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Sexual transmission of hepatitis C
In the past, sexual activity was thought to be low risk for hepatitis C transmission. However, there is now an increasing number of cases occurring among gay men and other men who have sex with men (MSM), particularly among those men living with HIV. Although some of these cases relate to sharing of injecting equipment, it would appear that the majority of cases are related to sexual transmission.
Unprotected anal sex is the main risk for sexual transmission of hepatitis C. This risk is increased by any sex that increases the risk of damage or injury to the lining of the anus, such as fisting, prolonged (long-lasting) sex sessions, rough sex, and unprotected anal sex—especially during party drug use and group sex. Sharing unwashed sex toys can also be a risk.
Each of these situations involves potential exposure to blood, bleeding or broken skin, that may not be easily seen allowing entry into the bloodstream, and therefore, potential exposure to the hepatitis C virus.
Hepatitis C is also found in semen, though it is not clear if this adds to the risk of sexual transmission during unprotected anal sex.
For more information about hepatitis C, please see the ‘Hepatitis C’ page in ‘The Bugs’.