Hepatitis B: a sexually transmitted infection
Hepatitis B virus (HBV) is 50–100 times more infectious than HIV through sexual contact. It is present in blood, semen, and vaginal fluids, and can be transmitted through vaginal, anal, or oral sex. It is also transmitted through sharing needles or other injecting equipment, and from mother to baby at birth. A highly effective vaccine is available on the NHS for people at increased risk, including anyone with multiple sexual partners, people who inject drugs, MSM, and sex workers.
Hepatitis C and sexual transmission
Hepatitis C virus (HCV) is primarily transmitted through blood-to-blood contact, most commonly sharing injecting equipment. Sexual transmission does occur but is less efficient than for HBV, and is more likely in the context of high-risk sexual practices involving blood exposure — particularly fisting, use of sex toys without cleaning, or during certain drug-facilitated sex sessions. MSM, particularly those who use recreational drugs during sex ("chemsex"), have experienced a significant increase in HCV sexual transmission in recent years.
Testing and vaccination
Hepatitis B and C testing is available at all sexual health clinics and can be ordered via home testing services. An HBV vaccination course provides long-term protection and is recommended for anyone at increased risk. There is no vaccine for hepatitis C, but highly effective direct-acting antiviral treatments can cure HCV in most people within 8–12 weeks with minimal side effects.