The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #57307

Sharon M. Hudson, PhD¹, Karla D. Wagner, MA¹, and Peter Kerndt, MD, MPH². (1) Health Research Association, 3580 Wilshire Blvd., Suite 1660, Los Angeles, CA 90010, 213-736-6017, shudson@hra-paramount.org, (2) Los Angeles County Department of Health Services Sexually Transmitted Disease Program, 2615 S. Grand Ave., Rm. 500, Los Angeles, CA 90007

Objective: Identify factors influencing injection drug users’ (IDU’s) exposure to and vaccination against hepatitis A virus (HAV) and hepatitis B virus (HBV), and settings where IDU access vaccination. Methods: Participants: 15-30 years old; reported injecting non-prescribed drugs at least once in past 6 months; recruited in Los Angeles for a multi-site behavioral intervention. Assessment included computer-administered questionnaire and blood draw. Samples tested for past infection by measuring total HBV core antibody and total hepatitis A antibody. Results: Of 285 individuals, 74% were male, 23% female and 3.2% transgender. Median age was 23 years. Over a third (37%) did not complete high school. Tests showed that 21% had been exposed to HBV and 23% to HAV. Chi-square tests for age and gender showed that 15-21 year-olds and transgender persons were significantly more likely to test HBV-positive (similar but NS results found for HAV). There was a non-significant trend for increasing exposure with higher education. More reported vaccination against HBV (47%) than HAV (31%). The most common reason for no prior vaccination was not knowing a vaccine existed. Community clinics and private physicians most commonly recommended and provided vaccine. Although 78% had been incarcerated, only 10% of these had been vaccinated there. Conclusions: Younger and transgender IDU are at high risk for HBV and HAV. There are multiple missed chances to inoculate them. Providing vaccine in correctional facilities is a key underused opportunity. A trend of increasing infection with schooling may support the CDC recommendation to provide school-age adolescents with HBV vaccine.

Learning Objectives:

• At the conclusion of the session, participants will be able to describe 2 subpopulations at greatest risk for HBV and HAV infection. They will be able to identify the most common sources that offer HAV/HBV vaccination to younger injection drug users, as well as the key missed opportunities for vaccinating these individuals.

Keywords: Drug Injectors, Hepatitis B

Presenting author's disclosure statement:
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.