A hepatitis B diagnosis involves more than living with a virus; it also entails making decisions about whom to tell, when to tell and what to tell others. Disclosure involves complex moral and legal issues.
There are certain circumstances in which you must disclose. For instance, if you are aware of having hep B and want long-term disability or life insurance, you must tell the truth when asked about your status. If you do not disclose to a sexual partner and you transmit HBV to him or her, you may be held liable for this. People have been sued and criminally prosecuted for failure to disclose their HIV status. These cases may set a precedent for HBV.
Although the choice to self-disclose is largely personal, there are moral concerns surrounding the subject, particularly if you have been in a relationship with someone and potentially exposed him or her to the virus without revealing your hep B status. Also, disclosure involves a certain amount of risk. If you tell someone you have hep B, you may encounter ignorance, fear, discrimination or harsh judgment. Hep B carries a stigma, in part because the disease is associated with injection drug use but also because the virus can be transmitted to others.
If you do decide to disclose your hepatitis B status, here are some suggestions to help you through the process:
- Know the risks of disclosure. People may be upset about this news. You may face discrimination. Relationships may change or end. Loved ones may worry about you. On the other hand, people may be supportive and offer to help.
- Before you tell others, be sure you know how hepatitis B is transmitted. People may want to know whether they are at risk of contracting the virus from you. Hep B may be passed when the blood of an uninfected person comes into contact with HBV-positive blood. Hepatitis B may be spread while sharing injection drugs and other items that may pass blood from an infected person to an uninfected one. It may also be transmitted during unprotected sex with an infected partner—and more easily anally than vaginally. Hep B may be acquired during pregnancy or delivery from an infected mother. Hepatitis B is not spread by kissing, hugging, sharing food or drinking from the same glass.
- Be prepared to answer questions. You may be asked how you got hep B. If you are uncomfortable with disclosing how you acquired it, then don’t. It is enough to say that you aren’t sure; few people are ever 100 percent sure.
- Share information. Arm yourself with knowledge from websites, literature or other resources to help answer further questions the person you are disclosing to may have.
- Ask the person to keep the information confidential. However, if you tell one person, be prepared for others to know. Some people aren’t very good at keeping secrets.
After revealing your hep B status, do not expect family and friends to digest all this news instantly. Give them time to react and respond. Everyone does this at his or her own rate. If this process becomes prolonged or negatively affects your relationship, you may want to talk to a counselor, member of the clergy or other trusted adviser.
Specific Disclosure Circumstances
Sex Partners Disclosure of your hep B status to those you hope to have sex with or are already having sex with is a delicate matter. The ethical choice is to disclose your status before there is sexually intimacy. However, sometimes a hepatitis B diagnosis occurs after you’ve already been having sex.
Before you disclose, be sure you know how hepatitis B can or cannot be transmitted. If your partner has been immunized against hep B, then he/she is not at risk. So the best way to begin the conversation is to ask your partner whether he or she has been immunized. Your partner may want to see his or her medical provider to confirm that he or she is immune; some people aren’t despite having completed the necessary series of three vaccines. In these cases, a doctor may recommend a booster.
Knowing how to practice safer sex is essential. It is equally important to familiarize yourself with the proper techniques, such as how to use a condom correctly.
The entire discussion is best had at a time and in a place with few distractions. Try not to have it late at night so as to avoid upsetting someone before bedtime. Be armed with information or links to websites so your partner can get more information.
Internet Disclosure Disclosing on the internet is especially risky because the internet is forever. If privacy is important to you, do not post information about yourself in chat rooms or social media. If you want to join a web-based group and still maintain a certain amount of anonymity, use an alias, though even this can be traced back to you. If you don’t want others to know your status, don’t share anything online about having hep B.
Health Care Settings Your health care provider may not disclose your HBV status without your prior consent. The Health Insurance Portability and Accountability Act (HIPAA) protects the information in your medical record. Your information may be shared with your insurance company if the insurer is paying for your care. Because health care professionals take precautions when handling blood and other body secretions, they are not at risk of acquiring HBV from you.
Telling Children Sometimes it may feel necessary to tell a child that you have hep B. For instance, your condition may be severe and you want children you live with to know why. What to tell them largely depends on their age and your assessment of their ability to handle this information. Children can sense when something is wrong, and acknowledgment gives them the space to ask questions. Try to find something genuinely reassuring to tell them. Be brief but truthful. Ask them whether they have any questions. Tell them that they do not need to worry about your health.
Even if you don’t disclose your HBV status, tell children who live with you how to stay safe. Make sure they know never to use your toothbrush, razor or cuticle clippers. Tell them they should not share anyone’s personal items.
Last Reviewed: March 4, 2019