Hepatitis A, B and C

Toronto Public Health provides free Hep A and B vaccines to people who meet the eligibility criteria - see the link at the bottom of this page.

Hepatitis A:

Hepatitis A is transmitted through feces (shit) that is ingested. It can make you sick, but does not cause death. If you enjoy rimming, you could get hepatitis A if you rim without using a latex barrier between your mouth and your partner’s anus (ass hole). You can also contract parasites as a result of rimming without the use of a barrier. Hepatitis A is also passed along through water that has been contaminated with feces (shit).

The hepatitis A vaccine will protect you - talk to your doctor about vaccination. You should take extra care to ensure the vaccine has worked if you are living with HIV and have a low CD4+ cell count.
Hepatitis B:

Hepatitis B is the most prevalent type of hepatitis in the world and the most infectious of the three viruses listed on this page.

Hepatitis B can be easily transmitted through many forms of sexual contact since it is found in blood, semen, vaginal fluids, and with lesser concentrations in saliva. It can be transmitted by punctures through the skin or with exposure of these fluids through mucosal membranes. Mucosal membranes are generally the pink moist surface areas on your body such as your eyes, vagina, anus (inside your ass), mouth, nasal lining (inside your nose), urethra (inside the hole you pee out of) and under your foreskin. It can also be passed through human bites and possibly through sharing toothbrushes or razors. Intimate contact (regular touching and living closely with someone else who is hepatitis B positive) is considered a risk for transmission. Casual contact, even for people such as hospital workers who have no contact with blood or bloodied fluids, is not considered a risk – it is uncertain as to why this is the case. There are no documented cases of hepatitis B infection in Canada that resulted from contact with urine.

Hepatitis B infection of the liver can be serious and may cause death.

If you use intravenous syringes, undergo medial procedures that often require puncturing your skin or contact with your blood, are a man who has sex with other men, or are someone living with HIV, then you are considered someone who should be offered the hepatitis B vaccination. You should take extra care to ensure the vaccine has worked if you are living with HIV. The hepatitis B vaccine is also used as a prevention technique within hours after a person thinks they may have been infected. Contact your doctor or local health clinic for more information on where to get vaccinated.

Condoms and other barriers help reduce the risk. This is one of the most difficult hepatitis viruses to sterilize for, so sharing any personal items that come into close proximity with a wound or a mucosal membrane is not advisable.
Hepatitis C:

No vaccine exists for Hepatitis C, a third virus that causes liver damage. Hepatitis C is transmitted when the blood of a person who has hepatitis C gets into the bloodstream of someone who doesn't have it. Sharing razors or needles/works for injection drug use is a very easy way to get hepatitis C. You can also get hepatitis C through unprotected sex if blood is involved. There is some new evidence of hepatitis C transmission through nasal mucosal membranes (the nose’s lining) with no blood present. Sometimes blood is present in various body fluids but cannot be seen. Therefore, do not share straws for snorting drugs or pipes for smoking drugs.

If you are living with HIV and have sex regularly, you need to be careful of hepatitis C infection, even when no blood seems likely to be transmitted from anyone else.

For more information on the sexual transmission of Hep C please see “Hep C & Sex for Gay, Bi and Queer Men

Hepatitis C can't be killed with any household cleaner, including bleach, and it's not known what hospital grade cleaners will do to your sex toys or other intimate sexual objects.

Some best practices for controlling Hep C include:

  • not sharing sex toys;
  • using condoms to reduce the risk of transmitting all forms of hepatitis (including hepatitis C) through sexual intercourse (vaginal or anal) and shared dildos/sex toys;
  • using fresh gloves for fisting;
  • not sharing needles/syringes, cotton, cookers, filters, or anything else that comes into contact with blood for injecting drugs, hormones, steroids, Botox, and therapies;
  • informing yourself of piercing sterilization practices (steam or chemical autoclaving should be used); and
  • asking tattoo and piercing facilities (even if you see a liscencse from your local public health unit) about what they do to ensure no infection happens (including ink not being shared).

Some People that are eligible to receive free hepatitis A and B vaccinations in Toronto, see Toronto Public Health’s web site for latest criteria on who can get vaccinated for free.

Updated July 2015