Is Hep C an STI or not?

Dear Sasha, I meant to write about this when the column [“Underpants roommates,” July 21] appeared, but better late than never. A reader asked you about when to tell a potential partner about herpes and so forth. In your reply, you lumped Hepatitis C in with sexually transmitted infections.

Hep C is a blood borne disease that is mostly confined to those who have received blood products/transfusions and intravenous drug users who have shared needles. Unlike Hep B, the virus isn’t present in other bodily secretions such as saliva, semen, vaginal fluids, tears, urine etc.

I have to bleed and my partner has to bleed as well in order for me to give it to them. This could happen during sex, but is extremely unlikely.

Regardless, it is important to tell a potential partner about it and I do this. However, I always encounter so much misinformation. Your column is widely read, so please be more careful about how you lump illnesses together.

—Name Withheld

Dear Withheld,

Several years ago I talked to a worker on a Hep C helpline from the States who told me firmly that Hep C was not considered an STI, yet other sources I’ve consulted list it as being, though rare, sexually transmissible. More recently, popular sexual health educator Heather Corinna claims in her new book S.E.X. that Hep C may be more easily sexually transmissible than originally thought, though unfortunately she doesn’t elaborate. In the column you cite, I deliberately referred to Hep C in the context of an STI as a blood-to-blood virus. It may be unlikely that you exchange blood during sex—especially now that you are aware of your status—but there are instances where this can happen. Instances where a condom, glove or dental dam can easily be used as a fluid barrier.

Though some sources may not classify Hep C as a sexually transmitted infection, like a cold, it can be sexually transmitted. But you can also get infections that are classified as STIs in non-sexual situations too. It seems to come down to semantics, but I also wonder if transmissibility classifications are based on assumed sex practices (don’t think that just because doctors and researchers practise in the field of sex that they’re open about sex practices), so when someone says that something is essentially non-transmissible sexually, that may have a lot to do with what they perceive as legitimate sex.

I admit it is extremely difficult at times to convey precise facts about STIs, given that even reputable sources offer varying opinions. This extends to sexual response as well. I was dismayed to hear Dr. Betty Dodson’s wholesale denial of the existence of multiple orgasms on Susie Bright’s podcast the other day. She claimed they are better described as “aftershocks.” As someone who has them, I can assure you, all the grinding and sweat is not the labour of an aftershock.

What are we really talking about when it comes to your concern about Hep C being perceived as an STI? In my experience, one reason people want something that can be transmitted sexually delisted is because it represents a social obstacle to them. Being “sick” in a culture of germ nellies is challenging. Add to that the possibility that one can acquire your illness sexually and well, you’d better go get yourself a big scarlet letter to pin on your coat. With infections as common as Chlamydia enough to send many people into moralizing fits, the more life-threatening ones scare people to the point of callousness. Whether it’s difficult to contract sexually or not is not really the point for folks who have a problem with sex and the deserved consequences of its dissoluteness, but pandering to this fearful, sexually negative viewpoint is, to me anyway, an even more detrimental form of misinformation.

I’d rather people understand and accept the various ways one can contract an
illness, learn how to be safe and not judge themselves and others for being sexual, rather than be permitted to ignore the possibility altogether.

Got any questions for Sasha? E-MAIL: POULEDELUXE@YAHOO.COM