Ask the Experts: Can HCV Be Transmitted Through Sex?

Last updated: August 2020

Hepatitis C (HCV) is passed through contact with contaminated blood. We've noticed that many people new to the hepatitis C community want to know if HCV be transmitted through sex. So, we asked our experts and here's what Corinne and Sue had to say:

Ask the Expert: From Corinne

CorinneMigaHepatitis C is spread from blood to blood contact; generally this happens when blood from a person infected with the Hepatitis C virus enters the body of someone who is not infected. Today, the most common route of HCV transmission is through intravenous or sharing injection drug equipment. Prior to 1992, many people contracted HCV through blood product transfusions. HCV can be transmitted through sexual contact, however, the risk is considered to be low.

According to the National Institutes of Health, for heterosexual discordant couples in monogamous relationships, the risk of HCV transmission is estimated only to be 0 to 0.6 percent. Based on the low risk of transmission, couples in a monogamous relationship do not need to use condoms, although it is important to know that condoms reduce the risk of transmission even more so.

However, there is increased risk for sexual transmission among individuals who have multiple sex partners and when sexual practices result in blood to blood exposure. The risk of sexual transmission is also more common among HIV-infected individuals, and men who have sex with men, especially if those partners are co-infected with HIV. If an individual has a sexually transmitted disease, engages in rough sex, or is co-infected with HIV it is recommended to use condoms to prevent the transmission of HCV as well as other sexually transmitted diseases. As always, it is important to discuss any risk factors with your doctor for appropriate education and counseling as each person’s situation is unique. It is important to know that there is no evidence that kissing, hugging, or casual contact without exposure to blood is associated with HCV transmission.

Ask the Expert: From Sue

SueSimonHepatitis C virus is not considered a sexually transmitted disease. In order for hepatitis C to be contracted, blood from an infected partner must enter the bloodstream of a non-infected person. Unlike hepatitis B or HIV, the virus is not found in infective amounts in sexual body fluids.

On the rare occasion that someone is infected through sex, it is usually due to the person having a sexually transmitted infection that causes lesions or cuts in the genital tract or the female partner is menstruating. It is also transmitted more frequently between men who have sex with men, and in people who have sex with prostitutes, and in sex between couples who have more than 5 sexual partners. Anal sex puts a person at higher risk than the people who engage in vaginal sex. Rough sex increases risk of transmission, as well. In long term monogamous couples the rate of transmission is less than 2%. In fact, the Centers for Disease Control and Prevention (CDC) does not recommend the use of barrier protection in long term monogamous couples. Some of that 2% statistic may actually be because married couples take care of each when there is illness or an accident and blood may be exchanged during those times.

The important thing to remember is that if you have more than one sexual partner, or are not in a long term monogamous relationship, barrier protection should be used. In fact, safer sex should always be practiced between unmarried couples as there is a much higher likelihood of hepatitis B or HIV being transmitted. The Mayo Clinic also cautions that if a person is infected with HIV, they are at higher risk of contracting HCV. Condoms are approximately 99% protective. Get vaccinated for hepatitis A and hepatitis B. It’s the best protection for those two viruses.

Ultimately, it's always beneficial to talk with your doctor or counselor about any concerns or ways to stay safe.

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