Hepatitis Fact Sheet for Men Who Have Sex with Men

Among MSM, activities such as oral sex, rimming and fisting are often considered “permissible” because the rate of HIV transmission is lower than penile-anal penetrative sex. However, these activities are a good way to acquire sexually transmitted diseases (STDs) as well as various forms of hepatitis.

Modes of Transmission

* The primary mode of hepatitis A transmission between individuals is fecal-oral, i.e. a person’s mouth comes in contact with fecal material infected with the hepatitis virus.

* Hepatitis B is transmitted via unprotected sex, sharing needles, needlestick, and mother to child during birth.

* Hepatitis C is transmitted by blood thereby making drug sharing/reusing equipment (cookers, needles, cotton, straws etc.) dangerous. HCV can be transmitted during sex, but this is not as frequent an occurrence as it is for HIV, and mother to child during birth.

Preventing Hepatitis

* Be vaccinated against Hepatitis A and B.

* Adopt safe sexual and hygiene practices: washing after using the toilet (liquid soap is better than bar soap), using dental dams and condoms when going down on your partner or when rimming, using gloves if you engage in fisting, washing any sex toys that come in contact with any of the fluids mentioned above, avoid sharing toothbrushes, razors or other personal articles that might contain blood, avoid sharing needles and other drug equipment.

* Do not share/reuse drug equipment (needles, cookers, cotton, straws etc.)

Symptoms of Hepatitis

Fatigue, fever, nausea, vomiting, stomach pain, loss of appetite, dark tea-colored urine, light clay-colored stool, yellow skin or eyes (“jaundice”), and muscle and joint aches.

While hepatitis A and B often produces the symptoms described above, the majority of people that become infected with HCV do not experience symptoms significant enough to make them take notice that something is wrong.

Consequently, it may not be until they are tested, or have significant health problems in years to come that they realize they have been infected.

Impact of Hepatitis

Persons infected with hepatitis A generally get well with no lasting problems. There is no chronic (long-term) infection. Once you have had hepatitis A you cannot get it again. About 15% of people infected with HAV will have prolonged or relapsing symptoms over a 6-9 month period.

For persons infected with hepatitis B, 90% of infants infected at birth, 30% of children infected at age 1-5 and 6% of persons infected after 5 years of age will develop chronic hepatitis B. Death from chronic liver disease occurs in 15-25% of chronically infected people.

For persons infected with hepatitis C, 75%-85% will develop chronic disease with 70% developing chronic liver disease. HCV is the leading cause of liver transplants in the United States. It is also a factor in a variety of illnesses including rheumatoid arthritis, fibromyalgia and even diabetes.

Vaccines for hepatitis A and B are available and are a sure way to prevent contracting these diseases. However, safer sex practices, good hygiene and not sharing drug equipment are still needed as there are many different diseases that can be transmitted otherwise.

Vaccination Information

In general, if you wish to obtain a vaccination for hepatitis A and or B, you should contact your health care provider. He or she will then write a prescription for you to obtain the vaccine from your local pharmacy.

Pharmacies will not usually stock this, so in many instances it will need to be ordered. When it has arrived you will need to keep the vaccine refrigerated until you can bring it to your provider who will then administer the injection. Most insurance companies will cover hepatitis A and B vaccinations.

Other agencies such as Planned Parenthood have a sliding scale for the cost of hepatitis vaccines. Call your local Planned Parenthood for more information.

At various times, organizations such as AIDS service organizations, and even gay bars, offer vaccinations.

In Vermont, vaccinations can be obtained from the Comprehensive Care Clinics in: Brattleboro 802-257-8860; Rutland 802-747-1831; Burlington 802-847-4594 and St. Johnsbury 802-751-7603. Call for an appointment.

If you live in Chittenden County, you can contact Vermont Cares at 802-863-2437 to arrange for a vaccination appointment.

In NH, contact the Infectious Disease program at Dartmouth Hitchcock Medical Center at 603-650-6060.