HIV, hepatitis and sport

People cannot be excluded from playing sport simply because they have a blood-borne virus (BBV) such as HIV or hepatitis B or C. The risk that a player with one of these viruses will pass it to others during sport is extremely small. There are no documented cases of HIV being transmitted from one athlete to another during a sporting event.

In many places it is also unlawful to prevent a person with HIV, hepatitis B or hepatitis C from taking part in sport. Standard infection control measures, such as the “blood rule”, protect players, coaches, trainers and officials from a range of infections, including these viruses.

About these viruses#

HIV damages the immune system and, if untreated, can lead to acquired immune deficiency syndrome (AIDS). Hepatitis B and hepatitis C are viruses that can cause serious damage to the liver.

To become infected with HIV or hepatitis B or C while playing sport, body fluid such as blood from an infected person would need to enter your bloodstream through:

• A significant abrasion or cut on your skin
• A bleeding wound
• Your mucous membranes, such as those in your mouth or eyes

How these viruses are spread#

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

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

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

Hepatitis C is spread through blood-to-blood contact only. It is not thought to be sexually transmitted unless blood is present.

These viruses cannot be spread through:

• Hugging or shaking hands
• Sweat or saliva
• Sharing drink bottles with team members
• Shared toilets, showers or spas

Sport and transmission#

The risk of HIV or hepatitis B or C being passed on by an infected player is:

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

Participation and your rights#

It is generally unlawful to refuse to select a person with HIV or hepatitis B or C for a team, or to exclude them from a sporting activity, because of their infection. People with these viruses are not required to disclose their health status to coaches, teammates or sporting organizations, and they are entitled to keep that information confidential. If you are unsure of the rules where you play, consult your sporting organization about its infection control policies.

Protecting everyone involved in sport#

Simple and inexpensive measures can prevent the spread of HIV and hepatitis B and C. All players, coaches, trainers, officials and first aid officers should treat every injury involving blood as a potential source of infection and follow these practices:

• Cover all pre-existing wounds before starting a game.
• Wear protective gloves when giving first aid to a bleeding player.
• Stop play if a player is bleeding, and allow them back only after the bleeding is controlled and the wound is properly covered.
• Bandage any wounds, clean any playing surfaces, and change any clothing exposed to blood before play restarts.
• Have your own drink bottle, towel, mouth guard, razor and other personal items to reduce the chance of small amounts of blood-to-blood transmission.

If blood splashes into the eyes, keep the eyes open and rinse the area gently but thoroughly with water or normal saline, rinsing away from the nose. If blood gets into the mouth, spit it out and rinse the mouth with water several times. If you are concerned about possible infection, contact a doctor or health information line for advice.

Treating an injured player#

If a player is injured and bleeding, wear protective gloves, then:

1. Stop the bleeding from the wound.
2. Dress the wound.
3. Clean up the blood.

Protecting yourself off the field#

It is important to practice safer sex off the field. Using condoms with a water- or silicone-based lubricant helps protect you from HIV, hepatitis B and other sexually transmissible infections.

People who inject steroids or other performance-enhancing drugs are at risk of HIV and 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 immunization#

You can be immunized against hepatitis B, but there is no vaccine against HIV or hepatitis C. People who manage on-field injuries and those involved in contact sports are strongly encouraged to be immunized against hepatitis B. Continue to use infection control procedures even if you are immunized.

Treatment#

New treatments can cure more than 95 per cent of people living with chronic hepatitis C. These are taken orally for 8–12 weeks and are widely available through a regular doctor. If you test positive for hepatitis C, starting treatment as soon as possible can improve your own health and greatly reduce the risk of passing the virus on.

Simple, effective treatments for HIV are also widely available. As well as protecting the health of people living with HIV, these treatments greatly reduce the risk of transmission. Almost everyone on HIV treatment has very low levels of virus in their body, known as an undetectable viral load. There is no risk of HIV transmission from a person with an undetectable viral load, a message sometimes summarized as undetectable equals untransmittable, or U=U.

For people who do not have HIV but may be at higher risk of it, medication is available that is more than 99 per cent effective at preventing infection. Known as PrEP (pre-exposure prophylaxis), it is available from a doctor or sexual health service. A youth-friendly sexual health or phone service can also give information about sexual health, contraception and pregnancy options.

Key points#

• You cannot catch HIV or hepatitis B or C just from playing sport with an infected player, and people cannot be banned from sport because they have one of these viruses.
• HIV damages the immune system and can lead to AIDS if untreated, while hepatitis B and C can seriously damage the liver.
• The risk of transmission during sport is negligible for players in contact sports and zero for coaches, officials and spectators.
• Simple infection control measures, such as covering wounds and stopping play for bleeding, protect everyone involved.
• Effective treatments exist for both HIV and hepatitis C, and a person with an undetectable HIV viral load cannot pass on the virus.

Where to get help#