Is Sexual Transmission of Chagas Disease Possible? Evaluating the Evidence and Future Directions.

Trypanosoma cruzi is the etiological agent of Chagas disease, traditionally transmitted by triatomine vectors. However, experimental and clinical evidence suggest a possibility that the parasite could also be transmitted sexually. In animal models, T. cruzi amastigotes and trypomastigotes have been identified in reproductive tissues and semen, and infection has been experimentally transmitted between mating partners. In humans, the presence of the parasite in menstrual blood, semen, and other genital secretions has been reported, raising the possibility of sexual transmission in both endemic and non-endemic settings. This potential route could contribute to the persistence of infection and the development of congenital cases. Here, we review the current evidence supporting the biological plausibility and experimental demonstration of sexual transmission of T. cruzi, and highlight key research priorities to clarify its clinical and epidemiological significance.