High Hepatitis B Rate Among Young Gay Men
Few get vaccinations despite access to health care
By Janice Billingsley
June 4 (HealthScoutNews) -- Almost one out of five gay men is
infected with the potentially fatal hepatitis B virus (HBV) by
the age of 22, despite the fact that a vaccine to prevent the
disease has been available for almost 20 years, a Centers for
Disease Control and Prevention (CDC) study has found.
9 percent of more than 3,000 males between the ages of 15 and
22, who were surveyed over a five-year period, had received a
vaccination against HBV. Yet more than 90 percent of them
visited health care providers on a regular basis to be tested
for the AIDS virus or other sexually transmitted diseases.
is an incredible missed opportunity to prevent a very serious
disease," says Duncan A. MacKellar, a CDC epidemiologist
and author of the study, which appears in this month's American
Journal of Public Health. "We have to do a better job
of making high-risk men and others aware of the need for, and
benefits of, the vaccine."
is no cure for hepatitis B, whose incidence increased by 37
percent from 1979 to 1989, according to the CDC. There are now
more a million people in the United States with chronic HBV
infection, and there are almost 5,000 deaths annually from the
B is caused by a virus that attacks the liver and can cause
cirrhosis (scarring) of the liver, liver cancer, liver failure
and death. The disease is transmitted by direct contact with
the blood or body fluids of an infected person. Gay men are
among those with a high risk of contracting the disease.
fact that the vaccine is relatively expensive and that three
injections are needed over a six-month period to ensure
immunity could be part of the reason why more men have not
been vaccinated, but MacKellar also says that many men don't
know about the virus.
men are not aware of the seriousness of hepatitis B and the
availability of the vaccine," he says.
many health care providers miss the opportunity to inform and
vaccinate people at risk for HBV when they come in for other
worrisome in the study, MacKellar says, was how the prevalence
of the disease increased with age. "At 15 years old, only
2 percent were infected, compared to 22 percent at age 22,
which is an incredible upward trend," he says.
the vaccine came on the market in 1982, there have been
various prevention programs to encourage vaccination against
the disease. In 1991, an early childhood vaccination program
was introduced, and by 1997, 85 percent of children under the
age of 3 had received it. Further, in 1994, the vaccine
coverage was expanded to include 11- and 12-year-olds, and, in
1997, those under 19 were included in recommended coverage.
that still leaves many young people vulnerable to the disease,
we integrate HBV vaccines with HIV and STD programs and catch
up with adolescents, we will decrease the window period for
the disease," he says. "But we [still] have a lot of
susceptible persons who can develop cancer and liver disease
and could die."
his study, MacKellar analyzed HBV data from the Young Men's
Survey -- a study of about 3,400 men in eight U.S. cities from
1994 through 1998 -- to identify high-risk behavior that led
to contracting the AIDS virus. Volunteers were solicited
between 10 p.m. and 2 a.m. at various sites like dance clubs,
social clubs and businesses. Willing participants were taken
to a van where they were interviewed, had blood tests and
received counseling for sexually transmitted diseases.
is an assumption that most people needing [the vaccine] are
health personnel who handle blood, and people forget about the
importance of sexual transmission," says Dr. Ronald Gray,
of the Population and Family Health Sciences department at
Johns Hopkins School of Public Health. "But it should be
a part of care for people at risk for HIV. Anyone who's
practicing risky behavior of any kind really needs to be aware