Safe Sex Guidelines for Hepatitis C

Medically Reviewed By William C. Lloyd III, MD, FACS
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If you have hepatitis C, you may worry about passing the infection to a sex partner. According to the Centers for Disease Control and Prevention (CDC), it’s possible to spread the disease through sexual contact, although it’s not likely.

But there are steps you can take to reduce the risk even further.

How Hepatitis C Is Spread During Sex

Hepatitis C is a viral infection of the liver. It can range in severity from a mild, short-lived illness to a serious, lifelong disease. The hepatitis C virus is spread primarily through contact with the blood of someone who’s infected. It’s still unclear whether the virus can live in saliva, semen, or vaginal secretions.

These factors increase the risk of spreading hepatitis C during sex:

  • Having multiple sex partners

  • Engaging in rough sex, which may lead to bleeding

  • Having a sexually transmitted disease

  • Being infected with HIV

Especially in those who have the above risk factors, hepatitis C can occasionally spread through vaginal intercourse. It might also spread through anal sex, which can damage the lining of the rectum, making it easier for the virus to gain access to the bloodstream.
It’s not known whether the hepatitis C virus can be passed during oral sex. There is no proof that this has ever happened. The virus is not spread by more casual contact, such as hugging or holding hands.

Guidelines for Long-Term Couples

If you have hepatitis C and are in a long-term, monogamous relationship, the risk of giving the infection to your partner during sex is very low. In one study, researchers looked at 500 longtime couples in which a partner had hepatitis C. They found a few cases in which one partner seemed to have passed the virus along to the other. That was rare, however, occurring in only about 1 out of every 190,000 sexual encounters.

The CDC says that people with hepatitis C who have one long-term, steady sex partner don’t need to change their sexual behavior. Your partner should be tested for the virus at least once, however. It’s also important to talk frankly about the situation. If either of you is concerned, using a latex condom provides added protection.

Guidelines for Other Individuals

If you’re not in a long-term, monogamous relationship, the risk of giving someone hepatitis C through sex is a bit higher. Be sure to inform any potential sex partners that you have the infection. These steps help reduce your risk of spreading the virus:

  • Avoid engaging in rough sex.

  • Get tested for sexually transmitted diseases and HIV.

  • Limit your number of sex partners.

  • Skip having sex when either partner has an open sore or cut in the genital area or is menstruating.

  • Use a latex condom every time you have sex.

Key Takeaways

  • Hepatitis C is spread primarily through contact with blood. It’s still unclear whether the virus can live in saliva, semen, or vaginal secretions.

  • Factors that increase the risk of spreading hepatitis C during sex include having multiple partners, engaging in rough sex, or having HIV or an STD.

  • If you have hepatitis C and are in a long-term, monogamous relationship, the risk of infecting your partner during sex is very low.
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2022 Aug 11
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Sexual Transmission of Hepatitis C Virus Among Monogamous Heterosexual Couples: The HCV Partners Study. N.A. Terrault et al. Hepatology, 2013, vol. 57, pp. 881-9.

  2. Sexually Transmitted Diseases Treatment Guidelines, 2010. Centers for Disease Control and Prevention, MMWR, 2010, vol. 59, no. RR12, pp. 1-110.
  3. Hepatitis C FAQs for the Public, Centers for Disease Control and Prevention. http://www.cdc.gov/hepatitis/hcv/cfaq.htm

  4. HIV and Viral Hepatitis, Centers for Disease Control and Prevention. http://www.cdc.gov/hepatitis/Populations/PDFs/HIVandHep-FactSheet.pdf

  5. Sex and Sexuality, U.S. Department of Veterans Affairs. http://www.hepatitis.va.gov/patient/daily/sex/single-page.asp