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Does Gay Sex Spread Hepatitis C?

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Since the HIV epidemic exploded in the 1980s, homosexuals have been targeted as responsible for spreading sexually transmitted diseases. Despite the evidence documenting how it is transmitted, many mistakenly assume that gay sex readily spreads the Hepatitis C virus.
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Editor’s Note: The material below is intended for mature readers only, and does not necessarily reflect the views of Hepatitis Central.

Differing religious and cultural views on homosexuality often find its way into popular medical beliefs. Despite the progress made with human rights, moral judgment on homosexuals has contributed to the condemnation of gay and lesbian sexual practices. This stigmatization is especially prevalent in non-academic discussions about the spread of various contagious diseases, like the Hepatitis C virus. One’s personal views on gay sex can have a variety of influences, but the evidence confirming how Hepatitis C is spread suggests that sexual orientation is not a factor in the spread of this virus.

Hepatitis C Transmission

A contagious liver virus that infects between four and five million American adults, Hepatitis C is contracted when infected blood enters the bloodstream of someone who is not infected. Because an estimated 30 percent of those with the virus cannot identify how they contracted their infection, each and every potentially risky activity has become suspect. Although not technically considered to be a sexually transmitted disease, the substantial number of infections with an unknown origin has placed sex under Hepatitis C transmission scrutiny.

Mostly encountered from receiving a contaminated blood transfusion or the sharing of intravenous needles, the transfer of blood can also occur with other activities such as:

  • Sharing toothbrushes, nail clippers or razors
  • Sharing intra-nasal drug devices
  • Using improperly sterilized tattoo, piercing or other equipment that breaks the skin

Hepatitis C is rarely transmitted via sexual activity; however, rigorous sexual behaviors are suspected risk factors. Various studies on what constitutes the risks associated with the sexual transmission of Hepatitis C have turned up inconsistent results. Nonetheless, researchers agree that blood-to-blood contact is a requirement for passing on this virus.

Some groups that frown on homosexuality have indicated that gay sex is a vehicle for spreading Hepatitis C. However, the factors that increase the risk of transmitting Hepatitis C during sex are the same for sexual activity between opposite genders as sexual activity between those of the same gender.

What Is Risky Sex?

As the transfer of blood is necessary to transmit Hepatitis C, sexual activities where blood is present or that could cause bleeding are the riskiest. Several instances where this risk exists include:

  1. Bleeding or Breaks in the Skin – If either partner is bleeding such as in bleeding gums, cuts, sores, blisters or during menstruation, there is a risk of sexually transmitting Hepatitis C.
  2. Multiple Sex Partners – Regardless of sexual orientation, those with multiple sex partners (simultaneously or consecutively) are at increased risk of spreading pathogens.
  3. Anal Sex – Since anal penetration can tear the sensitive skin around the anus or the sphincter, there is a chance of blood exposure. Practiced by an estimated two thirds of male homosexual couples and one third of heterosexual couples, anal intercourse rarely transmits Hepatitis C.
  4. Fisting – An uncommon sex act with heterosexual couples, fisting involves the insertion of the whole hand or forearm into the anus or vagina for sexual stimulation. Since the diameter of the hand or forearm is much greater than that of the penis, there is an increased risk of anal or vaginal injury. Thus, fisting is considered a potential vehicle for Hepatitis C transmission via injury to these sensitive tissues.
  5. Other Practices that Break the Skin – Whether a common sexual practice or unique fetish, activities that break the skin are risky. These could include anything from certain S & M practices, using sexual aids that could damage genital mucosa or rough heterosexual vaginal sex.

In addition, several studies have concluded that concurrent HIV infection, having a high Hepatitis C viral load, injecting intravenous drugs and being in the acute stage of Hepatitis C infection all increase the likelihood of transmitting Hepatitis C during sexual activity.

While there are many sexual practices that are capable of spreading Hepatitis C, those practices do not single out gay sex. Based on stigmatizing propaganda, individuals who are not aware of the most up-to-date research on Hepatitis C transmission might assume that homosexuals are most likely to spread this virus through sexual contact. However, this assumption is misleading. The truth is, engaging in any sexual behavior involving blood exposure raises the risk of transmitting Hepatitis C – a fact that is completely independent of someone’s sexual orientation.

References:

http://gaylife.about.com/od/stdinformation/g/hepatitisc.htm, Hepatitis C and Gay
Sex, Ramon Johnson, Retrieved December 3, 2010, About.com, 2010.

http://lesbianlife.about.com/cs/sex/a/safersex_2.htm, Safe Sex for Lesbians and Bisexual Women, Kathy Belge, Retrieved December 3, 2010, About.com, 2010.

http://sexandhepc.com/, Hepatitis C and sex: More questions than answers, Retrieved December 5, 2010, Glenn Abel, 2010.

http://www.hivandhepatitis.com/2010_conference/aasld/docs/1105_d.html, Danish Study Looks at Hepatitis C Sexual Transmission among HIV Positive Gay Men, Liz Highleyman, Retrieved December 3, 2010, hivandhepatitis.com, 2010.

http://www.netdoctor.co.uk/sexandrelationships/analsex.htm, Anal Sex, Dr. John Dean, Dr. David Delvin, GP, Retrieved December 3, 2010, NetDoctor.co.uk, 2010.

http://www.thebody.com/Forums/AIDS/Hepatitis/Archive/HepCtreat/Q11267.qna, Lesbians and Hepatitis C, Dr. Dieterich, Retrieved December 3, 2010, The Body, 2010.

http://www.thebodypro.com/content/art54451.html, Sexual Transmission of Hepatitis C Happens Through Blood, Not Semen, in Gay Men With HIV, Study Says, December 3, 2010, The Body, 2010.

Peterkin, Allan MD, Cathy Risdon MD, Caring for Lesbian and Gay People: A Clinical Guide, University of Toronto Press Incorporated, Toronto, Canada, 2003: p 37-42.

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