When/how to disclose hep b in a potential relationship?

Hi everyone, I have a question relating to dating with hep b: I was wondering if anyone had any experiences with dating with hep b, or had any advice on when/how to disclose having hep b to a potential partner (not dating yet)?

For some background, I’m a 21 year old woman who was born with hep b. I’m on treatment and my viral load is undetectable. Recently, a friend said he was interested in dating me. I know I have to disclose hep b before sex, but I’m pretty scared to even start dating people because that means I have to disclose. I’m afraid of the stigma that if other people know I have hep b, they’ll treat me differently or feel scared to be around me in fear of contracting it. I also know that having this condition can be a dealbreaker, which I’m prepared to deal with, but it would still make me sad. I’ve dated someone before who seemed like they were ok with it, but later said they weren’t ok with it. So it makes me cautious to tell people because I don’t like that feeling of uncertainty.

I’m also unsure of what I can or can’t do – like kissing. Some sources say that kissing doesn’t carry a risk of transmitting, but other sources online say that it is a method of transmission. Since my virus is undetectable, I think the risk would be relatively small, but I still wouldn’t want the other person to feel betrayed that I kissed them and didn’t first disclose. I know a vaccine is available, but I know some people would still not feel comfortable even if vaccinated.

Sorry, a lot of questions here lol! I think I’m just wondering how to date new people with hep b, especially when the physical part of relationships often go fast.

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Dear @Lala,

Thank you for your very important question.

Given your viral load is undetectable, there is only an extremely low chance of transmitting it to any potential partner. Take into consideration that a mother with a viral load of 10000 IU/mL (or lower) is unlikely to pass it onto their highly vulnerable new-born. We also allow surgeons with 1000 IU/mL (or lower) to practice surgery because there is very low risk of transmission even if there is an accidental cut. I hope these facts give you some comfort.

Regarding when you disclose your status, I guess this needs to be when you feel like you feel comfortable enough. I myself disclosed even before the first date with my now-wife, but everyone is different. Here are some tips from Hepatitis Australia:

Knowing when and how to disclose can be difficult. Some people may be supportive, whereas others may withdraw or even be angry. Often this is due to their lack of knowledge about the condition. Be prepared that a relationship may change.

Here are some tips that may help with the process:

  • Make sure you know the basics about hepatitis B so you can answer some of the more common questions.
  • Before you speak to them, practise how the conversation might go with a good friend, considering both best and worst scenarios.
  • Choose a meeting place where you feel comfortable and safe. Face-to-face is usually best, rather than through email, for instance.
  • Ask them to keep your diagnosis confidential.
  • Bring something you can show like a leaflet or point them to a website like Hepatitis Australia or the National Hepatitis Infoline phone number 1800 437 222.
  • Give the person time and space to digest what you tell them.
  • Look after your own mental health during and after disclosing.

Others have talked about similar issues of disclosure in other threads too:

Hope these help! Perhaps others can also share their experiences with talking to their partners about it.

Cheers,
Thomas

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Hi lala, I’m not sure whether you live in the U.S. or not? If so, then anyone in your age cohort should have already been vaccinated against hep b. The CDC recommended all newborns receive the hep b vaccine in 1991, and in 1997 there was a national “catch up” program to get middle schoolers vaccinated against hep b as well. Today, most young people your age have either been vaccinated at birth or more likely, with their regular baby immunizations.

In addition to the good guidance that Thomas shared above, it’s important that you realize that blood is a 2-way street. So often those of us living with hep b feel we’re the only contagious person. But a potential sexual partner can also have an infectious disease or STD. That’s why you might want to consider having “the medical talk” with a potential partner in terms of learning what THEY might have to share as well as your own condition. Additionally, you can talk about having a “vaccine-preventable infection” so that you can ask directly whether a potential partner has received the hep b vaccine. If they’re 24 years or younger, then the chances are excellent that they have been vaccinated, so your condition shouldn’t be an issue.

Finally, if you have a trusted friend or family member you could consider practicing a conversation so that you get more comfortable talking about this situation. Role playing make feel strange, but it really does help you gain more confidence.

Thanks so much for sharing your question and hopefully others will also be able to share their experiences and insights with you!! Always, Joan

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Thanks Thomas and Joan for your responses!
As someone who is quite private, I find it difficult to talk about this personal thing with other people. Ideally, a part of me wishes to tell everyone I have hep b, but unfortunately due to discrimination and other situations, I feel I can’t do that, at least not now.

And yep, I do live in North America and I remember there being mandatory hep b vaccines in middle school. And in high school if you didn’t have your full vaccination record (included hep b), you couldn’t go to school. So I’m sure most people I grew up with are vaccinated. Also, Joan, I like your point on blood being a 2-way street. Sometimes I feel like knowing I have hep b so young is a double-edged sword, but I’d very much rather know and be able to treat it and prevent it from transmitting vs not know.

For reasons entirely not related to hep b, I decided not to date the friend I mentioned in my first post. I’m not sure when I’ll find someone I’m interested in dating, but I think when that time comes I’ll know and if it feels right I’ll feel comfortable in disclosing!

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Dear lala, I completely agree that knowing one has hep b is better than not knowing so we can take active steps to manage the infection. Although it can feel like a heavy weight around your neck when navigating the dating and sex situations, I also agree that you will find someone who will be understanding (and most likely vaccinated!) and someone you trust. As painful as it is to be rejected because of hep b, a friend of mine said she’d much rather know from the beginning if someone is a loser than waste time on them! Good luck and please continue to share insights, concerns and questions on this forum. We all learn from each other! Always, Joan

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Also remember that just bc someone rejects you because you told them you have hepatitis B, does not make that person a bad person. It’s their choice to get involved with someone with STD or STI. I don’t like how hepatitis b is labeled that way.

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Very good point @NeptuneJ about not blaming the person who chooses to stay away from hep b. Although honestly, I think that if someone does their homework and understands what hep b is, how it can be easily prevented with a vaccine, then this diagnosis shouldn’t be a barrier. But then again, if the chemistry isn’t there, then the other person may not want to make the investment of time. And yes, I understand that having hep b labeled as an STD/STI (sexually transmitted disease or infection) is a turn-off, but here in the U.S. sexual transmission is the primary mode of transmission! Outside of the U.S., maternal-child transmission is the most common mode of transmission; that is, an infected mother can unknowingly pass the virus to her newborn during the delivery process (and even during pregnancy, especially the last trimester). So that’s one of the main reasons hep b is considered an STD/STI. So glad you presented another point of view!! Always, Joan