That paper is from 2004. The right-hand side links to a paper from 2013 at http://www.ncbi.nlm.nih.gov/pubmed/23175457 http://www.ncbi.nlm.nih.gov/pubmed/231754

That paper is from 2004. The right-hand side links to a paper from 2013 at http://www.ncbi.nlm.nih.gov/pubmed/23175457 http://www.ncbi.nlm.nih.gov/pubmed/23175457 , which says "The efficiency of hepatitis C virus (HCV) transmission by sexual activity remains controversial. We conducted a cross-sectional study of HCV-positive subjects and their partners to estimate the risk for HCV infection among monogamous heterosexual couples." They found that "Viral isolates in three couples (0.6%) were highly related, consistent with transmission of virus within the couple." This can be from non-sexual means, so this places an upper bound on the transmission rate; that being "approximately one per 190,000 sexual contacts." Indeed, it's very rare, if it does happen. However, that paper is titled "Sexual transmission of hepatitis C virus among monogamous heterosexual couples", and the paper you linked to was also for heterosexual couples. What about men who have sex with men? The paper at http://www.ncbi.nlm.nih.gov/pubmed/24669911 http://www.ncbi.nlm.nih.gov/pubmed/24669911 says "Outbreaks of hepatitis C virus (HCV) infection have been reported in HIV-positive men who have sex with men (MSM) in North America, Europe and Asia. Transmission is believed to be the result of exposure to blood during sexual contact." In the US context, the US Centers for Disease Control, at http://www.cdc.gov/hepatitis/c/CFAQ.htm http://www.cdc.gov/hepatitis/c/CFAQ.htm , says "Less commonly, a person can also get Hepatitis C virus infection through ... Having sexual contact with a person infected with the Hepatitis C virus", so I think it's perfectly acceptable for a US OB/GYN to follow their guidance.