The epidemiologic effects of Zika virus (ZIKV) sexual transmission in virus-endemic countries remain unclear. We conducted a 2-level, linear mixed-effects logistic regression analysis by using a recently acquired population-based ZIKV and chikungunya virus (CHIKV) serologic dataset obtained from persons residing in Northeast Brazil (n = 2,070 participants). We adjusted mathematical models for housing type and age of participants; the models indicated a significantly higher likelihood of ZIKV seropositivity among persons engaged in a sexual relationship within the same household (odds ratio 1.25 [95% CI 1.00–1.55]; p = 0.047), regardless of their partner’s ZIKV serostatus, and among participants with a ZIKV-seropositive sex partner within the same household (odds ratio 1.54 [95% CI 1.18–2.01]; p = 0.002). CHIKV was also modeled as a control; no sex-associated effects were observed for CHIKV serology. Inclusion of ZIKV sexual transmission in prevention and control strategies is urgently needed, particularly in ZIKV-endemic regions.

寨卡病毒 （ZIKV） 性传播对病毒流行国家的流行病学影响尚不清楚。我们使用最近获得的基于人群的 ZIKV 和基孔肯雅病毒 （CHIKV） 血清学数据集进行了 2 级线性混合效应 logistic 回归分析，该数据集是从居住在巴西东北部的人 （n = 2,070 名参与者） 获得的。我们调整了住房类型和参与者年龄的数学模型;模型表明，无论伴侣的 ZIKV 血清状态如何，同一家庭内发生性关系的人发生 ZIKV 血清阳性的可能性显著更高（比值比 1.25 [95% CI 1.00-1.55];p = 0.047），以及同一家庭内有 ZIKV 血清阳性性伴侣的参与者（比值比 1.54 [95% CI 1.18-2.01];p = 0.002）。CHIKV 也被建模为对照;CHIKV 血清学未观察到性别相关影响。迫切需要将 ZIKV 性传播纳入预防和控制策略，尤其是在 ZIKV 流行地区。