July marks Hepatitis Awareness Month, culminating in World Hepatitis Day on July 28th.
While anyone can get viral hepatitis, some forms – such as hepatitis A and B – can disproportionately affect gay, bi and other men who have sex with men (MSM) at higher rates because of how these viruses can be transmitted through sexual contact and exposure to body excretions. Additionally, South Africa has recently entered the top ten countries with the highest burden of new hepatitis C infections.
The good news is that hepatitis A and B are preventable through vaccination, and all types can be managed with appropriate medical care.
What is viral hepatitis?
The liver plays a vital role in filtering the blood, processing nutrients, supporting digestion, and removing harmful substances from the body. Viral hepatitis occurs when a virus infects the liver, causing inflammation. The main types are:
Hepatitis A: Hepatitis A usually causes a short-term infection. It does not typically become chronic, but it can make someone very unwell for weeks.
Hepatitis B: Hepatitis B can become a long-term (chronic) infection and may lead to serious liver problems, including liver failure or cancer if untreated.
Hepatitis C: Hepatitis C can also become chronic and may cause long-term liver damage; however, modern treatments can usually cure hepatitis C.
Why are MSM affected by viral hepatitis?
MSM are not at risk because of sexual orientation or identity. The risk is linked to certain ways these viruses can spread.
Hepatitis A transmission
Hepatitis A can spread through contact with tiny amounts of infected faecal matter. During sexual activity, this can happen through oral-anal contact, like rimming, or contact involving the anus. Outbreaks of hepatitis A among MSM communities have occurred in many countries.
Hepatitis B transmission
Hepatitis B is highly infectious and can spread through:
- Semen and other sexual fluids
- Contact with infected blood
- Unprotected sexual contact
- Sharing needles or drug-use paraphernalia
- Unsterile medical practices including medical procedures, tattoos, or blood transfusions
Hepatitis C transmission
Hepatitis C spreads mainly through blood-to-blood contact. Among MSM, transmission risk can increase through:
- Sexual activities that involve blood exposure
- Sharing drug-injecting equipment
- Sharing equipment used for certain sexual practices
- Having HIV can increase one’s vulnerability and disease progression
What are the symptoms of viral hepatitis?
Many people with hepatitis have no symptoms, especially in the early stages. This means someone can have hepatitis and unknowingly pass it on.
When symptoms do occur, they may include:
- Extreme tiredness
- Loss of appetite
- Nausea or vomiting
- Stomach pain
- Fever
- Joint pain
- Dark urine
- Pale stools
- Yellowing of the eyes or skin (jaundice)
Symptoms can range from mild to severe and may last weeks or longer. Because symptoms are not always obvious, testing is important, especially if you may have been exposed.
How can MSM prevent viral hepatitis?
1. Get vaccinated
Vaccination is the best protection against:
Hepatitis A: A safe and effective vaccine is available
Hepatitis B: The hepatitis B vaccine provides strong protection and is recommended for people who may have increased exposure risk.
2. Use safer sex practices
Ways to reduce risk include:
- Using condoms and barriers where appropriate
- Using lubricant to reduce skin damage during sex
- Avoiding sharing sex toys unless they are cleaned properly or covered with a new condom between users
- Avoiding contact with blood
- Getting tested regularly if you have ongoing risk
3. Get regular sexual health screenings
Ask your healthcare provider about hepatitis testing, especially if you:
- Have multiple sexual partners
- Are living with HIV
- Have had a sexually transmitted infection (STI)
- Have had condomless sex
- Use drugs that involve needles
Can viral hepatitis be treated?
Hepatitis A: There is no specific antiviral treatment, but most people recover fully with medical support and rest.
Hepatitis B: There is no universal cure, but antiviral medicines can control the virus, reduce liver damage, and lower the risk of complications. Some people clear the infection naturally.
Hepatitis C: Hepatitis C is usually curable with modern direct-acting antiviral medicines, often taken for a short course of treatment. Reinfection is possible.
Living well with hepatitis
A hepatitis diagnosis does not mean your sex life or relationships have to stop. With vaccination, testing, treatment and support, people living with hepatitis can maintain healthy lives. A balanced diet, exercise and reduced alcohol intake will aid the recovery of the liver. If you think you may have been exposed, do not panic — speak to a healthcare provider about testing and the next steps.
Knowing your status protects your health and helps protect your partners. Get vaccinated. Get tested. Get treated.
Article courtey of +DR – OUT LGBT Well-being’s stigma-free, patient-centred LGBT+ medical practice in Pretoria – which is offering a FREE hepatitis B vaccine and hepatitis C antibody test for the month of July! For more information about +DR or to make an appointment, WhatsApp +27 72 113 6597 or visit https://out.org.za/plusdoctor/.
