10 Facts About Sex and Hepatitis C

by Elizabeth Millard Health Writer

A diagnosis of Hepatitis C (also known as HCV) means a lot of things—potential treatment, different tests, and a boatload of information on the virus—but it doesn’t have to mean your sex life has to go MIA. Having some awareness about how HCV works and making sure you talk with your partner can go a long way toward staying safe, while still getting sexy.

FACT 1: Transmission Happens Through Blood Exchange

When considering the possibility of transmitting or contracting HCV, it’s important to know this is a blood-borne virus, says Viviana Figueroa Diaz, M.D., a hepatologist and assistant professor of medicine at NYU Langone Health in New York City. That means any sexual activity that involves a potential exchange of blood can increase transmission risk.

Because HCV can be transmitted through blood-to-blood contact, transmission risks include sharing needles, sex, tattooing, acupuncture, even using someone else’s razor or toothbrush. But even then, risks are low.

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FACT 2: Risk of Sexual Transmission Is Generally Low

Just like the other blood-to-blood transmission scenarios, risk through sex is very low, says Dr. Diaz. For example, the Hepatitis C Association notes that fewer than 3% will contract HCV through unprotected sex with a heterosexual, monogamous HCV-positive partner.

There’s also an extremely small chance of transmission through bodily fluids—like oral sex or even just kissing—but you would need to have some type of open sore that allows the virus to get into your bloodstream. Your partner would need an open sore, too. Although it’s theoretically possible, there’s never been a reported case of that kind of transmission, Dr. Diaz says.

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FACT 3: STDs, Multiple Partners, and HIV Increase Risk

Some populations are at higher risk for sexual transmission, says Dr. Diaz. There’s more transmission in gay men, as well as those who have multiple sex partners. Having a sexually transmitted disease (STD)—like HIV, gonorrhea, Hepatitis B, genital herpes, genital warts, and chlamydia—raises risk for contracting HCV as well because your immune system will be compromised to some degree, and not as effective at dealing with HCV. Also, the STD may involve sores that increase risk of transmission into the bloodstream.

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FACT 4: Sex During Menstruation Should Be Avoided

Because of the way HCV is transmitted, sex during menstruation is not recommended, even among monogamous couples, and even with condom use. The virus can be present in menstrual blood for women living with HCV, and if it’s a sexual partner who has the virus, menstruation can make it easier for the virus to enter a woman’s bloodstream because this phase of a woman’s cycle is associated with decreased immune response.

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FACT 5: Rough Sex Can Be a Transmission Factor

Even if you’re not in a higher-risk group or menstruation isn’t a factor, you can still raise your risk of transmission if sex involves blood in some way, Dr. Diaz notes. That can happen with rough sex, where microtears in the vaginal or anal tissue can occur, opening a transmission pathway. That makes it even more crucial to wear a condom.

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FACT 6: Boomers Should Especially Keep HCV in Mind

Baby Boomers are five times more likely to have HCV than other generations. The reasons are not completely understood, but one factor may be that infection-control procedures, including screening donated blood, didn’t begin until the 1990s, and many were likely infected before then. But that’s not the only reason. Currently, STDs are on the rise in Boomers mainly because they often don’t use condoms, raising infection risk.

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FACT 7: You Can’t Get Tested Right After Sex

Some STDs can be detected soon after unprotected sex, but HCV isn’t one of them, Dr. Diaz explains. The virus antibody generally appears 12 weeks after exposure, she says, but your doctor may wait a few additional months to be sure. In part, that’s because about 15% to 30% of people clear the virus on their own in that time frame with no major health impacts, Dr. Diaz says. So, if you’ve had sex with someone with HCV, you’ll likely be advised to wait for that amount of time before being tested.

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FACT 8: You’ll Have to Monitor for Hepatitis C Even After Being Cured

Hepatitis C is curable in most patients. Either your body will clear the infection on its own, or antiviral treatments will do the job, says Alina Allen, M.D., a gastroenterologist in the department of gastroenterology and hepatology at the Mayo Clinic, in Rochester, MN. But once you’ve had HCV, the antibodies will remain in your system for life, she says, and you can be re-infected the same way you were originally. So being cured doesn’t mean becoming immune to the virus. That sounds dramatic, but don’t think of HCV as an enemy that can’t be vanquished. Instead, consider it a reason to be tested periodically, Dr. Allen recommends.

FACT 9: HCV Usually Has No Symptoms

One important aspect to keep in mind with HCV is that it can be in your system for a long time without becoming active, Dr. Diaz says, and often people who are diagnosed are unsure how they got infected. That’s because symptoms are rare—that’s a big part of why it can spread so easily. Because of that, consider getting tested as part of a regular checkup, especially if you’re in a high-risk group and/or you’re a Boomer.

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FACT 10: Safe Sex Practices Are Your Best Bet

In a monogamous, heterosexual, long-term relationship, condoms may not be required, says Dr. Diaz. But even then, your doctor may recommend erring on the side of caution and practicing safe sex until both partners are shown to be negative for HCV. Taking medications as prescribed, being tested for other STDs, and staying in communication with your doctor about safe sex practices can all go a long way toward lowering your transmission risks.

Elizabeth Millard
Meet Our Writer
Elizabeth Millard

Elizabeth Millard is a freelance journalist specializing in health, wellness, fitness, and nutrition. Her articles have appeared in SELF, Men’s Health, CNN, MyFitnessPal, and WebMD, and she has worked on patient education materials for Mayo Clinic and UnitedHealth Group. She’s also a registered yoga teacher and organic farmer.