Gay Men and Hep C: what about sexual transmission?

hep c

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You can also download a Print-Ready fact sheet here.

 

How it is usually transmitted?

Hepatitis C (hep C) is a virus which affects and damages the liver. It’s passed on by direct blood to blood contact, when the blood of an infected person enters the blood-stream of another person even in small amounts that can be hard to see.

The most common way of contracting hep C, or passing it on, is through unsafe injecting drug use (sharing of needles and injecting equipment), and in some cases through tattooing or piercing with unsterilised equipment.  Sharing clippers, razors, toothbrushes, and tweezers where there may be small amounts of blood can be risky.  Needle-stick or sharps injuries have transmitted hep C (in occupational settings).  Some people who received a blood transfusion prior to 1990, may have been exposed to hep C.

 

 

The signs & symptoms
Tiredness, liver pain, and abdominal pain may be signs of hep C infection; however some people don't get any symptoms.
A test for hep C is the only way to know for sure.

Sexual transmission
In the past, sexual activity was thought to be low risk for hep C transmission.  However, new evidence suggests that sexual transmission of hep C, although still uncommon, is increasing among some gay men and men who have sex with men (MSM).

What are the risk factors for sexual transmission?
Unprotected anal sex where there are cuts, sores, wounds, abrasions or tears that may not be easily seen could risk passing on, or getting, hep C, including:

  • Fisting
  • Rough sex
  • Prolonged sex
  • Group Sex
  • Sharing unwashed sex toys
NEW RESEARCH & UNDERSTANDINGS

The hep C virus can be found in semen, more often at higher levels among HIV-positive men, possibly related to having a higher hep C viral load.  It is unknown whether hep C in semen may add to the risk of sexual transmission during unprotected anal sex (if there is damage to linings of the anus, creating a point of entry into the blood stream).  The blood-to-blood risk of hep C sexual transmission is the same in all gay men/MSM if condoms and effective protection are not used, regardless of HIV status.

Approximately 13% of HIV-positive people also have hep C.  It is estimated about 9% of gay men/MSM have hep C.  Some people don’t know they have hep C (or HIV) because they haven’t been tested.  Among HIV-positive people who have tested positive for hep C, 23% believe they were infected during sex and 19% don’t know how they contracted hep C.

How can I prevent passing on, or getting, hep C sexually?

  • Use condoms and water-based lube.  Lube stops condoms breaking, and condoms stop blood-to-blood exposure.
  • For fisting, use gloves and plenty of lube to minimise anal tearing.
  • Thoroughly wash sex toys in warm soapy water between partners, or put a new condom on the sex toy.


These methods also help protect against other sexually transmitted infections (STIs), including HIV.

How else can I prevent passing on, or getting, hep C?

  • Sharing injecting drug equipment or needles is risky.
  • Use clean fits (needles and syringes) and your own equipment.
  • Dispose of needles and equipment safely in an approved sharps container.
  • Thoroughly wash all other equipment (e.g. spoons, tourniquets).
  • Avoid sharing personal grooming items (e.g. razors, toothbrushes, clippers, tweezers).

Tattooing is safe through accredited tattoo artists who operate under legislated infection control guidelines.  People with hep C or HIV can elect to have tattoos just like anyone else, as infection control by the operator ensures there is no risk to others.  People with hep C or HIV do NOT have to disclose their status to a tattoo/body artist provider or operator.

Who should get a test and how often?
If you have ever injected drugs, or been in prison, have a hep C test.  Discuss your sexual transmission risk with your health professional.  Yearly hep C screening is recommended if you are HIV positive. More regular testing is a good idea if you are currently injecting drugs or engaging in risky sexual practices.

Is there a vaccine or treatment options?
There is no vaccine available for preventing hep C, although there are vaccines for hep A & hep B.  Hep A and hep B can also be acquired sexually, which can make HIV or hep C worse, so it’s a good idea to get vaccinated for them.  As for hep C, about 25% of people can spontaneously clear the hep C virus without treatment, but for HIV-positive people this is less likely.

Hep C can be treated, and the sooner it’s treated the better chance you have of clearing the virus. Treatment side effects can be challenging.  HIV-positive people may be less likely to respond to hep C treatment than HIV-negative people.  Therefore, preventing hep C becomes especially important.

Where can I get tested?
Your General Practitioner (GP) or regular doctor

A Sexual Health Service:
Phone 13-HEALTH or visit www.health.qld.gov.au/sexhealth/help/

Who can I talk to?
Hepatitis Queensland
Phone: 07 3846 0020  Toll Free: 1800 648 491 (within QLD)
Email: info@hepqld.asn.au Web: www.hepqld.asn.au

Queensland Positive People (QPP)
Phone: 07 3013 5555  Toll Free: 1800 636 241 (within QLD)
Email: info@qpp.org.au Web: www.qpp.net.au

Healthy Communities (QAHC)
Men’s Health Line 1800 155 141
Phone: 07 3017 1777  Toll Free. 1800 177 434 (within QLD)
Email: info@qahc.org.au Web: www.qahc.org.au

Where can I get this information?
Download a fact sheet here.