Gonorrhoea
Gonorrhoea is one of the most common bacterial sexually transmitted infections (STIs).
Testing for it is quick and painless, and it can be treated with a course of antibiotics, although a drug resistant strain has been on the rise in England. This strain is resistant to one of the two antibiotics used to treat gonorrhoea.
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What is gonorrhoea?
Gonorrhoea is the second most common sexually transmitted infection (STI).
Testing for it is quick and painless, and it is treated with a course of antibiotics, although a drug resistant strain has been on the rise in England. This strain is resistant to one of the two antibiotics used to treat gonorrhoea.
Some people with gonorrhoea don’t have or don’t notice any obvious signs or symptoms of infection or will have mild symptoms that go unnoticed. You will still be infectious and can pass on gonorrhoea even if you do not notice or show symptoms.
You can get gonorrhoea more than once, even if you have received treatment before.
What causes gonorrhoea?
Gonorrhoea is caused by bacteria called Neisseria gonorrhoeae. It can live in the cervix, the urethra (tube where urine comes out), the rectum (back passage), the throat and occasionally, the eyes.
Anyone who is sexually active can get gonorrhoea and pass it on, even if you don’t have lots of sexual partners.
Gonorrhoea signs and symptoms
About 50% of people who have a vagina/front hole and 90% of people with a penis who have genital gonorrhoea show symptoms. Symptoms can take up to 14 days to show, and you won’t test positive for it until around 14 days after you have come into contact with gonorrhoea.
If you do notice symptoms they can include the following:
If you have a penis it can cause:
- An unusual discharge from the tip of the penis which may be yellowish, white or green.
- A burning feeling, especially when urinating.
- Swelling of the foreskin.
- Sometimes pain or tenderness in the testicles.
If you have a vagina/front hole it can cause:
- An unusual or changed discharge which may be thin or watery, yellow or green.
- A burning feeling when urinating.
- Lower abdominal pain or tenderness.
Gonorrhoea in the throat is mostly symptom-free.
Gonorrhoea in the rectum often has no symptoms but there might be pain or discomfort and a discharge.
Gonorrhoea in the eyes (conjunctivitis) may cause pain, irritation, swelling of the eyelids and surrounding area and a discharge.
How gonorrhoea is passed on
Gonorrhoea is usually passed from one person to another when having sex. You can be infected if you come into contact with the semen or vaginal/frontal fluids of someone who has gonorrhoea.
Gonorrhoea is most commonly spread by
- Vaginal/frontal or anal sex without using condoms.
- Oral sex, when a condom or dental dam is not used to cover the vulva/front hole or penis.
- Sharing sex toys that are not washed or covered with a condom each time they are used with a different person.
It may be possible for gonorrhoea to be spread by transferring infected semen or vaginal/frontal fluids to another person’s genitals on the fingers or through rubbing vulvas together.
It’s possible for gonorrhoea to spread from vaginal/frontal discharge to the rectum. You don’t have to have anal sex for this to happen.
Gonorrhoea can be passed on during oral sex, so you can use flavoured condoms or dental dams if you have concerns about this.
Some studies have suggested that gonorrhoea in the throat can be passed on by deep kissing or by using saliva as a lubricant, but this needs to be studied further.
You cannot get gonorrhoea from normal social contact or from using public facilities like lavatories.
Testing and treatment for gonorrhoea
It is important to get tested if you have symptoms or a sexual partner has been diagnosed with gonorrhoea. Talk with a healthcare professional if you have concerns that you may have an STI,
All tests and treatment for sexually transmitted infections (STIs), including gonorrhoea are free on the NHS no matter your immigration or asylum status.
It can take up to 14 days before a test will show if gonorrhoea is present. If you have been told by a partner they have gonorrhoea a test may be carried out right away, and you may be advised to test again two weeks later to confirm any result. You also may be asked to test again after treatment to make sure that the treatment has worked.
There are a number of services that do gonorrhoea testing, so choose the one you feel most comfortable with.
Most people get tested and treated for infections such as gonorrhoea at a sexual health or GUM (genitourinary medicine) clinics. It’s free and confidential so no-one else, including your GP, will be told about your visit.
GP surgeries, contraception clinics, young people’s clinics and some pharmacies also test for and treat these infections.
Gonorrhoea tests are simple and painless.
A sample of cells can be collected for testing in two ways:
- if you have a penis you may be asked to provide a sample of urine (you will be advised not to pee for one to two hours before the sample is taken)
- gently wiping a swab (small cotton bud) over the area that might be infected. If you have oral and/or anal sex make sure that swabs are taken from those areas as well as the vulva/vagina/front hole or penis. A swab may be taken from the eye if conjunctivitis is present.
If you have a vagina/front hole the doctor or nurse may ask if it’s ok if they carry out an internal examination and they may swab the cervix, if you have one, to test for infection.
Swabs only take a few seconds and don’t hurt – they may be slightly uncomfortable for a moment or two. A doctor or nurse may take the sample, or you can ask to do the swabs yourself. A swab looks a bit like a smaller more rounded cotton bud, although sometimes it has a plastic loop rather than a cotton tip.
You may also be able to get free gonorrhoea testing kits to do at home. Check if you can get free tests in your area.
You can also buy tests to do at home but the accuracy of these tests varies so it’s best to visit a sexual health clinic, GP or pharmacy to get tested.
Gonorrhoea is treated with antibiotics.
A strain of so-called super gonorrhoea has recently been on the rise in England. This strain is resistant to the usual antibiotic that is used and so another antibiotic will be prescribed as it currently works for the majority of drug resistant cases.
It’s very likely that you will be asked to test again after treatment if:
- you have persistent symptoms or signs of infection
- you had gonorrhoea in the throat
- you are pregnant
- the strain of gonorrhoea you had may have been drug resistant.
The doctor or nurse may also advise you to have other tests, suggest further testing if the symptoms haven’t gone away, if you had gonorrhoea of the throat, or if a test was negative but you have developed symptoms. They will advise you which tests to take and when you can take them after your treatment. If you have any doubts or questions don’t hesitate to discuss them with the doctor or nurse.
You will notice an improvement in your symptoms quite quickly after having treatment.
- Discharge and pain when you urinate should lessen within 2 or 3 days.
- Discharge and discomfort in the rectum (back passage) should lessen in 2 or 3 days.
- Bleeding between periods or heavier periods should lessen by your next period.
- Pelvic pain and pain in the testicles should lessen quickly, although they may take up to two weeks to go away completely.
If you continue to have pelvic pain or painful sex that doesn’t improve, see your doctor or nurse as it may be necessary to have further treatment or investigate other possible causes of the pain.
When can I have sex again?
You will need to avoid any sexual contact with others until at least 2 weeks after you and any partner’s treatment has finished, to make sure the infection does not return or spread. If your doctor has asked you to return to test again to make sure the treatment has worked it is best to wait to have sex again until this test comes back showing the STI has been cleared.
Telling your partner/s
People you have had sex with also need to get checked – the clinic can let them know if you do not want to. If they know they can be tested and treated. The message they get will say that they may have been exposed to a sexually transmitted infection and encourage them to get tested. Your name won’t be on the message and it won’t identify you in any way, so your confidentiality is protected.
Protecting yourself from gonorrhoea
Use internal or external condoms, which lowers the likelihood of you coming into contact with bodily fluids containing the bacteria, but doesn’t eliminate it entirely, as fluids containing the bacteria can be transferred on the fingers.
Avoid sharing sex toys without using a new condom for each person using the toy. Wash sex toys well after you have used them. Some people use sterilising fluid that’s used to clean baby feeding bottles.
It is also advised that if you want to be as sure as you can be of not getting gonorrhoea via oral sex that a condom is used to cover the penis, or a latex or plastic ‘dam’ is used to cover the vulva or anus.
A new vaccine is being rolled out from August 2025 that offers protection against gonorrhoea. 4CMenB, a meningitis vaccine, offers between 32 - 42% protection against gonorrhoea. The vaccine could cut the numbers of people with gonorrhoea by over a third, meaning that there will be much less chance of you coming into contact with it and possibly picking up the infection.
You are most likely to be offered the vaccine if you have had a bacterial STI in the past year, although if you are part of the communities which carry the largest burden of gonorrhoea infection such as gay, bisexual and other men who have sex with men, trans and non-binary people and people from the Black Caribbean community you may also be offered the vaccine.
If you have a current active infection you will be offered the vaccine when you have completed your treatment and the infection has been cleared.
DoxyPEP is unlikely to be effective in preventing gonorrhoea infection because of the high level of drug resistance.
Other types of contraception, such as the contraceptive pill, or HIV prevention tools such as PrEP (pre-exposure prophylaxis) offer no protection against STIs.
Untreated gonorrhoea
If gonorrhoea is not treated it can spread to other parts of the body. The more times you have gonorrhoea the more likely you are to experience complications from the infection.
If you have a vagina/front hole gonorrhoea can spread and cause PID (pelvic inflammatory disease) which may lead to bleeding between periods and after sex, heavy painful periods, long term pelvic pain, blocked fallopian tubes, infertility and ectopic pregnancy, where the pregnancy develops outside of the womb.
If you have a penis, gonorrhoea can may lead to painful infection in the testicles and may reduce fertility.
Gonorrhoea and HIV
The diagnosis and treatment for gonorrhoea is generally no different for people living with HIV who are on treatment than for HIV negative people.
If you are living with HIV, taking effective treatment and have an undetectable viral load having gonorrhoea does not mean that you will then pass on HIV. This is because effective treatment means there will not be enough HIV in your semen or vaginal/frontal fluid to pass on to your partner/s.
If a person doesn’t know they are living with HIV and is not on effective treatment, having an untreated STI may make it more likely they will pass on HIV. This is because untreated STIs can increase the amount of HIV present in semen and vaginal/frontal fluid.
Gonorrhoea and pregnancy
You are likely to be offered a test as part of your antenatal care as gonorrhoea can be passed to the baby during childbirth, which can cause conjunctivitis in the baby’s eyes. Antibiotics can be taken and remain effective in treating gonorrhoea during pregnancy or while breastfeeding. The antibiotics won’t harm the baby but do tell the doctor or nurse if you are pregnant or chest/breastfeeding. Gonorrhoea is not passed on in breastmilk.
You will be advised to have another test after you complete your treatment to check that the infection has been cleared.
Gonorrhoea after gender affirming surgery
There have been a small number of cases of infection of the neovagina following penile inversion and sigmoid vaginoplasty. Symptoms include discharge, pain and bleeding.
You are likely to be more vulnerable to gonorrhoea if your reconstruction included tissue from the bowel, but infections in the urethra (tube you pee from) make it possible for anyone with a neovagina to get gonorrhoea.
For transwomen with a neovagina, test results when you swab yourself are similar to when a doctor swabs you and so doctors are happy for you to do the swab if you would prefer that. Doctors are generally happy for anyone with a vagina/front hole to swab themselves if that is more comfortable for them.
There have been no reports of gonorrhoea infection for those with a neopenis.
If, following surgery, you still have a front hole/vagina then a swab of that area will also be considered after discussions with you.
Any discussions about your recent sexual history should include any anal or oral sex you have had.
Regular testing
Anyone can get an STI, and you can only be sure you do have an STI is by testing for it. You don’t need to have multiple partners to get an STI and you can have STIs without realising it, as you may not have or recognise any symptoms.
It is a good idea to test for STIs if you are starting a new relationship, if you want to stop using condoms with your partner, if you have multiple partners or don’t use condoms during sex.
There is no reason to be embarrassed or feel guilty about having an STI. In fact we know that these feelings actually stop people from getting tested and treated making it more likely that STIs will affect their sexual health and are passed on to partners.
Further support
Terrence Higgins Trust can provide emotional support if you are worried about your sexual health or have concerns about living with HIV. They can help you access services local to you, whether provided by Terrence Higgins Trust or by someone else.
Call THT Direct on 0808 802 1221 for support, advice and information or email info@tht.org.uk
This information was updated in May 2025 and will be reviewed in May 2027.
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Hepatitis (sometimes shortened to hep) is an inflammation of the liver.
Hepatitis can be acute or chronic.
Acute hepatitis is short term and begins after the first infection. It can lead to chronic hepatitis, which is long term.
Some types of hepatitis – such as hepatitis A – only cause acute infection.
Chronic hepatitis is long term and can cause lasting damage to the liver. Very serious cases can lead to liver failure or cancer.
What causes hepatitis?
Hepatitis can occur because of:
- being exposed to and picking up the virus
- excessive exposure to alcohol over many years
The three most common viral forms that can be acquired sexually are Hepatitis A, Hepatitis B and Hepatitis C. The other forms of hepatitis – D, E, F and G – are far less common in the UK.
You can be vaccinated against hepatitis A and B. There is no vaccine for hepatitis C although there is effective treatment which cures over 95% of hepatitis C cases.
Hepatitis A is a form of hepatitis caused by a virus that infects the liver. It’s easy to pass on during sex or get from contaminated food and water. Nearly everyone makes a full recovery.
Hepatitis B is a form of hepatitis caused by a virus that infects the liver. It's easy to pass on during sex or by sharing injecting equipment. Most people who get it make a full recovery, but for a minority it can be more serious.
Hepatitis C is one of the most common types of viral hepatitis caused by a blood-borne virus that attacks the liver.
Hepatitis C is most commonly spread by sharing drug use equipment (both needles and snorting equipment). It can also be spread through sex, although this is extremely unlikely in heterosexual relationships, but the likelihood increases if one of the partners is living with HIV.
There has been a steady rise in the numbers of gay, bisexual and other men who have sex with men acquiring hepatitis C sexually, largely linked to the person acquiring hepatitis C already living with HIV.
Without treatment, the virus can cause liver disease that can be fatal.
All people diagnosed with hepatitis C will be offered 12 weeks of treatment that has few side effects and gives a cure rate of 90-95%.
There is no vaccine against hepatitis C.
Hepatitis signs and symptoms
Hepatitis A symptoms can be so mild you may not realise you have it, if you do notice symptoms they come in two phases. The first phase lasts between three to 10 days, symptoms include:
- flu-like symptoms like muscle pain and extreme tiredness
- pain in your upper right hand side.
The second phase lasts between one and three weeks, symptoms include:
- lack of appetite
- nausea
- itchy skin
- jaundice, where the whites of your eyes turn yellow, your skin may take on a yellowish colour, and your urine turns dark and your faeces (poo) turn pale.
For a few people, these symptoms can continue for 12 weeks or more.
Many people who get hepatitis B notice no symptoms, or have ones so mild that they're easily missed. But after some weeks or months the infection can cause:
- loss of appetite
- nausea or vomiting
- extreme tiredness
- fever
- pain in your upper right hand side
- jaundice, where the whites of your eyes turn yellow, your skin may take on a yellowish colour, and your urine turns dark and your faeces (poo) turn pale.
Symptoms can last for several weeks and it can take months to get back to normal.
Most people make a full recovery but up to 1 in 20 become ‘carriers’ with chronic (long-term) infection. They usually feel fine but stay infectious to others, with a small risk of going on to develop liver disease.
Around 1 in 100 people get a more serious illness which can be fatal if it's not treated.
The majority of people who get hepatitis C don't notice any symptoms when they are first infected. It can take years before you feel ill, and symptoms are often not easily identified as being linked to hepatitis C infection.
The symptoms can include:
- flu-like symptoms
- nausea
- extreme tiredness
- itchy skin
- stomach pain
- jaundice, where the whites of your eyes turn yellow, your skin may take on a yellowish colour, and your urine is dark and your faeces (poo) are pale mental confusion (often called ‘brain fog’) and depression – these are specific to the C strain of hepatitis.
The first six months of infection with hepatitis C is called the acute phase. Around 15- 30% of people will clear the virus naturally during this time. (This percentage is lower for people who also have HIV.)
People who don’t clear the infection will enter the chronic (or long-term) phase and can pass hepatitis C on to others.
How hepatitis is passed on
Someone with hepatitis A is most infectious two weeks before jaundice appears.
The virus lives in faeces (poo) and tiny traces of it carry the infection on the hands or on food prepared by an infected person. Water can also be contaminated, especially abroad.
The virus needs to get into the mouth to infect someone. This can happen during sex when tiny amounts of faeces get on fingers and into mouths through:
- rimming
- fingering
- anal sex without condoms
- handling used condoms and sex toys that have been in someone else’s anus.
The virus can be passed on in these body fluids:
- blood
- semen
- pre-cum
- vaginal/front hole secretions.
It's passed on through:
- oral, vaginal/frontal or anal sex when not using a condom
- rimming
- sharing sex toys without using a condom, and changing the condom if the toy is shared with a partner/s
- sharing injecting drug equipment, such as needles and syringes, which can carry infected blood
- childbirth, from a parent to their child.
It can be found in saliva but there are no proven cases of it being passed on through kissing.
Infections from bites are rare.
Avoid sharing razors, toothbrushes, nail scissors, hair clippers and tweezers because traces of blood on them can pass on hepatitis B. This includes dried blood as the virus can survive for at least a week outside of the body.
The hepatitis C virus is found in blood and is passed on when infected blood gets into another person’s bloodstream. It’s seen as unlikely (but not impossible) that it can be passed on in semen.
Most people get the virus from sharing drug use equipment such as needles, syringes, water cups, tourniquets, spoons, filters and swabs. Sharing things like straws and banknotes that are used for snorting drugs can also pass the virus on, as can sharing pipes.
In the UK, piercing and tattooing should be safe – but unsterilised equipment abroad can spread the virus.
An infected person increases the possibility of infecting others if they share anything that might have blood on it like a toothbrush or razor.
The virus can be passed on to a baby during pregnancy or childbirth.
Blood transfusions in the UK are safe as blood is screened.
You can also potentially get it from medical or dental treatment abroad in countries where hepatitis C is common and infection control is inadequate.
Testing and treatment for hepatitis
All tests and treatment for sexually transmitted infections (STIs) including hepatitis are free on the NHS, no matter your immigration or asylum status.
Most cases are diagnosed by GPs rather than sexual health clinics and no special treatment is needed.
A blood test will confirm whether you have picked up the virus.
The usual treatment for hepatitis A is simply to rest. You may need some time off work while you recover from the flu-like symptoms.
You should also:
- avoid paracetamol unless you discuss its use with a doctor. If possible, use ibuprofen instead.
- avoid recreational drugs to allow your liver to get better
- avoid alcohol until your liver recovers.
Once you have had hepatitis A you’re immune and cannot get it again, but you can still get other types of hepatitis.
Most cases are diagnosed by GPs. A blood test will confirm whether you have picked up the virus.
In most cases no treatment is needed for acute hepatitis B. It may take a while for you to recover and you may want to take some time off work.
You should also:
- avoid recreational drugs to allow your liver to get better
- avoid alcohol until your liver recovers
- avoid smoking because of its negative effect on your liver
- eat a healthy balanced diet.
If your body doesn’t clear the infection and you develop chronic hepatitis B, you will need ongoing treatment to slow down the replication of the virus. However, treatment cannot cure chronic hepatitis B. A small number of carriers go on to get liver disease (and a smaller number of those get liver cancer), and may need a liver transplant.
If your body clears hepatitis B, you’re immune and cannot get it again – but you can still get other types of hepatitis.
It’s recommended that you test for hepatitis C if you:
- inject recreational drugs or steroids
- test positive for HIV (you’ll be tested on a regular basis from your initial diagnosis)
- are a gay, bisexual or other man who has sex with men and test for HIV every three months
- use chemsex drugs and/or go to sex parties
- have a sexual partner who is hepatitis C positive
- had a tattoo outside of the UK
- have sex in exchange for things like money, food or accommodation
- are from a country where hepatitis C is widespread
- are, or have been an alcoholic
- snort cocaine, or other drugs
- are an ex-prisoner.
If you are an HIV negative gay, bisexual or other man who has sex with men, there is no reason for you to be screened routinely unless any of the things listed above apply to you.
If you are a gay, bisexual or other man who has sex with men who is living with HIV, you will be offered a test for hepatitis C if you are diagnosed with another STI like syphilis or LGV, or have had anal sex (including fisting) that may have caused a bleed, or have shared sex toys with others without using condoms and changing them for each new person using the toy.
It’s important to note that it’s not just injecting equipment (syringes/needles) as other drug equipment like straws and pipes can facilitate the transmission of hepatitis C.
You can get a free at home test kit for Hepatitis C from the NHS.
Treatment
Drug treatment is available and has few side effects. In fact, 90-95% of people are cured by the medications, known as direct acting antivirals (DAAs). These are taken in tablet form once or twice a day, typically for 12 weeks.
You can find out more detailed information about treatment for hepatitis C on the Hepatitis C Trust website.
If you have hepatitis C you should also:
- avoid alcohol
- avoid smoking as it can make the liver damage worse
- avoid recreational drugs to allow your liver to get better
- eat a healthy, balanced diet.
If you’re cured of hepatitis C, you’re not immune – you can get hep C again. You can also still get other types of hepatitis, and having hepatitis C and another type is more serious.
Protecting yourself against hepatitis
You can protect yourself by getting vaccinated.
It's especially important to do if you:
- have close contact with someone who has the infection
- are a gay or bisexual man or have sex with men who have sex with men (GBMSM and all their sexual partners)
- inject drugs, especially if you share equipment
- travel to parts of the world where the infection is common.
You might be able to get vaccinated for free by your GP or a sexual health clinic. The vaccine protects you for 10 years or longer.
Although not as good as being vaccinated, you can also cut the possibility of infection by:
- avoiding sex that involves contact with faeces, like fingering or rimming the anus
- using condoms for anal sex and changing condoms between partners
- washing hands after touching someone’s anus or handling used condoms and sex toys
- using a barrier like a condom cut into a square for rimming and latex or polyurethane gloves for fisting.
You can protect yourself by getting vaccinated.
This is especially important if you belong to one of the groups most affected by hepatitis B.
You're more likely to acquire hepatitis B if you:
- have close contact with someone with the infection
- are a gay or bisexual man or have sex with men who have sex with men (GBMSM and all their sexual partners)
- have multiple sexual partners
- have anal sex without using condoms
- rim (oral-anal sex) your partners
- inject drugs when you share equipment
- travel to parts of the world where the infection is common.
Transmission of the virus also happens via heterosexual sex, although to a lesser degree.
There is a vaccine which can protect you against both hepatitis A and B.
If you're in a group more affected by hepatitis B you can usually get vaccinated for free by your GP or at your sexual health clinic.
You may need a booster injection of the vaccination after five years.
If you have hepatitis B, tell people you live with or recently had sex with to urgently ask their doctor about vaccination. Avoid sex with others until your clinician tells you that you're no longer infectious.
Although not as effective as being vaccinated, you can also cut the possibility of infection by:
- using condoms for penetrative sex
- using a barrier such as a condom cut into a square for rimming, or latex or polyurethane gloves for fisting.
Never share injecting drug equipment (e.g., needles, syringes, swabs, spoons, filters) or things that may have blood on them such as toothbrushes and razors. Also avoid sharing straws or rolled up banknotes if snorting drugs with others.
Use condoms for anal sex, for vaginal/frontal sex during menstruation or sex that may cause bleeding and latex or polyurethane gloves for fisting.
During group sex, cover anything which goes from one partner to another with a new condom or new latex or polyurethane glove for each new person it enters. Clean objects with warm water and anti-bacterial soap after use and before using on a new partner.
Don’t share enema equipment or pots of lubricant.
Hepatitis C and sex
- Hepatitis C is rarely passed on during vaginal/frontal sex.
- There’s also no significant spread of hepatitis C among HIV negative gay, bisexual and other men who have sex with men. But the infection has spread sexually among gay, bisexual and other men who have sex with men living with HIV and is much more common among them.
Group sex, chemsex and hep C
Group sex and chemsex parties can be places where hepatitis C is easily passed on.
This is because if you’re taking drugs and having sex for longer your inhibitions are likely to be lowered and the skin lining the anus could be broken or damaged, causing bleeding.
Hep C is very infectious and is easily passed on during group sex in ways you may not consider, such as being passed from one person to another on fingers.
The virus spreads through anal sex and fisting when condoms and gloves are not used. It’s also passed on during group sex, on objects such as shared sex toys, fingers, shared enema equipment, condoms or latex or polyurethane gloves used on more than one person or in lubricant used by the group that has become contaminated with the virus.
The iBase guide Safer HCV sex for gay men is a useful reminder of what to avoid and what steps to take to protect yourself.
The Hepatitis C Trust has some useful information about transmission. They also provide an advocacy service for men who have sex with men who have been re-infected with hepatitis C after previously being successfully treated.
There is no vaccination against hepatitis C.
If you already have hepatitis C, it’s recommended to have the vaccination against hepatitis A and B to protect your liver from further damage.
What should I do if I have hepatitis?
Tell people you live with or have recently had sex with to ask their doctor about having an urgent vaccination.
Avoid having sex with, and preparing food for other people until you’re told you’re no longer infectious.
Take sick leave and stay away from work and limit contact with other people for 7 days after your symptoms (or jaundice if you didn’t notice symptoms) started.
Rest and drink plenty of fluids.
Wash your hands thoroughly after going to the toilet.
If you're not vaccinated and are exposed to hepatitis A, you may be given the vaccine if you get to see a clinician within 14 days of being exposed to the virus.
You may also be offered a drug called human normal immunoglobulins (HNIGs) which can protect you from infection. This can be given within two weeks after exposure and it can protect you for up to three to six months.
Cases are generally diagnosed by GPs, not sexual health clinics. If you had sex with someone recently or you share your house with others, they can be vaccinated to stop them getting the infection – they should see a doctor straight away.
Avoid sex with others until a clinician tells you that you’re no longer infectious or until your partners have been vaccinated.
A blood test will confirm whether you have the virus.
If you're a carrier, let any sexual partners know, so they can decide if they want to get vaccinated and take other precautions to lessen the likelihood they will acquire hep B.
If you're not vaccinated against hepatitis B and are exposed to the virus, there’s a treatment which may stop you being infected. Hepatitis B immunoglobulin (HBIG) is an injection of antibodies. It's best to get it within 12 hours, and at a maximum of 48 hours of exposure – you'll also be vaccinated at the same time.
A doctor or sexual health clinician can test you to see if you have hepatitis C. If you do, effective treatment with few side effects is available and you can discuss how to avoid infecting your sexual partners or people you live with.
It can take three to six months before the blood test for hepatitis C will be able to detect signs of infection in your blood. For people with HIV who may be immunocompromised, the antibody may not be detectable and it may be necessary to request an RNA test, which will detect the virus.
If you have hepatitis C it’s recommended that you tell your sexual partner/s and explain that you’re infectious. They can then decide what precautions they want to take to lessen the likelihood they will acquire hep C.
Untreated hepatitis
Hepatitis A is left to clear itself and has no lasting impact on your health.
In most cases no treatment is needed for acute hepatitis B. It may take a while for you to recover and you may want to take some time off work.
If your body doesn’t clear the infection and you develop chronic hepatitis B, you will need ongoing treatment to slow down the replication of the virus.
Hepatitis C can be fatal when left untreated.
Untreated hepatitis C can lead to scarring of the liver known as cirrhosis.
A small number of people with cirrhosis will go on to get liver failure, the only treatment for which is a liver transplant. A small proportion of people with cirrhosis develop liver cancer.
Giving blood and organ donation
If you have hepatitis C, you cannot give blood.
Now that we have treatments that clear hepatitis C infection, organs can be donated from people who have cleared hepatitis C infection.
HIV and hepatitis
If you are living with HIV you will not experience a more severe case of hepatitis A than someone who is HIV negative.
You may have higher viral load levels of hepatitis A and be able to pass on hepatitis A for a longer period of time, so may have to take protective measures for longer. Your doctor will be able to discuss this with you, as each case will be different.
It is very unlikely that you’d have to stop taking your HIV treatment and it would only be the case if you were experiencing a severe case of hepatitis A.
Any possible interruption of your HIV treatment would be discussed with your HIV doctor and if necessary another clinician experienced in the treatment of hepatitis and HIV.
If you are living with HIV your body will have a slower response rate to the vaccine for hepatitis B, so it’s very likely that you will be monitored and be given boosters as your antibodies to the hepatitis B virus disappear faster than in HIV negative people.
You will not be asked to interrupt or stop your HIV medications.
If you are living with HIV and acquire hepatitis C you will be offered the same treatment as HIV negative people, as it is as effective for all people with hepatitis C regardless of HIV status.
If you have not already had hepatitis A and B vaccines your clinician will recommend that you do as they will lessen the impact of hepatitis C on your health.
Pregnancy and hepatitis
Having hepatitis A while pregnant can increase the likelihood of experiencing a miscarriage or a premature birth so please discuss testing for hepatitis A with your clinicians or midwife if you believe you may have been exposed to the virus.
It is safe to breastfeed if you have been diagnosed with hepatitis A.
If you are pregnant you will be tested at 12 weeks for hepatitis B (and other blood borne viruses), and if you are found to be positive for hepatitis B you can be treated to stop the infection being passed to the baby, which has a 90% success rate.
It is safe to breastfeed if you have been diagnosed with hepatitis B.
If you are pregnant, you will be tested for hepatitis C (along with a couple of other blood borne viruses) at your 12-week appointment.
There is no evidence to show that hepatitis C causes problems during a pregnancy, although there is a small possibility of transmission of the virus to the baby during birth (thought to be between 2% and 8%) and currently there is no effective intervention to reduce this.
If you are also living with HIV then the possibility of passing on hepatitis C during birth is higher.
Breast/chest feeding is considered safe to do, as there is no firm evidence that it can transmit hepatitis C to the baby. If your nipples are cracked and bleeding, it’s recommended to not breast/chest feed until they are healed.
If you are hepatitis C positive, your baby will be tested for the virus at around 18 months old.
If you are pregnant or are planning a pregnancy and are hepatitis C positive, it’s important to discuss this with your clinician. Sometimes, you will be advised to have the hepatitis C treatment to clear the virus before you get pregnant.
Being hepatitis C positive should have little or no effect on you caring for your baby. You can do everything a parent wants to do for their child.
Regular testing
You can have STIs, including hepatitis, without knowing as you may not have or recognise any symptoms, so regular STI testing, and getting vaccinated against hepatitis A and B is both a good idea and important for your sexual wellbeing.
You don’t need to have multiple partners to get an STI and you can have STIs without you realising it, as you may not have or recognise any symptoms.
It is a good idea to test for STIs if you are starting a new relationship, if you want to stop using condoms with your partner, if you have multiple partners or don’t use condoms during sex.
There is no reason to be embarrassed or feel guilty about having an STI. In fact, we know these feelings actually stop people from getting tested and treated making it more likely that STIs affect their sexual health and are passed on to partners.
Further support
Terrence Higgins Trust can provide emotional support if you are worried about your sexual health or have concerns about living with HIV. They can help you access services local to you, whether provided by Terrence Higgins Trust or by someone else.
Call THT Direct on 0808 802 1221 for support, advice and information or email info@tht.org.uk
This information was updated in June 2025 and will be reviewed in June 2027.
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