Training Guide

Hepatitis C Overview Guide

Hepatitis C Transmission

HCV Transmission: It’s all about the blood.

Hepatitis C is transmitted through blood to blood contact: blood from one person with hepatitis C getting into another person’s body.

Risks include:

  • Sharing needles and other drug injection equipment (like cookers and cotton)
  • Overall, the risk of sexual transmission is low for Hepatitis C, but sexual activities that involve blood, such as anal sex or rough vaginal sex. 
  • From parent to baby at birth (about 5% risk; much higher if the birthing parent is also HIV+)
  • Body piercing or tattooing using unsterilized needles or shared inkwells – primarily seen in jail or prison settings
  • Possibly sharing things that may contain small traces of blood, like snorting straws, toothbrushes, razors, or manicure implements

Hepatitis C can remain infectious in blood outside of the body for several days or weeks.

The great majority of HCV infections are found among people with a history of drug injection, including people who have been incarcerated. HCV is easily transmitted among drug injectors by sharing syringes or other injection paraphernalia (such as cookers, filters). Hepatitis C is easier to transmit through shared injection equipment than HIV, and HCV is usually the first blood-borne virus people who inject drugs acquire. As a result, as many as 50-90% of IDUs have been infected with HCV.

Unlike some other forms of viral hepatitis, there is no vaccine to prevent HCV.

Most new hepatitis C infections are among people who inject drugs from sharing needles, syringes and injection equipment. Hepatitis C can also be transmitted through sharing cookers or spoons, cotton and filters, and water.  If you shoot drugs, you can avoid transmission by using a new, sterile syringe for each injection (or, at least, a syringe that only you have used), along with your own injection cookers, cottons, water and ties. If you’re shooting up with someone else, make sure everyone is using their own sterile needle, and preferably, mix your shots in separate cookers using separate sources of water. Clean out used cookers and spoons.

If you need to use a needle or syringe that someone else has used, first rinse it out. If you only have water – rinse several times with COLD water to try and get any blood out of the syringe. If you have bleach, rinse first with water, then clean it with full-strength bleach (avoid splashless bleach), and rinse it again with water. Research suggests that bleach is effective in neutralizing HCV most of the time, but NOT 100% of the time. Still, if you don’t have a sterile syringe, rinsing with either bleach or water is better than nothing. Click here for more information on the effectiveness of cleaning syringes with bleach.

Sexual transmission of hepatitis C is uncommon. If you’re concerned about the risk of sexual transmission, use a condom and be sure to use ample lubrication during sex to reduce the risk of tearing/bleeding.

Click here to see our full Hepatitis C Basics for People Who Use Drugs brochure.