Awareness and perceptions of Hepatitis B and Liver Cancer among three Asian American groups: A focus group inquiry

Background: Hepatitis B rates among Asian Americans (~10%) are higher than those of any other racial group in the United States. Since 80% of liver cancer is associated with Hepatitis B, the burden of morbidity and mortality is extremely high in this population, highlighting the need for culturally appropriate interventions.

Objective: To explore Asian Americans' knowledge, awareness, and perceived barriers toward Hepatitis B screening and vaccines.

Methods: Using focus groups (n=8) with Korean, Vietnamese, and Chinese immigrants in the Baltimore/Washington Metropolitan area, we explored participants' understanding of, and experience with, Hepatitis B and liver cancer. Focus groups were audio-taped, transcribed, and translated into English. Content analysis was conducted to identify themes related to knowledge and awareness, risk perception, and barriers to prevention.

Results: Emergent themes included generally low levels of knowledge and awareness of Hepatitis B risks, screening and vaccination; inter-generational differences in knowledge and behaviors; and existing barriers to preventive activities (including lack of insurance and stigma). Though low knowledge levels were uniformly reported, there were several significant differences across ethnic groups, particularly with regard to perceived stigma and the role of religion in attitudes toward prevention.

Conclusions: High rates of Hepatitis B infection among the Asian American community have prompted interest in a public health response. These results highlight the need to tailor interventions to specific ethnic groups to increase effectiveness. These findings may assist policy strategists in implementing interventions that will create enabling environments that facilitate the integration and scale-up of Hepatitis B vaccine and screening campaigns.