How do you get it?
Hepatitis C is not as easily passed on as hepatitis A or hepatitis B, but it can cause long term damage to your health and there is no vaccine to prevent it. The hepatitis C virus is present primarily in blood (including dried blood) and can also be present in cum. Traditionally injecting drug use was the most common way to catch hepatitis C but it is now known that unprotected sex, particularly high risk sex, and chem sex is associated with hep C infection. In particular HIV-positive gay men are getting hepatitis C sexually [1]. However, this does not mean HIV-negative guys are not at risk from unprotected sex.

There are a number of ways that hep C can be transmitted. These are:

  • Fucking without condoms with a man who has hep C. 
  • Sharing needles or works for injecting drugs, including steroids, with someone who has hep C. 
  • Being fisted by a man with hep C who has cuts or sores on his hand and isn't wearing a glove. 
  • Being fisted by a man who has just fisted another man with hep C and who hasn't put on an unused latex glove or thoroughly washed his hands between partners. 
  • Being fucked by someone who has just fucked another man with hep C and who didn’t change condoms between partners (or use condoms at all). 
  • Using a dildo or other sex toy that has just been used on a man with hep C and which hasn't been thoroughly cleaned, or had a new condom put on it. 
  • Sharing a drug snorting straw, banknote or bullet with someone with hep C, as small specks of infected blood could be on the straw, banknote or bullet.

How do you prevent it?
You can reduce the risk of getting hep C by:

  • Using a new condom when you fuck or get fucked
  • Using a new sterile syringe and needle for injecting steroids or recreational drugs. 
  • Making sure the man fisting you is wearing an unused latex glove. If you don't have any latex gloves, make sure the man fisting you doesn't have cuts or sores on his hands and has washed his hands thoroughly if he has just fisted someone else. 
  • Using a new condom on your dildo if it's been used on someone else. 
  • Using your own drug snorting straw, banknote or bullet.

How do you know you've got it?
Hepatitis C produces many of the same symptoms as hepatitis A and B, although most people do not notice any symptoms when they are first infected. A sexual health clinic can test you for hepatitis C. Make sure you ask for a test if you think you have been at risk. It is tested for by taking a blood sample.

How do you treat it?
When you first get hep C (within the first six months) it is called Acute Hepatitis C. In this situation approximately one in five people may clear the virus themselves over the first six months but you still need regular blood tests to ensure it has fully gone. The majority of people will not clear hep C without treatment. If diagnosed in time they can be treated early with interferon injections and ribavirin tablets, usually for six months, aiming to cure the infection.

If you are not treated early or if you have chronic (more than six months) hepatitis C there are many new treatments now becoming available which can also cure the infection. The choice of treatment depends on the strain of Hep C and should be discussed with your specialist. The treatment course is for several months and the drugs can have frequent side effects which may be severe.

Acute hepatitis C from sex is more common among HIV positive men but if you feel you have been at risk it is free and easy to do the test in a GU clinic. Treatment is more effective early on so if you've been at risk, getting tested regularly is recommended. People with hepatitis C should stay away from recreational drugs, steroids, fatty foods and especially alcohol.

In 2009, about 300 gay men were diagnosed with hepatitis C at sexual health clinics in the UK [2]. If you have had hepatitis C treated and cured or you cleared it yourself you still have no protection or immunity from catching it again. Many men will be re-infected if they continue to take risks. Long term hep C can cause many health issues including liver cirrhosis, liver cancer and death.

Which sexual partners should I inform if I've been diagnosed with hepatitis C?
You should inform anyone you've had sex with, or shared a needle with if you have injected drugs, up to two weeks before any jaundice appeared. If you don't have symptoms, it will depend on what stage of hepatitis C you have and the level of risk involved, so talk to your health adviser about this.




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1 Taylor LE, Holubar M, Wu K, Bosch RJ, Wyles DL, Davis JA, Mayer KH, Sherman KE, Tashima KT. Incident hepatitis C virus infection among US HIV-infected men enrolled in clinical trials. Clinical Infectious Diseases, 2011;52(6):812-818.
2 Health Protection Agency (HPA). Total numbers of STI diagnoses and other episodes of care seen at genitourinary medicine clinics by gender and sexual orientation, UK and England: 2000 - 2009. Health Protection Agency, 27 August 2010.