Physical Intimacy with Hepatitis C

One of the concerns that some people with hepatitis C have is whether or not they can transmit the virus through physical contact with their intimate partner(s). Here we will review the risks associated with various forms of intimate contact and the ways in which these risks can be mitigated, where applicable. It is important to reveal one’s hepatitis C status to any potential sexual partners so that those partners can make an informed decision about their health.

How is hep C transmitted?

Hepatitis C is transmitted through contact with an infected person’s blood. Rule of thumb is: Wherever there is direct exposure to blood or the potential for exposure to blood, the risk is higher for transmission of hepatitis C. With this fact in mind, we can say with 100% certainty that hugging presents zero risk of transmission of hepatitis C.^1,2

Kissing on the mouth, whether done with closed lips or open mouth, is a very low risk activity. However, the risk for transmission of hepatitis C increases if either person has an open sore or cut on their lips or on the inside of their mouth.²

Oral sex is considered a low-risk intimate activity.² However, engaging in oral sex when there is an open sore or cut on the lips or in the mouth of the person performing oral sex or an open sore or cut on the genitals of the person receiving oral sex is risky. The only sure way to completely reduce risk of transmission of hepatitis C during oral sex is through the use of condoms or dental dams on the genitalia of the receiving partner.

Considerations for sexual intercourse

The risk of transmitting hepatitis C during sexual intercourse varies. Long-term monogamous intercourse is considered low risk but hepatitis C-negative partners should be tested at least one time and typically do not need to be tested again if they test negative. However, the risk of transmitting hepatitis C increases with multiple, short-term partners. The risk of transmission is also higher if penis-in-vagina intercourse is done during menstruation, if intercourse involves strong, fast thrusts of the penis which can cause vaginal tearing, or if either partner has an open sore or cut on their genitals.³

Anal sex is considered a higher risk form of intercourse because anal tissue is thinner than vaginal tissue and can more easily tear. The use of latex condoms during vaginal or anal intercourse is the only sure way to prevent transmission of hepatitis C.³ Any type of physical intimacy that involves blood play carries a very high risk of hepatitis C transmission. To avoid hepatitis C transmission in blood play, consider substituting real blood for liquids that mimic the look of real blood such as red wine or ketchup.⁴

The key takeaway when it comes to hepatitis C and physical intimacy is that any activity that involves exposure to blood or the potential for exposure to blood is considered a risky activity and precautions should be taken to mitigate the possibility of transmission.