Blog Archive

Sex and Hep C (Q&A)

Posted by HIM on Tuesday June 16th, 2009

Tell me about the liver and hepatitis.

The liver is the largest gland in the body. It plays a vital role in digestion, blood clotting, and energy storage. Many people think of the liver as a filter because it detoxifies chemicals and drugs that enter the body. People cannot live without a functioning liver.

Medical people often use the term hepatic, which is from the Greek word for liver. Hepatitis means inflammation of the liver. Hepatitis may be caused by side effects from medicines, alcohol abuse, or liver diseases but usually, hepatitis is caused by viruses. Hepatitis C is a chronic form of viral hepatitis.

This article is for gay men who are concerned about getting Hepatitis C from sexual activity.

Tell me more about viral hepatitis and Hepatitis C.

There are 3 main types of viral hepatitis: Hepatitis A, B, and C. All of them cause varying degrees of liver damage. Hepatitis A and B tend to cause a brief illness that is noticeable by tiredness, fever, stomach pain, and yellow skin or eyes. Most people heal on their own within a month or two.

Hepatitis C is more serious. It starts out as mild illness that is not noticeable. Unlike Hepatitis A or B, however, most people do not clear Hepatitis C on their own. This means that the liver damage continues gradually over a number of years. Eventually the liver stops working properly and people become very ill or die.

Some people may talk about the Hepatitis C virus as Hep C or HCV. There are different strains of Hepatitis C, sometimes called genotypes. The most common strain in North America is genotype one.

About 1% of the population has Hepatitis C. This number is estimated to be much higher in HIV-positive gay men. For various reasons HIV-positive gay men are prone to getting Hepatitis C.

Is there a vaccine for Hepatitis C?
There is no vaccine for Hepatitis C. However, there is a vaccine for both Hepatitis A & B.

Is Hepatitis C different for people living with HIV?
Yes. People with HIV usually develop noticeable liver damage from Hepatitis C faster than people who do not have HIV. As well, people with HIV are even less likely to clear Hepatitis C on their own. Damage from Hepatitis C makes it harder for the liver to process HIV drugs, making them less effective.

How do people get Hepatitis C?
Hepatitis C is spread by blood-to-blood contact. In other words the blood of an infected person has to get into the bloodstream of another person who does not have Hepatitis C.

The most common way for this to happen is by sharing needles or equipment when injecting drugs. Some people may also get Hepatitis C from sharing straws or other equipment when snorting or inhaling drugs (e.g. cocaine, meth, poppers).

People in Canada used to get Hepatitis C from blood transfusions or other blood products. Since the early 1990’s all blood donations are screened for Hepatitis C. Less commonly people get Hepatitis C from tattoos or piercings or during medical procedures using unsterilised equipment. Sharing razors, toothbrushes, or nail grooming equipment with an infected person is another possible source of Hepatitis C.

Do people get Hepatitis C from sex?
The risk of getting Hepatitis C from sex is very low for heterosexual couples in which one partner has hepatitis C. Anal sex is more risky because it causes small tears inside the ass, making exposure to blood more likely.

In the early 2000’s outbreaks of sexually transmitted Hepatitis C in gay men were reported in Europe. Since then the trend has increased, moving to North America and other countries. So far, only HIV-positive gay men are getting Hepatitis C in this way.

How do HIV-positive gay men get Hepatitis C during sex?
Hepatitis C seems to get passed around during group sex, when blood is more likely to be transferred between people.

Fucking causes small tears inside the ass, which act both as a source of blood and as tiny openings for blood to get into the body. When any two bottoms share the same top invisible traces of blood may be transferred between the two men. If one of the men has hepatitis C it could be passed on in this way. This can happen with sex toys and fists as well.

In public settings like sex parties, bathhouses, or parks it is not always easy to keep track of where sex partners have been. Condoms will reduce blood transfer but only if a fresh one is used for each new partner.

Does Hepatitis C live in semen (cum)?
Hepatitis C does not normally live in semen but sometimes men have traces of blood in their cum. Hepatitis C may be rarely passed on this way during condomless sex.

What about rough sex and drugs?
Rough or lengthy sex causes lots of friction making tears in the ass and exchange of blood more likely. Some men who get Hepatitis C during sex have also used party drugs like ecstasy, cocaine, crystal meth, or poppers. Using these drugs makes it easier to handle rough sex or long sex sessions.

What about other sexually transmitted infections (STIs)?
Having sores or inflammation from other STIs increases the chance of exposure to blood during sex. As well STIs lower immunity making people prone to other infections.

How long does Hepatitis C live outside the body compared to HIV?
HIV dies soon after exposure to air. Hepatitis C is tougher, living outside the body for days or weeks.

How do I know if I have Hepatitis C?
Some guys who have Hepatitis C don’t even know it. The only way to find out for sure is to get a blood test. Some HIV-positive men find out that something is wrong with their liver during routine blood tests. During the early stage of Hepatitis C infection the liver tests will be abnormal.

Is there treatment for Hepatitis C?
Yes. The treatment is a weekly injection plus daily pills, lasting for 6 to 18 months. Most people find the side effects to be very unpleasant. HIV medications are given at the same time. A cure is difficult to achieve for the most common strain of Hepatitis C, especially if the person also has HIV. Starting treatment early after infection is considered better for clearing the virus. A cure does not protect against re-infection by other strains of the Hepatitis C.

How do I protect myself?
To reduce your chances of getting hepatitis C from sex it’s best to avoid putting anything into your ass that might have someone else’s blood on it. Sharing lube or poppers should also be avoided. Using a fresh condom whenever you get fucked is good for preventing Hepatitis C and other sexually transmitted infections. A fresh glove on a clean arm is best for fisting.