Can Candidiasis Be Transferred to a Sexual Partner?
Vulvovaginal candidiasis is not traditionally considered a sexually transmitted disease, and routine treatment of male sexual partners is not recommended by the CDC. 1, 2
Understanding Sexual Transmission
While candidiasis can occasionally be transmitted during sexual contact, this is not the primary mechanism of infection:
- Candida species can be sexually transmitted between partners, with documented transmission of isolates (including fluconazole-resistant strains) between HIV-infected partners, though this represents a minority of cases 1
- Sexual transmission appears more relevant in specific contexts: epidemiological evidence suggests that anogenital and especially orogenital contact can transmit Candida, particularly in cases of recurrent vulvovaginal candidiasis 3
- The contribution of sexual transmission to disease pathogenesis remains limited: only 17.2% of heterosexual couples showed genetically similar Candida isolates when both partners had positive cultures 4
Why Partner Treatment Is Not Routinely Recommended
The evidence strongly supports a non-sexual transmission model for most cases:
- Approximately 10-20% of women normally harbor Candida species in the vagina without symptoms, indicating that colonization does not equal infection 5, 2
- Male genitalia do not represent a relevant reservoir for recurrent vulvovaginal candidiasis: women with recurrent disease were significantly more likely to have Candida-negative sexual partners (83.3% negative) compared to women with non-recurrent disease (31.8% negative) 4
- Treatment of male sex partners has not been shown to alter the clinical course or relapse/reinfection rate in women 1
When to Consider Partner Evaluation
There are specific circumstances where partner involvement may be warranted:
- Male partners with symptomatic balanitis (penile inflammation with redness, itching, or discharge) may benefit from topical antifungal therapy 6
- For women with recurrent vulvovaginal candidiasis (≥4 episodes annually), partner treatment may be considered as part of a comprehensive management strategy, though evidence remains limited 2
- In HIV-infected couples, examination of partners is recommended due to documented transmission of resistant isolates 1
Important Clinical Caveats
- Recurrent infections are more likely due to gastrointestinal reservoir reinfection, impaired host defenses, or persistent vaginal colonization rather than sexual reintroduction 7
- Women who have sex with women show increasing odds of candidiasis with greater numbers of female sexual partners, raising the possibility of transmission between women, though specific sexual practices were not independently associated 8
- Focus treatment on the symptomatic woman using either topical azole therapy for 1-7 days or oral fluconazole 150 mg as a single dose, both achieving >90% response rates 5, 2