The risk of Hep C transmission through sexual contact is very small. However, it is possible to get the virus or pass it on to other people through sex if there is a possibility that blood is present, such as menstrual blood when a woman is having her period or blood from tiny cuts or tears during rough sex. Examples of this include fisting or prolonged sex without lubrication. The presence of STIs or HIV can also increase transmission of Hep C. Blood can also be present when people have cracks or cuts on their lips or in their mouth (that often occur with homemade or broken crack pipes), which means even oral sex has the potential to spread Hep C. Under these circumstances, using a condom or dental dam during oral, vaginal or anal sex will prevent the spread of Hep C.
Of course, safer sex is not just about condoms.
Some research says that the lifetime risk of Hep C transmission via unprotected sex in a lifelong monogamous heterosexual relationship is about 5%. For some people that risk is low enough to never use a condom. However, some people would never want to put their life partner at risk, no matter what the percentage. Using a condom is important for sex with almost anyone under almost any circumstance. With unprotected sex, people can be exposed to other infections, such as HIV, hepatitis B, or other STIs. Getting co-infected with a combination of diseases can have more serious impacts on a person’s health than one disease alone.
Of course, safer sex is not just about condoms. The choice to have safer sex requires willing partners, personal commitment and access to supplies like lube, dental dams, latex gloves and condoms. Learning to negotiate with a partner involves communication and trust and can be undermined by the pressure of instant sexual gratification or the need to feel intimate or included. Fear of rejection or low self-esteem can lead people to choose pleasure over protection, even though the two are not mutually exclusive.
Presenting people with all of their options, including access to male and female condoms, learning how to make safer sex decisions, and, ultimately, the autonomy to make such decisions, will empower them to make informed choices that are right for them.
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