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How to Be Smart About Sex and Hep C

Reviewed by Brunilda Nazario, MD on October 13, 2020

To tell or not to tell? 

If you have hep C, that is the question. But the answer isn’t the same for everyone.

Paul Bolter, community outreach and education manager at the Greater New York Division of the American Liver Foundation, says a lot depends on the people and the setting.

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photo of happy couple outside
 

“If you’re in a loving, committed relationship and know you will be supported, then we suggest you tell your partner because you’re going to need support,” he says. 

But he adds that if you’re in an abusive relationship, don’t feel safe, or worry that other people might find out, telling might not be the right choice.

What’s more, even a loving partner may need some time to absorb the news.

Be patient and stay open to any questions your partner may have, advises Lynn Wang, MD, a gynecologist and sexuality counselor in Philadelphia.  

For instance, they might want to know how you got hep C and whether they could have it, too.

Continued

Bolter says those are hard questions to answer because there’s still a lot of stigma around the disease.

“When people hear hep C, they think of drug use -- one of the main risk factors,” he says.

But hep C can spread in other ways, too. You might have been exposed if you had a blood transfusion or organ transplant before 1992. Or if your body piercer or tattoo artist didn’t use clean tools. Also, health care workers can get hep C from needle sticks.

If you don’t feel comfortable saying how you got it, just say you don’t know. Many people aren’t 100% sure how they got hep C.

What to Say to Your Partner

Assure your partner that hep C isn’t spread through kissing, touching, or sharing dishes. The chance of getting it through sex is very low -- less than 1% per year if you and your partner only have sex with each other. Unlike an STD, hep C can only spread through blood.

Module: video
photo of couple hanging out
 
Tips to Navigate Hepatitis C and RelationshipsYou can enjoy a healthy relationship while you have hep C. Learn what steps you need to take to make it happen.78

Hepatitis C is difficult to pass

to someone.

So even within a family,

it's rare to pass it on.

Today, most people get hep C

by sharing needles

or through other risky behavior.

But sometimes hep C can be

spread through sex.

So you and your partner

need to know how to best protect

yourselves.



Hep C doesn't spread

through kissing.

You also can't get it

through cuddling, snuggling,

handholding, hugging, or sharing

utensils.

Hep C spreads through blood

contact.

So stay away from situations

where you might come in contact

with open cuts.

Don't share razors

or toothbrushes.

Don't have sex

during your period,

and be sure to bandage

any wounds or sores.



For monogamous couples, the CDC

says routine condom use isn't

necessary.

But your chances of getting hep

C go up if you have

multiple partners, you have HIV

or another sexually

transmitted disease,

or if you have rough sex.



Communication is

key in any relationship.

Talk to your partner about best

practices to lower the risk

of infection

while being treated.

If you're concerned you might

have hep C, you can take

a simple blood test to find out.

If you have it,

you may be able to take medicine

that clears the virus

from your bloodstream.



Hep C is a curable disease,

and with a little planning,

you can have a happy and healthy

sex life with your partner.

Mayo Clinic: "Hepatitis C: How common is sexual transmission?”<br> National Institutes of Health: "Hepatitis C virus transmission and its risk factors within families of patients infected with hepatitis C virus in southern Iran: Khuzestan.”<br> CDC: "Hepatitis C Questions and Answers for the Public,” "Viral Hepatitis.”<br> Vermont Department of Health: "Living with Hep C.”<br> American Sexual Health Association: "Hepatitis C.” /delivery/aws/ef/a9/efa9d4a4-9e48-36b5-bf97-e589fab0f96f/091e9c5e81dc0364_vo-feature-hep-c-and-relationships_,4500k,2500k,1000k,750k,400k,.mp401/02/2020 12:00:0018001200photo of couple hanging out/webmd/consumer_assets/site_images/article_thumbnails/video/vo_feature_hep_c_and_relationships_video/1800x1200_vo_feature_hep_c_and_relationships_video.jpg091e9c5e81dc0364

“Two pools of blood have to come together,” Bolter says. “For most people, if there’s no blood, there’s no infection.”

Continued

He says your odds are even lower if you have less of the virus is your blood.

“The amount of virus that a person has -- called the viral load -- can be really high or really low. The nature of hep C is that it goes up and down. But if someone has a steady low viral load, they’re less likely to spread the virus. So it’s important to know your status,” he explains.

Your partner may also wonder if you need to change the way you have sex. For some couples, the answer is no. For instance, most people who are married or partnered for a long time don’t use condoms. But you may want to discuss safer sex options if you make love during a woman’s period or have rough or anal sex, when tissue is more likely to tear and bleed.

The chance of spreading hep C is higher if you have sex with more than one partner or have an STD or HIV. Using a latex condom every time can help lower the risk.

“These are very intimate, personal conversations,” Bolter says. “You can’t tell people what to do. You can only suggest.”

Living Safely With the Virus

Once you learn you have hep C, your doctor should talk to you about ways to keep your household safe. The most important is not to share razors, toothbrushes, nail clippers, or other personal care items that might come in contact with your blood. Bolter says asking family members not to use these items might be a good way to start the conversation about hep C.

Even if you don’t tell them you have the virus, keep the children you live with safe. Make sure they know never to use your personal care items.

And don’t reuse them yourself after treatment.

“When you’re cured, throw away all your old grooming products, because you could become infected again,” Bolter says. “The same goes for manicures and pedicures. Make sure the technician doesn’t cut your skin and sterilizes all the instruments in front of you. Better yet, bring your own.”

Continued

He says one thing to keep in mind when you talk to your family is that hep C doesn’t make you a different person.

“You’re the same person; now they just know one more thing about you.”

WebMD Feature

Sources

SOURCES:

Paul Bolter, community outreach and education manager, American Liver Foundation, Greater New York Division.

Lynn Wang, MD, gynecologist and sexuality counselor and educator, Philadelphia.

New York State Department of Health.

American Liver Foundation.

CDC.

Hepatology: "Sexual Transmission of Hepatitis C Virus Among Monogamous Heterosexual Couples: The HCV Partners Study."

National Institute of Diabetes and Digestive and Kidney Diseases.

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