Theme: Social Science & Policy Research Year: 2018
Background: MSM are highly vulnerable to sexually-transmitted viral hepatitis.
Although effective vaccines for HAV and HBV have long been recommended by public
health authorities for all MSM, data on awareness and uptake of the vaccines among
this population are sparse.
Methods: Cross-sectional data were collected as a part of an intervention trial study for
at-risk substance-using MSM ages 18-55 (N=453). Survey items included
demographics, sexual risk behaviors, lifetime HAV, HBV, HCV and HIV diagnoses, and
awareness and uptake of HAV and HBV vaccines.
Results: Median age was 41; 46% HIV-positive; 20% Black; 25% Hispanic, 49% White
and 6% other race/ethnicity. Recent substance use, in addition to alcohol and
marijuana, included amyl nitrites (54%), cocaine (50%), benzodiazepines (33%),
prescription opioids (25%) and methamphetamine (25%). Participants reported an
average of 13 anal sex partners and 22 occasions of unprotected anal sex in the past
90 days. Lifetime hepatitis prevalence: 14% HAV, 14% HBV, and 11% HCV; all were
significantly higher among HIV-positive compared to HIV-negative men (p<.001).
Injection drug use history was reported by 67% of HCV-positive men. Awareness of
HAV (73%) and HBV (74%) vaccines was similar across HIV serostatuses. Uptake of
vaccines among aware men was similar for HAV (66%) and HBV (68%). Men without
prior immunity who had not been vaccinated cited a range of structural and personal
factors limiting their access to prevention services.
Conclusion: Lifetime prevalence of HAV, HBV and HCV were high among our sample;
HIV-positive men had higher rates than HIV-negative men. Only about three-quarters of
our sample were aware of available vaccines, and uptake among aware men was
hampered by access to prevention services. Hepatitis public health policy requires
additional support mechanisms to increase awareness and access to vaccines. Our
data also indicate potentially significant levels of sexually-transmitted HCV among this
population.
Declaration of interests: Nothing to report.