Most of the five hepatitis viruses can be spread through sex. There are, however, significant differences in how they're spread and the risk of exposure during sexual contact. Here's a short description of your risk of exposure to hepatitis from sex for each virus.
It's estimated that about 20 percent of new hepatitis A infections are spread through some form of sexual contact. The hepatitis A virus spreads from ingesting feces that are infected with the hepatitis A virus (fecal-oral spread
). Having oral-anal sex with someone infected with hepatitis A can expose you to the virus. Although anyone can get hepatitis A (who isn't already immune due to vaccination or prior infection) men who have sex with other men and people who have oral-anal sexual contact are at an increased risk for getting hepatitis A.
Sexual intercourse is a very common way that hepatitis B spreads. Nearly two out of every three acute cases in the United States are caused by sexual exposure. It's possible for the hepatitis B virus to be in several body fluids, including semen, vaginal fluids, and of course, blood.
You can be exposed to the hepatitis C virus during sexual contact with an infected person, but this isn't common. Your risk of getting the virus increases if you have sex with more than one person, have an STD (sexually transmitted disease), have rough sex, or have HIV.
You can be exposed to the hepatitis D virus (HDV) through sexual contact. HDV, which spreads by contact with infected blood, spreads much like hepatitis B. However, HDV isn't able to cause infection by itself. It can only cause disease in people already infected with hepatitis B. Therefore, if you have hepatitis D, you'll also have hepatitis B (you can, though, have hepatitis B without hepatitis D).
The Hepatitis E virus (HEV) spreads, in many ways, like the hepatitis A virus. Both can spread from an infected person to someone not infected using the fecal-oral route and both can contaminate water or food supplies, causing community outbreaks. However, unlike hepatitis A (according to the World Health Organization), hepatitis E doesn't easily spread from person-to-person (for example by shaking hands) and there is no evidence that HEV spreads from sexual contact
. Hepatitis E isn't very common in the United States.
Kissing and Hepatitis Exposure
Most types of kissing are not a high-risk way to spread hepatitis. However, there may be ways of kissing that increase this risk of spread, especially with the hepatitis B virus. For more information, read How Infectious Is a Kiss?
Preventing Sexual Spread
You can take several effective steps to lower your risk of infection from sexual spread, and in some cases, prevent it completely. Avoiding oral-anal contact and any direct contact with infected blood, vaginal fluids, semen and saliva is a very safe approach to prevent any exposure. However, there are less restrictive ways that will significantly lower your risk of exposure during sex.
Vaccination is an effective way to prevent exposure to the viruses that cause hepatitis A, hepatitis B and hepatitis D (hepatitis D doesn't have a specific vaccine, but can be prevented with the hepatitis B vaccine). Another effective strategy to lower your risk of exposure is to use condoms when having sex, especially with someone who has viral hepatitis. For information on how to properly use and wear a condom, here's an easy to follow list of steps.
Centers for Disease Control and Prevention. Viral Hepatitis. Accessed September 28, 2009. http://www.cdc.gov/hepatitis/
World Health Organization. Hepatitis Delta: An Introduction. Accessed September 28, 2009. http://www.who.int/csr/disease/hepatitis/whocdscsrncs20011/en/index1.html
World Health Organization. Hepatitis E Transmission. Accessed September 28, 2009. http://www.who.int/csr/disease/hepatitis/whocdscsredc200112/en/index3.html#transmission