Hepatitis C

Getting infected with hepatitis C (HCV) is a serious matter. It may lead to liver disease and liver cancer in the long term. Sexually transmitted hepatitis C is most common in HIV-positive homosexual and bisexual men, however there are cases where HIV-negative men have contracted the virus through sex. Even if you are 'top' only, this information is still important for you to read.

A serious STI

Hepatitis C can lead to liver disease and liver cancer in the long term. If you have HIV, it may speed up the rate of damage to your liver.

Difference between Hepatitis A, B and C

Hepatitis C should not be confused with hepatitis B and hepatitis A. There is a vaccine for the last two but none for C. Once you have had hepatitis A or B, you cannot be infected with it again, but you can get hepatitis C any number of times, even after successful treatment.

Especially HIV-positive men...

HIV-positive men are particularly susceptible to getting hepatitis C during sex. Even if you take HIV medication, you can still get this STI.

And in a few cases, HIV-negative men…

This does not mean that HIV-negative men are not at risk. There have been cases of HIV-negative men contracting the virus by having sex. It really depends on the type of sex you have as well as the network of men whom you have sex with. There may be more hepatitis C in your network than in other sex networks.

At risk for hepatitis C

You are more at risk of contracting hepatitis C when for example minuscule bleeding occurs during fucking or fisting, when sharing lubricant and sex toys, having sex with several men at a time, during anal ejaculation and oral ejaculation when there are small wounds present. You can find a list of all the risk factors at the bottom of this page (see the blue box).

Contact with blood

During sex, hepatitis C is transmitted through contact with blood that contains the virus. Damaged mucous membranes, small wounds or ulcers (for example due to an STI) are ways through which hepatitis C can enter the body. Blood particles are not always visible. Tiny wounds on the mucous membrane of the anus can easily occur during fisting, when you fuck (long and hard) or when dildos or other toys are used.

Extremely contagious

Hepatitis C is extremely contagious. It can survive outside the body, far better than for example HIV. Hepatitis C may stay active for up to 6 weeks at room temperature on materials such as steel, plastic, rubber and in lubricants. That is why hepatitis C can be easily be contracted if slings or mattresses used by several people aren’t disinfected properly during or after sex.

Possibly via sperm

Research has shown that hepatitis C can sometimes be found in sperm. This is more likely in a recent or an acute infection with hepatitis C (approximately the first six months after infection). More research is needed on sperm as a route of transmission. Whether or not hepatitis C can be present in pre cum, has not yet been investigated.

Sex with multiple partners

There is a greater risk of contracting hepatitis C from other HIV-positive men if you have sex with multiple partners at the same time or consecutively. Threesomes, moresomes, group sex and orgies provide the perfect conditions for hepatitis C to spread rapidly. Not only do (private) sex parties constitute a higher risk but also sex with multiple men in a dark room, cruising area or sauna.

Reducing the risk of hepatitis C

You can reduce the risk of becoming infected with hepatitis C by:

  • ensuring that no sperm enters the anus or rectum
  • using latex gloves and your own lubricant during fisting
  • between every change in partner or role, thoroughly disinfecting and degreasing:
    -Your hands, arms, penis, balls, pubic hair and groin (even if you use gloves and/or condoms)
    -The sling and play area

Extensive information about preventing hepatitis C can be found here.

The top as ‘helping hand’

Unfortunately, as a top you may unknowingly play a role in spreading the virus among your sex partners. Being top, you have little chance of becoming infected yourself, however you can transfer the virus from one bottom to another. In other words, you act as a “helping hand” to the virus. As a top, make sure that you too know what to do to reduce the risk of transmission.

Get Tested

Are you HIV-positive and do you get fucked or fisted? Get tested for hepatitis every three to six months. This recommendation does not necessarily apply to you if you are HIV-negative. But if you think that you are at risk for contracting hepatitis C, do not hesitate to get tested. Discuss this with your general practitioner (GP). At the moment doctor's offices are the only places where hiv-negative men can get tested for hepatitis C.

Get tested if a partner has told you he has hepatitis C or if you think you have symptoms of hepatitis C.


Risk factors for Hepatitis C

Below are the risk factors for hepatitis C:

Sex in a 'network' where relatively more men are hepatitis C infected.

  • Fuck without a condom
  • When somebody ejaculates inside you (without a condom)
  • Sex with multiple men at the same time or consecutively

(Invisible) bleeding in the rectum and anus due to:

  • Fisting and using toys
  • Dry mucous membrane due to drug use
  • Increased blood circulation in the anus due to popper use
  • Long and hard fucking
  • Fucking with too little lubrication
  • Fucking with a glans piercing

Lesions (small wounds) due to:

  • Recent operations to the anus, for example, the removal of anal warts
  • Lesions on hands and infected cuticles

Sharing the following:

  • Dildos, toys and anal douches which are not properly disinfected
  • Pots of crisco, bottles of j-lube or other lubricants
  • Syringe needles
  • Snorting paraphernalia (straws, rolled-up bank notes, spoons, etc.)
  • Other drug paraphernalia
  • Paraphernalia for anal insertion of drugs
  • Towels with traces of blood or lubricants
  • Razors or nail clippers

Improper disinfection of the following during sex:

  • Hands, arms, penis, balls, pubic hair and groin
  • Toys
  • Play area

We regularly update the information on this site. Last modified: january 2017

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