Hep B Blog

Romance in the Air? Take a Deep Breath and Disclose

Image courtesy of tiverylucky, at FreeDigitalPhotos.net
Image courtesy of tiverylucky, at FreeDigitalPhotos.net

Valentine’s Day may be a time to celebrate romance, but first you need a relationship. When you have chronic hepatitis B, starting a relationship and initiating sex is fraught with stress, hard disclosures, and the potential for break-up before an intimate relationship can even begin.

Recently, the Hepatitis B Foundation received this heart-breaking post from a 33 year-old man who thought his “inactive” hepatitis B could not be transmitted sexually.

“I’ve lived my entire life with this, but always thought it was just a normal thing (my mother said many Asians have it) and thought it was nothing to be concerned about as I never showed symptoms,” he wrote. “My doctor never said anything either. I lived my life thinking being a carrier was nothing out of the ordinary, and that I … could transfer it via blood, but could not sexually.

“I recently became sexually active with a wonderful girl who I care about dearly. The thought of my inactive hep-B never crossed my mind until after the act. It was irresponsible of me to not look into this more before we had sex, I admit, but I was not educated on the severity of this disease.

“After reading a bunch about it, I learned that even in the inactive state, it is possible, though not too likely, to transmit it sexually,” he explained. “I told her about this and she was understandably very upset. I asked her to get tested and to get the vaccine and also the immune globulin, which she will, but the conversation did not go over too well.

“I betrayed her trust and though she understands I wasn’t ‘hiding’ this from her, she said it was incredibly irresponsible of me to not understand my own condition and now have it potentially affect her (she is right). I’m not trying to pass the buck here, but I wish my doctor and parents told me more details about this when I was growing up. Regardless of what her tests come back as, I doubt our relationship will be the same, which breaks my heart, but I understand that I did something terrible.

“I’d like to know of ways to talk about this without eliciting too much fear. When I told her, I was very nervous because I didn’t know how she’d react and I was also very concerned for her health, which didn’t help things as she got very nervous as well. I tried to keep telling her that I was inactive and that transmission is not likely, but I couldn’t lie and say it was impossible,” he concluded.

When we disclose before sex–even if it’s safe sex with a condom–we don’t jeopardize the person’s trust in us–or their health–before the relationship deepens. Talking about hepatitis B helps reduce the stigma surrounding this infection and may even prompt the person to get vaccinated.

So how do we tell a potential partner that we have hepatitis B? Calmly and carefully. Here is one way to initiate disclosure: “Before we become intimate, we need to talk about STIs and contraception. The reason I’m bringing this up is that I have hepatitis B. You need to know that, and we need to decide how to protect ourselves… ”

Do some research. Having a thorough understanding about hepatitis B can make it easier for you to explain it to a potential partner. The more you know, the less you fear, and the more comfortable you will be in dispelling their fears and conveying a sense of truth and integrity.

Here are some tips from the American Sexual Health Association for disclosing an STI.

  1. Pick a time when both of you will be in reasonably good moods and relaxed for this conversation. Choose a place with few, if any, distractions.
  2. Start out on a positive note (“I’m really happy with our relationship…”). This will put them in a positive mindset, and they may respond more agreeably than if you start out saying something like, “I have some really, really bad news… “
  3. Your delivery can influence their reaction to what you say. If you talk calmly about hepatitis B, they may respond similarly. If you act like it’s the end of the world, they might agree that it is.
  4. Allow a conversation to take place, rather than doing all of the talking yourself.

Disclosure is the right and ethical thing to do. How they respond is out of your control, but their response might just surprise you.

14 thoughts on “Romance in the Air? Take a Deep Breath and Disclose”

  1. Well, I totally understand her reaction and also have some execuse for you guy.
    For me i’m 32 years old now and i didn’t have any relationship till now because I don’t think that any girl would accept to be married to a hep b positive partener. Especially that i’m a doctor and if i got teted now i would be dismissed form my job and it would be imppssible to get a job anywhere
    It’s really blocking my life

    1. Hello: As a doctor, you know that if your wife was immunized, you could safely married and have children without any risk of infection to her or your children. As long as you are honest, I think the right woman would marry you! Good luck.

    2. I am sad to say that I am also positive to hep B And also afraid to tell it to my friends because I know they will reject me. Unfortunately all the people who are suffering from this decease can not tell the truth to their partners because if we were at their position , we will also be afraid and want to break up just in case we get the decease.. I really hope that in the future doctors will find the medicine to cure it..

      1. Hello: I am sorry that hepatitis B carries with it such stigma. Perhaps if we take the chance and talk about it, people will not be so afraid. Good luck.

  2. Below 300iu/l the viral load is considered undetectable, however my viral load report was able to report 21iu/l. How is this possible?

    1. Hello: From a medical standpoint, doctors consider “detectable” viral load to be at least 200 Iu/mL. Below that, the amount of virus is your body is so low as to be of little medical consequence. Also, some labs may measure down to only 300 Iu/mL, because that is considered medically significant, while other labs can measure down to the single digits, even though there is no medical reason to. Good luck.

  3. Am a hep b Carrie ,but afraid of telling my paterner ,he has always been afraid of this deseases ,now am afraid he may find out when getting married

    1. Hello: You owe it to him to tell him about your infection, as you can put him at risk through sex. It is the ethical thing to do. He will find out some time in the future, and he will lose trust in you if you do not tell him now. Do you know if he has been vaccinated? And, have you always practiced safe sex?
      I know disclosure is difficult, especially when it comes late in a relationship, but it is the honest and right thing to do. Good luck.

    1. Hello: Please do not think of yourself as damaged goods. Do not let hepatitis B define you. If the person who were dating left because of your hepatitis B, he or she was not worth having a relationship with.
      As one of the leaders of the hepatitis B email list (http://hblist.net/) wrote, “I am disheartened to see so many people find us because they feel rejected and lonely. You CAN Date. You CAN marry. You CAN have sex. You CAN have a normal life. It’s not health, income, or outside circumstances that hold us back. It’s our perspective. There are many people who succeed in this world in the presence of severe obstacles. They succeed because they don’t let it limit them. And they don’t feel sorry for themselves – they use what they do have to their advantage.
      Remember the big picture and do not get discouraged staring at one locked door when the room is full of other doors and windows.”
      Good luck.

      If there is one thing I could leave this list with after 9 years of learning from you all is to ‘KNIOW’ HBV is not a punishment or a disability. It can be an opportunity to discover how to love and accept yourself. And to learn what really matters in relationships and life.

  4. Hi
    My fiancé is an inactive Carrier of the hep B virus. Although I’m negative & received the vaccine, im still worried about possible infection. Is there any way to test the effectiveness of the vaccine? & what does being an inactive carrier actually mean?

    1. Hello: As a result of your vaccination, you should get tested for hepatitis B surface antibodies (anti-HBs). If you have at least 10 mIU/mL of surface antibodies, it means your immune system is able to permanently protect you from hepatitis B, and you should no longer worry. However, it’s important to get tested to make sure.
      An inactive carrier means someone has a low level of the hepatitis B virus in their body, and it is not harming their liver, which is a good thing. However, he should still continue to be monitored at least once a year to make sure the infection does not harm his liver. Good luck.

    1. Hello: Your viral load (HBV DNA) is quite low, which is very good news.
      Keep in mind that not everyone with hepatitis B requires treatment, many people live long and healthy lives with hepatitis B. Generally, medical guidelines recommend treatment only if you are experiencing liver damage. This is indicated by an ultrasound and a simple blood test for the liver enzyme ALT (also called SGPT). Our liver cells release ALT when they are damaged or die. Healthy ALT levels for men are up to 30, and for women they are up to 19. Please consult with your doctor and see what your ALT levels are to determine if you require treatment.
      If you ever do, there are two very effective antiviral medications that are recommended: tenofovir (Viread) and entecavir. Good luck.

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