Men who have sex with Men & Hepatitis: Know the Risks

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MEN WHO HAVE SEX WITH MEN & HEPATITIS: KNOW YOUR RISKS 

Hepatitis A

Hepatitis A is a virus that causes liver inflammation. After a brief illness, most people get better on their own.

How is hepatitis A spread?

  • Hepatitis A is passed through the feces of an infected person
  • The most common way to contract hep A from eating food or drinking water that has been contaminated with the feces of an infected person
  • One can get hep A from licking the anus (or rimming) of an individual who has been infected

What are the symptoms of hepatitis A?

  • Symptoms usually develop within two to eight weeks following infection. Sometimes the symptoms are very mild and many people don’t realize that they have the virus. Such symptoms may include a general flu-like feeling with a loss of appetite, fever, nausea, and vomiting. Dark-coloured urine, clay-coloured feces, yellow skin and/or eyes, and tenderness on your right side below your ribs are also symptoms.
  • Symptoms might last from two weeks to several months, but you will recover. After recovering from hepatitis A, you will be immune to reinfection but you can still get infected with other hepatitis viruses like hepatitis B or C.

How do you test for hepatitis A?

Be honest with a health care professional about your sexual history and your symptoms. You may be asked to have a blood test to confirm the presence of hepatitis A antibodies.

How do I protect myself?

  • There is an effective vaccine that will prevent infection; it is free for gay men. You could share a shower or suggest one to your partner before you lick his anus.
  • Avoid drinking water that could be contaminated with fecal matter, especially when you are travelling in countries in the developing world. Avoid eating fruits or vegetables that have been washed in contaminated water.

Hepatitis B

Hepatitis B is a virus that causes liver inflammation. Most people infected with hepatitis B will get a mild case and will completely recover. This is called an acute or short-term infection. For a small number of people, their bodies do not clear the virus on their own and they go on to develop chronic or long-term hepatitis B.

How is hepatitis B spread?

Hepatitis B is spread through direct contact with saliva, blood, semen, or other body fluids from an infected person. It is passed during sex or by sharing drug equipment like needles, cocaine straws, and crack pipes.

What are the symptoms of hepatitis B?

  • Whether you have acute or chronic hepatitis B, you may or may not have symptoms.
  • Symptoms of acute hepatitis B usually develop within four to six weeks of infection. Sometimes the symptoms are so mild you might not realize you have the virus. You may notice a general flu-like feeling with loss of appetite, fever, nausea, and vomiting. You might also notice dark-coloured urine, clay-coloured feces, yellow skin and/or eyes, and tenderness on your right side below your ribs.
  • Symptoms of a chronic hepatitis B infection can be similar to those of an acute hepatitis B: they tend to be mild to moderate in intensity and typically they come and go.

How do you test for hepatitis B?

Be honest with a health care professional about your sexual history and drug use. You may be asked to give a blood sample to confirm the presence of hepatitis B antibodies.

How do I protect myself?

  • There is an effective vaccine that will prevent infection; it’s free for gay guys.
  • Regular use of condoms will reduce your chances of getting hepatitis B and other STIs.
  • You can reduce your chances of coming into contact with hepatitis B by reducing your number of sexual partners and by not sharing drug equipment.

Hepatitis B and HIV

  • Because HIV weakens the immune system, HIV-positive people who are also infected with hepatitis B are more likely to progress to chronic hepatitis B. If you have both HIV and hepatitis B, consult with your doctor about your options.

Hepatitis C

Hepatitis C is a virus that causes liver inflammation. There are acute and chronic stages of the disease. A small number of people’s bodies are able to clear the virus on their own during the acute or early stage of infection. However, this is not the case for most people and, as a result, they develop chronic hepatitis C.

How is hepatitis C spread?

  • Hepatitis C is passed when blood from an infected person gets into the bloodstream of an uninfected person. Microscopic traces of blood can carry the virus and the virus can survive in dried blood outside the body for several days to weeks.
  • The most common way to get hepatitis C is by sharing needles during injection drug use. Sharing cocaine straws and other drug equipment that may have blood on it is another way to get hepatitis C.
  • Hepatitis C can be passed during certain types of sex between guys. This usually occurs when an infected partner inserts a penis, sex toy, or hand into the anus of another guy. This often happens during group sex, where more than one bottom is sharing the same top or sex toy. Both rough sex and prolonged sex increase the chances that blood will be passed between guys. Sharing lube and poppers during group sex may also be ways to pass hepatitis C.
  • Hepatitis C is not passed in semen or feces.
  • Less commonly, hepatitis C can be passed when people share razors, nail clippers, or other personal care items that may have blood on them.

What are the symptoms of hepatitis C?

  • Hepatitis C may not produce symptoms for several years. Many people are surprised to find out they have been infected.
  • The acute or early stage is the first six months after infection. During this time, you may experience a general flu-like feeling with a loss of appetite, fatigue, and fever. You might also notice dark-coloured urine, yellow skin and/or eyes, and tenderness on your right side below your ribs. Many people do not experience any symptoms at all. A small number of individuals’ bodies will clear the infection on their own during this stage.
  • Chronic or long-term infection occurs in the majority of people; their bodies aren’t able to clear the infection on their own during the acute stage. Symptoms typically do not occur for several years. Gradually, however, the disease progresses to the point where the liver cannot function properly. Fatigue and poor appetite are common problems at this stage.

How do you test for hepatitis C?

Be honest with a health care professional about your sexual history and your history of drug use. You may be asked to give a blood sample to test for hepatitis C antibodies.

How do I protect myself?

  • Try to eliminate your exposure to the virus.
  • Don’t share anything that may have blood on it.
  • Don’t share drug equipment, especially needles, cocaine straws, or pipes.
  • During sex, don’t put anything into your anus that might have someone else’s blood on it. Sharing lube or poppers should also be avoided.
  • Use condoms during anal sex, and use plenty of lube to reduce tearing in your anus. Have anal sex for less time, and with less force. For fisting, use gloves on a clean arm and don’t share lube. Change condoms or gloves each time you move between partners. Be sure to wash up between partners as well.
  • You can reduce your chances of coming into contact with hepatitis C by reducing your number of sexual partners. If you have numerous partners, get tested regularly.

Hepatitis C and HIV

  • HIV-positive folks are especially vulnerable to getting Hepatitis C during sex. Compared to HIV-negative people, HIV-positive individuals’ bodies are less likely to clear Hepatitis C on their own. They are also less likely to respond to antiviral drugs.

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