Hepatitis A: transmission through rimming, symptoms and vaccine

What is hepatitis A?

Hepatitis A is liver inflammation caused by a virus (HAV). According to WHO it spreads mainly by the faecal-oral route: contaminated food or water, but also close physical contact, including oral-anal sex with an infected person. Invisible amounts of faeces are enough.

Among men who have sex with men, outbreaks happen regularly, hence Santé publique France’s vaccine recommendation.

How is it caught during sex?

Sexosafe lists oral-faecal contact, in particular:

• rimming (mouth on anus);
• fingers going from anus to mouth;
• toys, condoms or gloves handled then brought to the mouth;
• scat play (risks).

What are the symptoms?

According to WHO, they appear 14 to 28 days after infection:

• fever, loss of appetite, nausea, stomach pain;
• diarrhoea;
• dark urine, jaundice (yellow skin and eyes);
• severe fatigue, sometimes for weeks.

Hepatitis A does not become chronic and usually clears on its own, but it can be severe in people whose liver is already weakened (hepatitis B or C, alcohol). While ill, avoid alcohol and medicines without medical advice.

How to protect yourself?

The vaccine

It’s the best protection. According to Sexosafe:

• it is recommended for men who have sex with men;
• you are protected about a month after the injection;
• once the full course is done (usually two doses), protection is long-lasting, with no booster;
• it is free at CeGIDD clinics in France.

If you’re not sure whether you were vaccinated or already had hepatitis A, a blood test can check. A combined hepatitis A and B vaccine also exists.

Barrier measures

• a dental dam for rimming;
• wash your hands and anal area before and after;
• a new condom on shared toys.

I’ve been in contact with someone who has hepatitis A

See a doctor quickly: vaccination within days of contact can prevent the illness. Tell your recent partners too.