Sexual transmission of HCV

The risk for sexually transmitted HCV is more complicated than HIV. 

HCV is still primarily a blood borne infection, so contact with blood has the highest risk.

Although HCV has been found in semen, rectal and vaginal fluids, it is unclear how infectious HCV is in these fluids because levels are often very low.

However, some studies have reported high HCV levels in semen that are independent of HCV levels in blood.

The risk is low in monogamous, HIV negative heterosexual couples. However, much higher rates of sexual HCV transmission have been reported in gay men.

Three things might explain this higher risk.

1. HIV might reduce immune protection.
2. People with HIV/HCV coinfection having higher HCV viral load.
3. That some types of sex between men have a higher risk of HCV transmission.

Last updated: 1 November 2024.