Sexual Transmission and Viral Hepatitis
Certain adults who are sexually active should be vaccinated against hepatitis B.
CDC and the Advisory Committee on Immunization Practices (ACIP) recommend hepatitis B vaccination for
- sexually active people with more than one sex partner during the previous 6 months;
- people seeking evaluation or treatment for a sexually transmitted disease;
- sex partners of people with hepatitis B; and
- men who have sex with men (MSM).
Sexual Transmission and Hepatitis A
Transmission of hepatitis A virus can occur from any sexual activity with an infected person and is not limited to fecal-oral contact. People who are sexually active are considered at risk for hepatitis A if they are MSM, live with or are having sex with an infected person, or inject drugs. Vaccination is the most effective means of preventing hepatitis A transmission among people at risk for infection. CDC has published recommendations for prevention of hepatitis A that identify all groups recommended for vaccination, including hepatitis A vaccination for MSM.
Sexual Transmission and Hepatitis B
Hepatitis B can be transmitted through sexual activity. Unvaccinated adults who have multiple sex partners, along with sex partners of people with chronic hepatitis B infection, are at increased risk for transmission. Injection-drug use and sexual contact are other common modes of hepatitis B transmission in the United States.
Among adults seeking treatment in STD clinics, as many as 10%–40% have evidence of past or current hepatitis B virus infection. Many of these infections could have been prevented through universal vaccination during delivery of STD prevention or treatment services. Offering vaccination to all adults as part of routine prevention services in STD treatment facilities has been demonstrated to increase vaccination coverage among adults at risk for hepatitis B infection, as the behavioral risk factors for STDs and hepatitis B are similar.
Sexual Transmission and Hepatitis C
Although not common, hepatitis C can be transmitted through sexual activity. Having a sexually transmitted infection, having sex with multiple partners, and engaging in anal sex appear to increase a person’s risk for hepatitis C. MSM with multiple sex partners who are coinfected with HCV and HIV have been shown to transmit hepatitis C. There is no vaccine for hepatitis C. The best way to prevent hepatitis C is by avoiding behaviors that can spread the disease, especially sharing needles or other equipment to inject drugs. CDC recommends one-time hepatitis C testing of all adults (18 years and older) and regular testing for people with risk factors. The American Association for the Study of Liver Disease (AASLD) and the Infectious Diseases Society of America (IDSA) also recommend that people who are infected with HCV be provided with curative, direct-acting antiviral medicationsexternal icon to treat their HCV infection.
Scientific Guidelines and Recommendations
CDC Recommendations for Hepatitis C Screening Among Adults — United States, 2020. MMWR 2020; 69(2);1–17.