HIV, hepatitis and sport

People with human immunodeficiency virus (HIV), hepatitis B or hepatitis C participate in a wide range of sports without restrictions. The risk that a player infected with one of these blood-borne viruses (BBVs) will spread it to other players is extremely small. For example, there are no documented cases of transmission of HIV from one athlete to another during participation in a sporting event.

It is unlawful to prevent a person infected with HIV, hepatitis B or hepatitis C from participating in sport. Infection control guidelines such as the ‘blood rule’ help keep all sportspeople, coaches, trainers and officials from a range of infections including these blood-borne viruses.

How HIV and hepatitis B and C are spread

HIV damages the immune system and can cause acquired immune deficiency syndrome (AIDS) if untreated. Hepatitis B and C are viruses that can cause serious damage to the liver.
To become infected with HIV or hepatitis B or C while playing sports, body fluids such as blood from an infected person would need to enter your bloodstream through:

• a significant abrasion (cut) on your skin
• a bleeding wound
• your mucous membranes (such as in your mouth or eyes).

HIV and hepatitis B are spread in similar ways. Because both HIV and hepatitis B are found in blood, semen and vaginal fluids, these infections are transmitted:

• by having condomless anal, vaginal or oral sex with an infected person
• by sharing needles, syringes and other injecting equipment with an infected person
• from mother to baby during childbirth or breastfeeding.

HIV cannot be transmitted by a person who is on treatment and who has low levels of virus in their body (referred to as undetectable viral load). In other words, there is no risk of HIV transmission through exposure to blood during sport (or through sexual contact) from a person has an undetectable viral load.

Hepatitis C is spread through blood-to-blood transmission only, but is not thought to be sexually transmitted unless blood is present.

Sport and transmission of HIV and hepatitis

The risk of transmission of HIV or hepatitis B or C from an infected player is:

• negligible (so small that it can be disregarded) for other athletes and players involved in contact sports
• negligible for first aid officers who follow infection control guidelines
• zero for coaches, trainers, officials and spectators.

HIV and hepatitis B and C cannot spread through:

• sweat or saliva from other sportspeople
• sharing drink bottles with team members
• shared toilets, showers or spas
• hugging or shaking hands.

HIV and hepatitis and participation in sport

The Equal Opportunity Act 2010 makes it unlawful in Victoria to fail or refuse to select a person with HIV or hepatitis B or C for a sporting team, or to exclude them from participating in a sporting activity, because they have HIV or hepatitis B or C.

People with these viruses are not required to disclose their health status to coaches, sporting teams or sporting organisations. They are entitled to keep the fact that they have HIV, hepatitis B or C confidential.

Protecting everyone involved in sport against HIV and hepatitis

Consult your sporting organisation’s infection control policies. Simple and inexpensive procedures can prevent the spread of HIV, hepatitis B and C, including:

• Remember to cover all pre-existing wounds before starting a game.
• Wear protective gloves when giving first aid to bleeding players.
• If someone’s eyes have been splashed with blood – with the eyes open, rinse the area gently but thoroughly with water or normal saline, rinsing away from the nose.
• If blood gets in your mouth – spit it out and rinse your mouth with water several times.
• Standard practice is to stop play if a player is bleeding and allow them to return to play only after bleeding is controlled and the wound is properly covered.
• Bandage any wounds that occur, and properly clean any playing surfaces and change any clothes exposed to blood before play restarts.
• Have your own drink bottle and towel, mouth guard and other personal items, including razors, to reduce the possibility of small amounts of blood-to-blood transmission.
• If you are concerned about potential infection, contact a doctor or health information line for further advice.

If a player is injured while playing sport:

• Remember to wear protective gloves when giving first aid to a player who is bleeding.
• Stop the bleeding from the wound.
• Dress the wound.
• Clean up the blood.

All players, coaches, trainers, sporting officials and first aid officers should be aware of these infection control guidelines and treat every injury associated with blood as a potential source of HIV, hepatitis B and hepatitis C.

Protecting against HIV and hepatitis off the field

It is important to practise safer sex when off the field by using condoms and water or silicone-based lubricant to protect yourself from HIV, hepatitis B and other sexually transmissible infections.

People who inject steroids or other performance enhancing drugs are at risk of HIV, and both hepatitis B and C, if they share needles, syringes or any injecting equipment such as swabs or tourniquets. Injecting equipment should be used once only and never shared.

Hepatitis B immunisation and sport

You can be immunised against hepatitis B, but not against HIV or hepatitis C. Those responsible for managing on-field injuries and players involved in contact sports are strongly advised to be immunised against hepatitis B. Use infection control procedures even if you are immunised.

Hepatitis C treatments

New treatments are available for hepatitis C that can cure more than 95 per cent of people living with chronic hepatitis C. These simple treatments are taken orally for 8–12 weeks, and are available at low cost through the Pharmaceutical Benefits Scheme from your regular GP.

If you test positive for hepatitis C, getting on these treatments as soon as possible can help improve your own health, and greatly reduce the risk of onward transmission of the virus.

HIV treatment and prevention

Simple, effective treatments for HIV are widely available in Australia. In addition to protecting the health and wellbeing of people living with HIV, these treatments significantly reduce the risk of HIV transmission. Almost all people on HIV treatments have very low levels of virus in their body. This is called having an undetectable viral load. There is no risk of HIV transmission from a person with an undetectable viral load. This is sometimes referred to as undetectable equals untransmissible, or U=U.

For people who do not have HIV, but may be at higher risk of it, affordable medication is available that is more than 99 per cent effective at preventing HIV. Known as PrEP (pre-exposure prophylaxis), this medication is available through the Pharmaceutical Benefits Scheme from your regular GP.

Where to get help

• Your GP (doctor)
• Your school nurse or school welfare coordinator
• Your local community health service
• Sexual Health Victoria (SHV). To book an appointment call SHV Melbourne CBD Clinic: (03) 9660 4700 or call SHV Box Hill Clinic: (03) 9257 0100 or (free call): 1800 013 952. These services are youth friendly.
• Melbourne Sexual Health Centre Tel. (03) 9341 6200 or 1800 032 017.
• Victorian Sexual Health Network – where to get tested – visit Melbourne Sexual Health Centre's GP partner clinics for STI check-ups and treatment
• Thorne Harbour Health (formerly Victorian AIDS Council) Tel. (03) 9865 6700 or 1800 134 840
• The Centre Clinic, St Kilda Tel. (03) 9525 5866
• Equinox Gender Diverse Health Centre Tel. (03) 9416 2889
• PRONTO! Tel. (03) 9416 2889
• Ballarat Community Health Sexual Health Clinic Tel. (03) 5338 4500
• Bendigo Community Health Sexual Health Clinic Tel. (03) 5434 4300 Or (03) 5448 1600
• Gateway Health Clinic 35, Wodonga Tel. (02) 6022 8888 or 1800657 573
• Sunraysia Community Health Services Tel. (03) 5022 5444
• Barwon Health Sexual Health Clinic Tel. (03) 5226 7489
• 1800MyOptions Tel. 1800 696784 – is a statewide phone service for information about sexual health as well as contraception and pregnancy options