In general, you can’t pass hep C on by having sex
If hep C is transmitted during sex, it is likely to be through blood-to-blood contact. This is more likely if you have an STI like herpes or genital warts, if you’re having rough sex, sex that involves blood-play or if you are a man living with HIV.
This emphasises the need for safe sex practices where there is a risk of blood-to-blood contact, e.g. sex when you have cuts or lesions on or close to the genitals, during anal sex (because the lining of the anus is easily broken), during menstruation and during sexual practices that may involve bleeding or broken skin.
If you only have sex with your partner and you’re a heterosexual couple then the risk of passing on hepatitis C during sex is very low. Some studies suggest a slightly increased rate of hep C transmission in people with multiple sexual partners and high levels of sexual activity. These studies, though, have usually found it difficult to exclude other possible routes of transmission, e.g. injecting drug use.
If you’re a gay man and you’re HIV positive, there is an increased level of risk of hep C transmission
In a nutshell, there is an increased risk of sexual transmission for men who have sex with men (if one or more partners has HIV).
It is estimated that up to 5% of gay men and men who have sex with other men have hep C, compared with 1% of the general population. Around 13% of people with HIV in Australia also have hep C.
Among men who have sex with men, the risk of hep C being transmitted is higher if one or more partners has HIV, or if the sex involves blood-to-blood contact, of if they have other STIs, or if recreational drugs are used.
To reduce the risks:
- use condoms and lots of lube for anal sex
- wear gloves and use lots of lube for fisting
- use condoms on toys and change them between partners, or wash toys with hot soapy water and dry them between partners
- if affected by alcohol or recreational drugs, your judgement around risks will be impaired and you’ll have decreased inhibitions so take special care to avoid blood-to-blood contact.
Some men choose not to use condoms when having sex with other men who believe they have the same HIV status. This is called sero-sorting and can further increase people’s risk of contracting hep C.
Also check out the website The New Deal for other information on sex and hepatitis C.
This page was last updated 25 May 2016.