susceptibility to azithromycin among men who have sex with men – United States, 2002-2013. MMWR Morb Mortal Wkly Rep. 2014;63(6):132-3.
  5. Bowen A, Eikmeier D, Talley P, Siston A, Smith S, Hurd J, Smith K, Leano F, Bicknese A, Norton C, Campbell D. Notes from the Field: Outbreaks of Shigella sonnei infection with decreased susceptibility to azithromycin among men who have sex with men – Chicago and Metropolitan Minneapolis-St. Paul, 2014. MMWR Morb Mortal Wkly Rep. 2015;64(21):597-8.
  6. Bowen A GJ, Bicknese A, Campbell D, Hurd J, Kirkcaldy R. Elevated risk of multidrug-resistant Shigella infections among men who have sex with men—United States, 2011– 2015. Emerg Infect Dis. 2016;22(9):1613-16.
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