You can’t neatly package and control everything, but you can use good judgment and not over react when thinking about hepatitis B transmission. HBV is not casually transmitted, but you know yourself, and both infected and uninfected individuals can take simple precautions. If you don’t have hepatitis B and you are sexually active, make sure you are vaccinated. If you have HBV, encourage your partners to get vaccinated.
Back to the questions I hear often about “adult” hepatitis B transmission:
Can I have sex with my partner(s) and not transmit HBV?
Your partner is at risk if he or she is not vaccinated. At a minimum, you should be practicing safe sex by using a condom. There is a double whammy of both infected sexual fluids, along with direct contact with mucous membranes of either male or female genitalia. Anal sex presents a higher risk than vaginal sex, but both are risky.
Is oral sex safe for my partner if I have HBV?
There are no studies or confirmed reports of transmission as a result of oral sex. However, you should consider the following: how high is your viral load? Are you or your partner having oral problems – bleeding gums, mouth sores, or anything that might increase the likelihood of infection through direct contact with blood? This sexual activity would be of limited risk, but use good judgment before engaging.
What about French kissing?
Once again, there are no data or confirmed reports of HBV transmission through French kissing. Just use good judgment and consider the viral load and the oral health of you and your partner.
What is the risk if someone’s “hand” comes in contact with “sexual fluids”?
It is not uncommon to get questions about a hand that has come in contact with sexual fluids. As you can imagine, the venues vary from strip clubs to secluded work- place areas and everything in between. Transmission certainly seems unlikely, but if there is direct contact with infected blood, there is risk. Use common sense. Take simple prevention measures and thoroughly wash your hands.
If you have participated in a high or low risk sexual activity, and you’re concerned about infection with hepatitis B – either giving it or getting it, testing is the only way to know for sure. Remember there is up to a 9 week window where a person may not test positive, even if infected with HBV. Be sure to test or re-test outside the window. If the person does not have a current or previously resolved HBV infection, then they should be vaccinated. Both partners still need to consider the risk of transmission of other sexually transmitted diseases, but the “shades of gray” of hepatitis B are hopefully a little clearer.