Sex & Hepatitis C

'I have hep C. Is my sex life over?'

No, your sex life is alive and well. If you're in a marriage or other longtime monogamous relationship, the use of a condom may not even be necessary.

For those with more savory sex lives, adjustments may well be in order for the protection of your partners. Condoms are a must for hep C people (or anyone) with multiple sex partners.

Rough sex often leads to some bleeding, the medium of transfer for hepatitis C. Basically, forget it. Gay men, in particular, need to examine the research on male-to-male sex dangers from hep C.

In any case, telling sex partners about hep C is an absolute must.

'What about oral sex?'

Researchers believe oral sex is safe for those with HCV and their partners. The standard advice about avoiding blood applies here. If cuts or bleeding gums are present, oral sex is not considered safe. No one has gotten hep C from oral, as far as doctors and researchers know.

'Can we have anal sex?'

Gentle anal sex using a condom is considered safe. Emphasis on "gentle." Anal sex can lead to tearing of the rectum lining, which brings blood-on-blood dangers into play. Avoid rough anal sex.

'Should my partner be tested?'

Not a bad idea. Anyone who is physically close with a hepatitis C carrier probably should be tested periodically, although routine blood testing in medical checkups should indicate the virus' presence. Check with your doctor. There is evidence that those who are treated for hep C soon after infection have the best chances of clearing the virus.

'Why can't they figure out if sex transmits hep C?'

One difficulty is the predominant role of intravenous drug use in hepatitis C contraction. Self-reporting of illicit needle-drug use is unreliable at best. For example, since hepatitis C can take decades to show itself, people who used these drugs in their distant pasts are inclined to deny that activity. Fear of arrest or stigmatization or loss of insurance are powerful counterinfluencers. If no needle use is indicated, sex sometimes becomes a suspect in the infection.

A 2010 survey of heterosexual hepatitic c transmission in the U.S. found that a clear majority of subjects who reported infection via sex also were drug users.