An STI clinic visit is the best chance to prevent a different disease

Hepatitis A, B and C spread in ways that overlap with sexual transmission
without being limited to it, which puts prevention in an awkward place: the
vaccines exist, and the people who most need them are not usually at a
vaccination appointment.

One number resolves it.

**Among adults seeking treatment in STI clinics, as many as 10%–40% have
evidence of past or current hepatitis B virus (HBV) infection. Many of these
infections could have been prevented through universal vaccination.**

**STI treatment facilities can offer vaccination to all adults as part of
routine prevention services**, and doing so **has helped to increase
vaccination coverage among adults at risk.** The visit is already happening;
the vaccine is added to it rather than requiring a second appointment that
often does not happen.

Hepatitis A

**Transmission can occur from any sexual activity with an infected person. It
is not limited to faecal-oral contact** — a correction worth making, because
the faecal-oral route is what most people associate with hepatitis A.

At increased risk: men who have sex with men, people who **live with or
have sex with someone with HAV infection**, and people who inject drugs.
CDC's 2020 recommendations identify all groups recommended for vaccination,
including MSM.

Vaccination is the most effective means of preventing transmission.

Hepatitis B

Transmitted through sexual activity. **Unvaccinated adults who have
multiple sex partners, or a partner with hepatitis B, are at increased risk.**
**Injection drug use is another common mode of transmission in the United
States.**

Two recommendations, doing different jobs:

• Screening for all adults 18 and older at least once in their lifetime,
  plus periodic risk-based testing for people with multiple sex partners or
  a history of STIs
• Vaccination (ACIP, 2022) for all adults aged 19–59, and **for adults 60
  and older with risk factors.** **Adults 60 and older without risk factors but
  seeking protection may be vaccinated**

Hepatitis C

**Although not common, hepatitis C can be transmitted through sexual
activity.** **Having an STI or HIV, having sex with multiple partners, and
anal sex appear to increase risk.**

There is no vaccine, so the recommendation is testing: **one-time hepatitis C
testing of all adults 18 and older, and periodic testing for people with risk
factors.**

The short version

Source: Centers for Disease Control and Prevention.