Is Hepatitis B Considered a Sexually Transmitted Disease?
Yes, Hepatitis B is definitively considered a sexually transmitted disease—sexual contact is one of the two primary modes of HBV transmission among adults in the United States, accounting for approximately 63% of new infections (39% heterosexual transmission and 24% among men who have sex with men). 1
Primary Transmission Routes in Adults
The CDC explicitly identifies sexual transmission as a major route of HBV spread: 1
- Sexual contact accounts for the majority of adult HBV infections in developed countries 1, 2
- Percutaneous exposure to blood (injection drug use, occupational exposure) is the other primary route 1
- HBV is transmitted efficiently through both heterosexual and homosexual contact 1
Why HBV Qualifies as an STD
Infectious body fluids: Semen and vaginal secretions contain infectious HBV and are concentrated enough to transmit disease through sexual contact 1
- Prospective studies show 20-27% secondary attack rates among serosusceptible spouses of HBV-infected persons 3
- The highest incidence of acute hepatitis B occurs in adults aged 25-45 years, the sexually active population 1
- Serologic evidence of HBV infection ranges from 10-40% among adults in STD clinics 1
Risk factors mirror other STDs: 1
- Having unprotected sex with an infected partner
- Having multiple sex partners
- History of other sexually transmitted infections
- Among MSM: multiple partners, anal intercourse, and history of other STDs
Clinical Management as an STD
The CDC's STD Treatment Guidelines explicitly include HBV management: 1, 4
- Screen with HBsAg in patients presenting with STI concerns 4
- Partner notification and postexposure prophylaxis (HBIG plus vaccine) must be provided to sexual contacts within 14 days 1, 4
- Condom counseling is recommended for sex partners of HBsAg-positive persons until immunity is documented 1
- Co-testing for HIV, syphilis, gonorrhea, and chlamydia is recommended given overlapping transmission routes 4
Important Caveats
HBV has multiple transmission routes beyond sexual contact: 1
- Perinatal transmission (mother to infant)
- Household contact through sharing razors/toothbrushes
- Healthcare-associated exposures
- Contaminated surfaces (virus remains viable for >7 days) 1
Not all HBV is sexually acquired: The classification as an STD applies primarily to adult-acquired infections in developed countries, whereas perinatal and early childhood transmission predominate in endemic regions 1
Prevention strategy: Vaccination is recommended for all adults at risk for sexual transmission, including those seeking STD evaluation, MSM, and persons with multiple sex partners 1, 5