Hepatitis C and sex: More questions than answers

A diagnosis of hepatitis C infection changes your life in an instant. You will never be the same person. You may, in fact, become a better, more mature person with a broader perspective on life.

But there is not getting around the fact that hepatitis C (HCV) can be a fatal disease -- even though most people simply will outlive it. Or be cured by the new generation of antivirals such as Sovaldi and Olysio, coming to market with great hopes in 2014.

Once these realities are absorbed, life goes on. And for many people it's immediately on to the question of safe sex with HCV.

The news about sex and hepatitis C is good, mostly.

Many researchers feel the chances of transmission in a monogamous relationship are quite small, or even nonexistent.

"It's a very unusual mode of transmission," says the CDC's expert on hep C. A team of researchers reported in early 2013 that the transmission among monogomous partners was 0.07 percent per year, a typical finding.

But other experts fear the risks of sexual transmission have been understated in recent years, especially for high-risk individuals.

Certainly the odds of getting hepatitis C via sexual activity can be decreased by common-sense behaviors. Just as those infected with hep C are cautioned not to share toothbrushes or razors, they should be made aware of potentially dangerous sexual activities. Here are some of them:

• Do not have sex while either partner is bleeding. This includes gums and, of course, any cuts, blisters or other skin breaks on genitals. Sex during the menstrual cycle is thought to increase risks, at least in theory.

• Use condoms unless you're in an exclusive relationship. Basic safety advice for everyone, of course. People with multiple sex partners appear to be at greater risk of spreading hepatitis C (or getting it) than those who are monogamous.

• Avoid anal sex or at least be extremely careful. This means being gentle, using a condom and applying lubrication.

• Male-on-male sex has been linked to significantly higher risks of transmission.

• Rough sex is out. Period.

Some medical pros even think sex can be helpful for those with hepatitis C. Two major symptoms of the disease are fatigue and depression. The deep rest made possible by sex helps the liver heal, while depression often is lifted by the endorphins released post-climax.

This web site seeks to provide the most up-to-date information on sex and hepatitis C. We believe it to be the only site dedicated solely to safe HCV sex. Your comments and factual corrections are most welcome. (Please check out our Sex & Hepatitis C reader feedback page.) We're all in this together.

Sex & Hepatitis C's pages include information on how the virus is spread; the odds of hep C transmission via sex; how to tell potential sex partners about your infection; and the short list of dating sites for hepatitis c carriers.

You'll also find links to major hepatitis C studies of the role of sex in transmission. These studies and others are the sources for most of the information on this web site. We are not doctors or scientists. Please read the site disclaimers regarding reliability of the information found here.

As the old roll-call sarge used to say, "Let's be careful out there." And enjoy life.

Good news for those without health care: Read about pre-existing conditions and the Affordable Care Act changes.

Required reading: 'Sex, drugs and the hepatitis virus'

Judith A. Hahn of the University of California, San Francisco, analyzes the current research on heptitis C and sex in this 2007 article from The Journal of Infectious Diseases:

"Nearly 20 years after the identification of the hepatitis C virus (HCV), there is still debate about the extent of sexual transmission of HCV. Because the pool of infected persons is very large (the World Health Organization estimates that 170 million people worldwide are infected with HCV) and sexual intercourse is common, even a low rate of sexual transmission can account for a large number of new cases."

Read "Sex, drugs and the hepatitis virus"