Hepatitis and Sex: Frequently Asked Questions

It’s widely known that viral hepatitis can spread though consuming contaminated food or sharing dirty hypodermic needles. But the liver-destroying disease can also sometimes be spread through sexual contact. Here’s what you need to know to protect yourself.

How many kinds of viral hepatitis are there?

Scientists have identified at least five types of viral hepatitis that lead to liver problems. In the U.S., the main threats are hepatitis A, hepatitis B, and hepatitis C.

Can all types be spread by sexual contact?

Hepatitis A spreads via fecal-oral contact, which can occur if there is direct oral-anal contact or contact with fingers or objects that have been in or near the anus of an infected person. If even a microscopic amount of virus-laden feces gets into the mouth, infection potentially can result.

Hepatitis B (HBV) is 50 to 100 times easier to transmit sexually than HIV ( the virus that causes AIDS). HBV has been found in vaginal secretions, saliva, and semen. Oral sex and especially anal sex, whether it occurs in a heterosexual or homosexual context, are possible ways of transmitting the virus. It is not transmitted by holding hands, hugging, or even dry kissing on the lips. The chance of transmission with deep kissing is unknown, as no infections have been definitively documented after exposure to infected saliva. Yet, since HBV has been found in saliva, the risk of transmission with deep kissing probably exists and the risk increases if one partner wears orthodontic braces or has open cuts or sores in the mouth. The likelihood of becoming infected with HBV grows with the number of sexual partners a person has. Thus, promiscuous individuals are more likely to get HBV.

Hepatitis C (HCV) is spread through contact with an infected person’s blood -- which may be present because of genital sores or cuts or menstruation.HCV has been detected with greater-than-average frequency among people who have a history of sexual promiscuity -- which can be defined as a history of a sexually transmitted disease, sex with a prostitute, more than five sexual partners per year, or a combination of these. A person who is in a long-term monogamous relationship with an HCV-infected person rarely contracts this virus. Only approximately 2% of sexual partners of HCV-infected people also test positive for HCV. However, it is important to note that this statistic is based on indirect evidence only. Therefore, whether these people became infected through a sexual act or by another route is unclear. For example, people in long-standing relationships generally care for one another in times of illness or injury. During such times, HCV may be transmitted to the spouse or partner, because the couple may not be as cautious about avoiding contact with blood.

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Are men and women equally at risk of getting and spreading hepatitis through sex?

The risk is determined by a person’s behavior, not his/her gender, although some studies have shown that it is easier for a man to transmit HCV to a woman than vice versa.

Men who have sex with men are 10 to 15 times more likely than the general population to be infected with hepatitis B.

How can I make sure my partner is free of hepatitis before we have sex?

There is no surefire symptom or sign to indicate that someone has hepatitis. Some infected people look perfectly healthy even in advanced stages of illness. Experts recommend talking openly with sex partners about the risk of hepatitis and other sexually transmitted infections.

Of course, if you notice that someone has yellowing of the skin or eyes (a condition known as jaundice), consider that a red flag. Other symptoms of hepatitis include fever, fatigue, loss of appetite, nausea, vomiting, joint or abdominal pain, and clay-colored bowel movements.Blood tests are available to help determine if someone has hepatitis that could spread through sex.

Are some sex acts especially likely to transmit hepatitis?

Any sexual activity that might cause abrasions, cuts, or other trauma is especially risky.

Anal sex is thought to be more risky than vaginal sex. And both forms of sex are more risky than oral sex. Oral-anal contact is also risky. To minimize the risk of viral transmission, experts say that any sexually active person not in a mutually monogamous relationship should take precautions, such as placing a barrier, such as a condom, dental dam, female condom, and finger cots between you and another person’s body fluids and blood in addition to getting vaccinated against hepatitis A and B. There is no vaccine for hepatitis C.

Is it possible to catch hepatitis from kissing?

Catching hepatitis by kissing an infected person is unlikely -- although deep kissing that involves the exchange of large amounts of saliva might result in HBV, especially if there are cuts or abrasions in the mouth of the infected person.

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Can vibrators and sex toys spread hepatitis?

That’s possible, because the hepatitis B virus can survive outside the body for a week or more. Immersing the vibrator in boiling water may reduce the risk. But the safest advice is to avoid the use of these products until your sexual partner is vaccinated.

How effective are condoms at stopping sexual transmission of hepatitis?

Latex condoms are believed to be at least 99% effective. Unless you’re in a mutually monogamous relationship, it’s best to use a condom in every sexual encounter. Some experts recommend sticking with a plain condom. Flavored or scented condoms may be more likely to fail. Don’t use an oil-based lubricant, as it can degrade latex.

WebMD Medical Reference Reviewed by Jennifer Robinson, MD on July 30, 2016

Sources

SOURCES:

Scott D. Holmberg, MD chief, epidemiology and surveillance branch, division of viral hepatitis, Centers for Disease Control and Prevention.

Joseph Lim, MD, assistant professor of medicine, Yale School of Medicine and director, Yale Viral Hepatitis Program.

Melissa Palmer, MD, clinical professor of medicine, New York University School of Medicine.

John W. Ward, MD, director, division of viral hepatitis, Centers for Disease Control and Prevention.

CDC: “The ABCs of Hepatitis.” 

Avert.org: “Hepatitis A, Hepatitis B, & Hepatitis C.” 

CDC: “Viral Hepatitis: Information for Gay and Bisexual Men.” 

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