What Causes Hepatitis C?

Hepatitis C spreads when blood carrying the virus enters another person's bloodstream. It is not transmitted through casual contact. The most common ways HCV is transmitted include:

• Sharing injection equipment: The leading cause of new HCV infections. Sharing needles, syringes, or other drug preparation equipment puts people at significant risk.
• Healthcare exposures: Accidental needlestick injuries or contact with contaminated blood in medical or dental settings can transmit the virus, though rigorous sterilization protocols make this uncommon.
• Unregulated tattoos and piercings: Using non-sterile or reused equipment in unlicensed facilities increases exposure risk.
• Childbirth: A pregnant person with HCV can pass the virus to their baby during delivery.
• Sharing personal items: Items that may come into contact with small amounts of blood — such as razors, toothbrushes, or glucose monitors — can be a transmission route if shared.
• Sexual contact: Less common, but possible — particularly among men who have sex with men, people with multiple partners, or those with other STIs.
• Blood transfusions and organ transplants: Prior to 1992, this was a significant source of infection in the United States. Routine blood supply screening has made this risk extremely rare today.

What does not cause hepatitis C

HCV is not spread through everyday, casual contact. You cannot get hepatitis C from:

• Hugging, kissing, or holding hands
• Coughing or sneezing
• Sharing food, drinks, or utensils
• Breastfeeding (unless nipples are cracked or bleeding)

Sexual Transmission of Hepatitis C

In some cases, hepatitis C can be transmitted via sexual contact—though this isn't the most common mode of transmission. Because HCV spreads through blood-to-blood contact, sexual transmission is only possible during activities with an increased potential for blood exposure.

Higher-risk scenarios include unprotected intercourse during menstruation and unprotected anal sex, which is more likely to cause bleeding and microtears. Note that sharing drug injection equipment with a sexual partner carries a much higher transmission risk than unprotected sex alone.

Transmission rates are also higher when one partner is living with HIV, as HIV can increase the viral load of hepatitis C — meaning a greater amount of the virus may be present in the body.

Other sexual behaviors that may increase your risk of HCV transmission include:

• Sharing sex toys used anally
• Having multiple sex partners
• Rough vaginal sex that could contribute to tearing or bleeding

Fingering and oral sex generally carry low transmission risk, though caution is still advisable if either partner has open sores.

Although hepatitis C is now curable, it's best for your health to avoid contracting the virus in the first place. The best way to prevent hepatitis C is to avoid any behaviors that can result in contact with another person's blood. Do not share needles, syringes, or other injection equipment. If you get a tattoo or piercing, choose a reputable establishment — ask about sterilization procedures and check that they open new needle packs in front of you.

Even with the low risk of sexual transmission, it's a good idea to consistently practice safe sex using condoms, dental dams, or other barriers. Because STIs can increase your risk of hepatitis C infection, regularly testing for STIs is an effective preventive step.