Concerns about the fast spread of the Zika virus in the Americas are keeping public health officials on their toes, and discussion about the often uncomfortable topic of sexual tourism is emerging as a sort of side effect.

As recently reported by The Costa Rica Star, the first endemic case of the Zika virus in our country appears to have been contracted by a tourist from the United States. The tourist traveled to a yoga retreat in Nosara, in the province of Guanacaste, in late December. The tourist later fell ill after returning to the United States, and tested positive for the virus in mid-January. The Centers for Disease Control (CDC) alerted Costa Rican health authorities on January 29th.

Sexual Transmission of the Zika Virus

Only a few days after the CDC announcement, Costa Rica was placed on a list of Zika hotspots that U.S. travelers should be aware of. Then, another Zika infection was reported in Dallas, and this case involved sexual transmission from an individual who had previously traveled to Venezuela. For the record, Venezuela, Brazil and Colombia are currently the three South American nations with the highest incidence of the Zika virus.

As can be expected, the CDC report of a sexually-transmitted Zika virus infection has turned attention to the topic of sexual tourism. Prior to the CDC Dallas report, health officials in Brazil investigated the sexual transmission potential of the virus as they evaluated a possible link between Zika pregnancies and microcephaly births. To this effect, Revista Perfil from Argentina reports that travels agencies in various countries are offering pregnant women full reimbursements of their planned trips to Zika hotspots.

German molecular virologist Susanne Modrow, professor of genetics at the Institute for Medical Microbiology and Hygiene at the University of Regensburg, has already recommended that tourists who visit Zika hotspots such as Costa Rica should not have unprotected sex, even with their sole partners, for at least three to four weeks after their return.

Sexual Tourism in Latin America and the Zika Virus

On the topic of sexual tourism and the Zika virus, one municipality in Peru is being proactive. Writing for El Comercio, correspondent Ralph Zapata recently reported on the measures being taken in the Tumbes region, located on the northern border with Ecuador.

Tumbes is a very pretty coastal region of Peru that welcomes about 10,000 visitors each day; most of them are Latin American visitors on extensive tour packages of the Andean regions. Tumbes residents from the Aguas Verdes and Zarumilla regions, located closer to the border with Ecuador, have reacted with extreme concern to the news about the sexual transmission of the Zika virus. Although in recent months there have been no Zika infections and only three cases of dengue diagnosed, municipal health officials are not taking chances; they are distributing mosquito repellent and condoms to local residents, and they are counseling tourists who cross the border about the dangers of sexual tourism at this time.

Brazil will be a major concern with regard to sexual tourism and the Zika virus. As reported by The Costa Rica Star last year, Brazil is considered by many to be the sexual tourism capital of Latin America, and the top city happens to be Rio de Janeiro, which will host the upcoming Summer Olympics. The Brazilian Justice Ministry has been targeting sex tourism and blocked 2,165 websites that promote this activity; however, the number of sites still in operation far exceed those blocked.

Zika Fears Among Prostitutes in Costa Rica

It is estimated that about two percent of all tourists who visit Costa Rica do so for the purpose of engaging in sexual tourism. One local hotspot in this regard is the Del Rey Hotel and Casino in downtown San Jose; this establishment is notoriously known as a meeting place for North American and European male tourists in search of female companionship in Costa Rica.

To get an idea as to what effect the headlines related to the Zika virus may be having on sexual tourism in San Jose, The Costa Rica Star spoke with an informal taxi driver who routinely transports prostitutes -and sometimes their clients- to and from the Del Rey Hotel. Jose Carlos may be familiar to some of our readers; he has given commentary on two previous articles: one about the communities of Hatillo (where he lives), and another about the heroin trade in Costa Rica. It should be noted that Jose Carlos also operates as a retail drug dealer in addition to driving an unregulated taxi.

We asked Jose Carlos to take casual polls among his clients about their familiarity with the Zika virus. He told us that between Friday evening and Sunday morning, he either gave rides or sold drugs to five women who ply their sexual trade at the Del Rey Hotel; four of them were familiar with the Zika headlines, the only one who said she had not heard about it was a younger woman from Nicaragua.

Four of the call girls interviewed by Jose Carlos mentioned that they have discussed the Zika virus headlines with fellow sexual workers. They have not noticed an immediate effect on the number of men visiting the Blue Marlin bar at the Del Rey Hotel, where most of the sexual encounters are arranged. However, the ladies of the night are concerned that some of their co-workers often engage in unprotected sex if the client is willing to pay more or if their judgment is impaired by drugs or alcohol.

Jose Carlos spoke about Vanessa, a veteran of the sexual tourism trade who splits her time between the Del Rey Hotel in San Jose and the Hotel Cocal and Casino in Jaco Beach. Vanessa is more concerned about the younger women who enter the trade; she said they are the most likely to agree to have unprotected sex for money or drugs, and these are the same women who are mostly interested in sleeping with the younger and better looking clients.

According to Jose Carlos, Vanessa thinks that:

“Some of these young girls are so dumb. I mean, they go home with no money because they enjoy turning down guys or they just want to get alcohol and drugs from them. Then they rush to have sex without a condom with any man because their rent is due. These are the same girls whose neighborhood boyfriends are trying to get them pregnant just so they can leave the Del Rey; you know, those are the girls I am worried about, and I tell them to watch the TV news about the Zika virus. I don’t know if they listen.”

Interestingly, the sexual transmission of the Zika virus is a topic currently being discussed on the CostaRicaTicas.com forums, which are mostly frequented by sexual tourists from the United States and Canada.

The issue of sexual tourism and infectious diseases is hardly new to the medical community. In and of itself, travel is an activity conducive to viral and bacterial transmission. In an article written for the British social enterprise FastBleep.com, medical researcher Megan Whittaker of Manchester University notes:

Fever in returning travellers is common; around 8% of travellers to developing countries seek healthcare whilst abroad or after returning home, and over a quarter of such consultations are for fever with or without other symptoms. Far more travellers suffer health problems whilst abroad, but do not seek medical attention.

 

Sexual contact with new partners is common during travel, and sexual tourism is increasing. 19% of travellers have a new partner whilst away, and around 6% of these acquire a sexually transmitted infection. [When physicians treat these patients, the history collected] should include; number of new partners, use of barrier contraception, type of sexual activity [as well as] other potential exposures to blood or body fluids including tattoos, piercings, dental or medical procedures and use of drugs.

Author’s Note: Jose Carlos is not the real name of our informant, and we changed the name of the prostitute whom we quoted herein.