References UK clinical guidance from the NHS, the British HIV Association (BHIVA), and the British Association for Sexual Health and HIV (BASHH). Last updated: April 2026.
Shigella is a bacterial infection that causes severe diarrhoea, stomach cramps and fever. It spreads through the faecal-oral route — contaminated food, water or during sexual activities involving oral-anal contact. Outbreaks of sexually transmitted shigella have been documented in MSM communities in the UK and globally, and antibiotic resistance is a growing concern.
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Symptoms
- Severe watery or bloody diarrhoea
- Stomach cramps
- Fever
- Nausea
- Urgency to pass stools
- Symptoms usually start 1-3 days after exposure
How It Spreads Sexually
| Activity | Risk |
|---|---|
| Rimming (oral-anal contact) | Main sexual route |
| Anal sex followed by oral contact | High |
| Contaminated fingers or toys | Moderate |
| Kissing after rimming | Possible |
Treatment
- Most cases resolve on their own with fluids and rest
- Severe cases may need antibiotics
- Antibiotic resistance is common — culture and sensitivity testing guides treatment
- Stay hydrated
Prevention
- Thorough hand washing after sexual contact
- Avoid oral-anal contact if either partner has gut symptoms
- Use dental dams for rimming
- Hepatitis A vaccination (protects against a different faecal-oral infection)
Antibiotic Resistance
Drug-resistant shigella has been a growing problem, particularly in MSM networks. This is why stool cultures are important for guiding treatment.
Read more: Faecal contact and STIs | Hepatitis A | STI care for MSM
Frequently Asked Questions
Is shigella an STI?
Not traditionally, but it can spread through sexual contact.
How is it diagnosed?
Stool sample sent for culture.
Can I prevent it?
Good hand hygiene and avoiding oral-anal contact during gut illness.
Related reading
- What Is a Female (Internal) Condom?
- What Is Bacterial Vaginosis (BV)?
- What Is Gonococcal Arthritis?
- What Is Human Papillomavirus (HPV)?
- What Is Mycoplasma Genitalium?
Sources
- NHS — Sexual health conditions
- BASHH — UK clinical guidelines for STI management
- British HIV Association (BHIVA) — HIV treatment guidelines
- Terrence Higgins Trust — sexual health information
- UK Health Security Agency — STI surveillance data
Steve Page is a recognised expert on Sexually Transmitted Diseases (STDs) and STD treatments, having published numerous articles in peer-reviewed journals and presented his research at conferences around the world. He has an in-depth understanding of the latest medical research on STDs, and is an advocate for the development of new treatments and protocols to improve the health of those affected. In addition to his research, he has dedicated his career to understanding the causes and symptoms of STDs, as well as how to best treat those impacted.
