References UK clinical guidance from the NHS, the British HIV Association (BHIVA), and the British Association for Sexual Health and HIV (BASHH). Last updated: April 2026.
Hepatitis C is primarily transmitted through blood-to-blood contact, most commonly through sharing injecting equipment. Sexual transmission is possible but far less common than for HIV or hepatitis B. Hepatitis C virus can be present in semen, though usually at low levels, and the risk of transmission during sex depends heavily on the type of sex and whether any blood is present.
Here’s what the evidence shows.
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Is Hepatitis C in Semen?
Yes, hepatitis C RNA has been detected in semen, though usually at much lower levels than in blood. The concentration varies between individuals and is higher in people with:
- High hepatitis C viral load in blood
- Co-existing HIV infection
- Genital inflammation or ulceration
- Other STIs that cause bleeding or inflammation
How Common Is Sexual Transmission?
| Scenario | Risk Level |
|---|---|
| Heterosexual couples, one partner with hepatitis C | Very low — typically under 1% per year |
| Anal sex, particularly rough or with blood | Higher than vaginal |
| MSM with HIV co-infection | Significant — outbreaks of sexually transmitted hep C documented |
| With other STIs present | Increased risk |
What Increases Sexual Transmission Risk
- Bleeding during sex
- Anal sex (especially rough)
- Menstrual sex
- Multiple partners
- Presence of other STIs
- HIV co-infection
- High hepatitis C viral load
- Chemsex and group sex environments
What About Reproductive Fluids Specifically?
The hepatitis C virus in semen is thought to come from low levels of blood or genital tract inflammation rather than from the testes themselves. This means the amount of virus in semen is closely linked to overall viral load and local inflammation.
Protection
- Condoms reduce but don’t eliminate the small sexual transmission risk
- Avoiding sex during menstruation or when either partner has genital ulcers
- Treating hepatitis C (over 95% cure rate) removes the risk entirely
- Regular STI screening for people at risk
Fathering Children
If you have hepatitis C and want to father a child, talk to your hepatology team. Options include:
- Treating and curing hepatitis C first (strongly recommended)
- Natural conception if treatment isn’t an option — low risk to the partner and baby
- Assisted conception in specific circumstances
The curative treatment for hepatitis C means that in most cases, clearing the infection is the best option before trying to conceive.
Read more: Hepatitis C survival | Hepatitis B and C introduction | Liver disease and HIV
Frequently Asked Questions
Can hepatitis C be transmitted through sex?
Yes, but it’s uncommon in most settings. Risk is higher with rough sex, anal sex, HIV co-infection or other STIs.
Should I use condoms if my partner has hepatitis C?
The overall sexual transmission risk in heterosexual couples is low. Condoms add protection, particularly for anal sex or when other risk factors are present. Treating the infection is the most effective long-term solution.
Can my baby get hepatitis C through sperm?
Conception itself is not a significant risk route. The main mother-to-child transmission route is during birth, not through sperm.
Related reading
- Blood Test for Syphilis, Hepatitis B and Hepatitis C
- Can You Catch an STI From a Toilet Seat?
- Can You Die From Hepatitis B?
- Can You Get Chlamydia From Kissing?
- Can You Get Herpes From a Toilet Seat?
Sources
- NHS — Sexual health conditions
- BASHH — UK clinical guidelines for STI management
- British HIV Association (BHIVA) — HIV treatment guidelines
- Terrence Higgins Trust — sexual health information
- UK Health Security Agency — STI surveillance data
Steve Page is a recognised expert on Sexually Transmitted Diseases (STDs) and STD treatments, having published numerous articles in peer-reviewed journals and presented his research at conferences around the world. He has an in-depth understanding of the latest medical research on STDs, and is an advocate for the development of new treatments and protocols to improve the health of those affected. In addition to his research, he has dedicated his career to understanding the causes and symptoms of STDs, as well as how to best treat those impacted.
