This page will be updated as new information becomes available.
All men should know the basics about how transmission of hepatitis B and hepatitis C between sexual partners can be prevented
In general, if a person has hepatitis B, which is easily transmitted sexually through semen, they should always use condoms (either male or female) unless they know for sure that their partner is protected from hepatitis B by vaccination.
Sexual transmission of hepatitis C, which is transmitted by blood-to-blood contact, is quite rare among heterosexual couples, with some important exceptions (continue reading…). There is no vaccination for hepatitis C, so condoms (either male or female) are the recommended course if you are concerned about transmission. Hepatitis C can be transmitted sexually when tiny (often invisible) amounts of blood are transmitted from one partner to another through sores or bruises in fragile skin or mucous membranes, such as in rough or anal sex or during menstruation. Sex with multiple partners, or between partners with sexually transmitted infections (STIs) including HIV, puts partners in greater risk of hepatitis C transmission.
Finally, know that there is a time-gap of several weeks between exposure to hepatitis B or hepatitis C, and the exposure showing up as positive on a test. Ask your health services provider to confirm how long this period is for any HBV or HCV test. When in doubt, use protection.
Men who have sex with men (MSM) are at particular risk of hepatitis C
The prevalence of hepatitis C in men is higher than that in women, most probably because men are more likely to have been exposed to more risk factors than women. Men who have sex with men (MSM) are at higher risk than the general population. A recent article in the respected online magazine, HepMag (https://www.hepmag.com/basics/hepatitis-c-basics/hcv-men-sex-men) claims that “…the incidence among MSM is highest in those who have any of the following risk factors:
- HIV positive
- Drug use
- Engaging in unprotected anal-receptive sex
- Fisting (the practice of inserting the hand into the rectum or vagina)
- Sex with multiple partners…”
The same HepMag article also says that
“Recent data found evidence of hepatitis C in rectal fluid samples. Despite the absence of visible blood, HCV was detected in 20 out of 43 specimens of rectal fluid obtained from HCV/HIV-positive MSM. Those whose blood tests showed higher viral loads were both more likely to shed HCV into the rectum and to shed it at higher levels. In short, sexual transmission via body fluid or other abrasions may lead to rectal transmission of hep C in HIV-infected MSM.” and that “There have been reports of some HIV-infected individuals for whom HCV antibody didn’t show up for more than three years. One extreme case reported an HIV-positive man who had positive HCV viral load results but no positive HCV-antibody results for seven years. Because of this, some researchers recommend HCV viral load testing rather than relying solely on antibody testing for HIV-infected MSM.”