Hepatitis C: sex & relationships

Hepatitis C is not classified as a sexually transmissible infection (STI).
Hepatitis C is transmitted through blood-to-blood contact (where the blood of one person passes into the bloodstream of another). In rare cases where hepatitis C may be passed on during sexual contact, it is likely to be through blood-to-blood contact.

Where there is a risk of blood-to-blood contact during foreplay or sex it is recommended that you practise safe sex. You should also practise safe sex if there is a risk of transmission of a sexually transmissible infection.

If I have hepatitis C do I need to practice safe sex?

Hepatitis C is transmitted via blood-to-blood contact. If there is a risk of blood-to-blood contact during foreplay or sex, it is recommended you practise safe sex at this time.

When one or both partners have hepatitis C, couples should assess their sexual practices and determine whether safe sex practices are required to reduce the risk of blood-to-blood contact. Examples of sexual activities that may be a risk of blood-to-blood contact include: sex during menstruation; anal sex (because the anus is not self lubricating and the lining is easily broken); rough or abrasive sex; or, sex when there are any areas of broken skin in the genital area.

Safe sex means correctly using a condom and water-based lubricant during penetrative sex, condoms and dental dams during oral sex and latex gloves when penetration with the hands or fingers occur. Safe sex practices also apply to sex toys.

Safe sex is also recommended where there is a risk of transmission of sexually
transmissible infections.

Do I need to tell my sexual partners I have
hepatitis C?

Because of the low risk of infection during sex, if you are practising safe sex, whether or not to disclose to a sexual partner is your choice.

For some people disclosing that you have hepatitis C to a sexual partner can be daunting and confronting.

Does hepatitis C affect sex drive?

There is some evidence to suggest that hepatitis C affects sex drive for some people. The pressures and symptoms of living with a chronic illness may also mean some people sometimes have less interest in and energy to devote to sex.

For some people, combination therapy and its side effects can put a dampener on sexual feelings. However, after therapy many people find that their sexual feelings and sex drive return to normal.

Sex and treatment

Whilst you or your partner is taking combination therapy (Pegylated interferon and ribavirin) you must use effective forms of contraception.

The Pharmaceutical Benefits Scheme requires that both sexual partners use an effective form of contraception (that means two forms of contraception per sexual couple) when one is taking combination therapy. Drugs used in combination therapy may affect the health of the foetus and course of the pregnancy.

Hepatitis C and relationships

Living with a chronic illness such as hepatitis C can impact on friendships and relationships. Relationships may change or be challenged by living with an illness. Chronic illness can change relationships, some get closer and others become strained.

Some hints for maintaining healthy relationships for those living with

hepatitis C:

accept changes and evaluate which relationships are helpful to you. Accept that there are people who you can count on for support and others that you can’t. You may find that what you can’t get from one person another can provide (whether kindness, understanding or a chance to escape);
communicate with those you feel close to. By communicating your needs to others it gives them the choice and opportunity to help and support you. Talk to your partner, family or friends. Discuss with them what you want, need and expect and what they feel able to do;
acknowledge the feelings and needs of others. People you care for may need space and support to explore their own feelings about your hepatitis C. It’s important to remember that people in your life may have worries and challenges that have nothing to do with your illness;
maintain a life outside hepatitis C. Having a variety of interests and relationships can help to meet your needs at different times. Maintaining relationships that are about more than your hepatitis can sometimes provide a much needed escape or distraction; and
remember that it is your choice whether to tell family and friends that you have hepatitis C. You may decide that it is appropriate to disclose this information to some people you are close to and not to other family and friends.