172151 Hepatitis A among young men who have sex with men

Wednesday, October 29, 2008

Vaughn Barry, MPH , Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA
Stephanie R. Bialek, MD, MPH , Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Beth P. Bell, MD, PhD , Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Stephanie Behel, MPH , Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Gina Secura, PhD, MPH , Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO
Duncan MacKellar, MPH, MA , Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Linda Valleroy, PhD , Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA
BACKGROUND: Hepatitis A outbreaks are well documented among men who have sex with men (MSM), but sexual risk factors have not been consistently associated with hepatitis A virus (HAV) infection. This analysis examines characteristics associated with HAV infection among young adult MSM from 5 U.S. cities.

METHODS: The Young Men's Survey, a cross-sectional study of HIV epidemiology and behavioral risk factors among MSM, enrolled men in 2 phases: men 15-22 years old during 1994-1998 and men 23-29 years old during 1998-2000. Serum specimens from HIV-negative participants were tested for antibody to HAV (anti-HAV). Data were analyzed by race/ethnicity using logistic regression.

RESULTS: Anti-HAV prevalence was 20.3% among the 2,985 participants, (18.8% among 15-22 year olds, 22.2% among 23-29 year olds (p=0.02)). Anti-HAV prevalence varied by race/ethnicity; it was lowest among white men (11.8%, n=1,570) and highest among Hispanic (45.8%, n=515) and Asian (37.1%, n=232) men (p=<0.001). Anti-HAV prevalence increased with age across all race/ethnic groups. Prevalence varied by city among white participants and Asian participants aged 23-29 years. Having > 20 lifetime male sex partners was associated with anti-HAV-positivity among white men aged 15-22 years old (AOR=2.1, 95% CI=(1.0-4.1)) and 23-29 years old (AOR=2.4, 95% CI=(1.2-4.5)) but not among black, Asian, or Hispanic men.

CONCLUSIONS: Anti-HAV prevalence among HIV-negative MSM varied by race/ethnicity and increased with age. Among white MSM, those with the greatest number of lifetime male sex partners had the highest anti-HAV prevalence. Healthcare providers should offer hepatitis A vaccine to MSM patients, as recommended since 1996.

Learning Objectives:
1. Determine characteristics associated with hepatitis A virus infection among young adult men who have sex with men. 2. Recognize the low vaccine coverage rates among young adult men who have sex with men.

Keywords: Hepatitis A, Gay Men

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have formulated and carried out the conception, analysis, and writing of the data presented in this abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Infectious Disease Epidemiology Poster Session II
See more of: Epidemiology