Methods: From 10/98 through 12/99, 366 IDUs recruited from street settings in 2 inner-city neighborhoods in San Francisco were tested for hepatitis B virus (HBV) surface antigen (HBsAg) and anti-core (anti-HBc) and anti-surface (anti-HBs) antibodies. Participants negative for HBsAg and anti-HBs were offered hepatitis B vaccination. Participants received their first vaccine dose at enrollment and were randomized into two follow-up arms to receive the remaining doses. In the Cash Incentive (CI) arm, participants received $20 once a month for 6 months at a community field site. In the Outreach (OR) arm, an outreach worker was assigned to maintain contact with participants and encourage them to return for the 2 remaining vaccine doses. Results: Of 366 IDUs, 74/366 (20%) were negative for all 3 HBV markers and 75/366 (21%) had anti-HBc only. Of the 149 eligible for vaccine, 96 (64%) accepted their first vaccine dose and were randomized into the CI (n=48) or OR arms (n=48). There were no significant differences between the 2 arms; the median age was 44; 56% were male; 46% were African American, 32% white, and 15% Latino. Adherence to the second vaccine dose at one month was 46/48 (96%) in CI and 30/48 (63%) in OR (p<0.0001). Adherence to the third vaccine dose at 6 months was 33/48 (69%) in CI and 11/48 (23%) in OR (p< 0.0001). Conclusions: Cash incentives are superior to community outreach in achieving adherence to the 3-part hepatitis B vaccine in IDUs.
Learning Objectives: To compare the effectiveness of cash incentives vs. community-based outreach to acheive completion of the hepatitis B vaccine series (0,1, and 6 months) by street-recruited injection drug users (IDUs)
Keywords: Adherence, Injection Drug Users
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.