Skip to main content
American Journal of Public Health logoLink to American Journal of Public Health
. 2001 Jun;91(6):965–971. doi: 10.2105/ajph.91.6.965

Two decades after vaccine license: hepatitis B immunization and infection among young men who have sex with men.

D A MacKellar 1, L A Valleroy 1, G M Secura 1, W McFarland 1, D Shehan 1, W Ford 1, M LaLota 1, D D Celentano 1, B A Koblin 1, L V Torian 1, H Thiede 1, R S Janssen 1; Young Men's Survey Study Group1
PMCID: PMC1446476  PMID: 11392942

Abstract

OBJECTIVES: This study investigated hepatitis B immunization coverage and the extent of hepatitis B virus (HBV) infection among young men who have sex with men (MSM), a group for whom hepatitis B vaccine has been recommended since 1982. METHODS: We analyzed data from 3432 MSM, aged 15 to 22 years, randomly sampled at 194 gay-identified venues in 7 US metropolitan areas from 1994 through 1998. Participants were interviewed, counseled, and tested for serologic markers of HBV infection. RESULTS: Immunization coverage was 9% and the prevalence of markers of HBV infection was 11%. HBV infection ranged from 2% among 15-year-olds to 17% among 22-year-olds. Among participants susceptible to HBV infection, 96% used a regular source of health care or accessed the health care system for HIV or sexually transmitted disease testing. CONCLUSIONS: Despite the availability of an effective vaccine for nearly 2 decades, our findings suggest that few adolescent and young adult MSM in the United States are vaccinated against hepatitis B. Health care providers should intensify their efforts to identify and vaccinate young MSM who are susceptible to HBV.

Full Text

The Full Text of this article is available as a PDF (174.6 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alter M. J., Hadler S. C., Margolis H. S., Alexander W. J., Hu P. Y., Judson F. N., Mares A., Miller J. K., Moyer L. A. The changing epidemiology of hepatitis B in the United States. Need for alternative vaccination strategies. JAMA. 1990 Mar 2;263(9):1218–1222. [PubMed] [Google Scholar]
  2. Coleman P. J., McQuillan G. M., Moyer L. A., Lambert S. B., Margolis H. S. Incidence of hepatitis B virus infection in the United States, 1976-1994: estimates from the National Health and Nutrition Examination Surveys. J Infect Dis. 1998 Oct;178(4):954–959. doi: 10.1086/515696. [DOI] [PubMed] [Google Scholar]
  3. Dardick L., Grady K. E. Openness between gay persons and health professionals. Ann Intern Med. 1980 Jul;93(1):115–119. doi: 10.7326/0003-4819-93-1-115. [DOI] [PubMed] [Google Scholar]
  4. Dienstag J. L., Ryan D. M. Occupational exposure to hepatitis B virus in hospital personnel: infection or immunization? Am J Epidemiol. 1982 Jan;115(1):26–39. doi: 10.1093/oxfordjournals.aje.a113277. [DOI] [PubMed] [Google Scholar]
  5. Goilav C., Piot P. Vaccination against hepatitis B in homosexual men. A review. Am J Med. 1989 Sep 4;87(3A):21S–25S. doi: 10.1016/0002-9343(89)90526-3. [DOI] [PubMed] [Google Scholar]
  6. Hollinger F. B. Controlling hepatitis B virus transmission in North America. The North American Regional Study Group. Vaccine. 1990 Mar;8 (Suppl):S122–S138. doi: 10.1016/0264-410x(90)90232-b. [DOI] [PubMed] [Google Scholar]
  7. Kalichman S. C., Schaper P. E., Belcher L., Abush-Kirsh T., Cherry C., Williams E. A., Nachimson D., Smith S. It's like a regular part of gay life: repeat HIV antibody testing among gay and bisexual men. AIDS Educ Prev. 1997 Jun;9(3 Suppl):41–51. [PubMed] [Google Scholar]
  8. Kane M. A., Alter M. J., Hadler S. C., Margolis H. S. Hepatitis B infection in the United States. Recent trends and future strategies for control. Am J Med. 1989 Sep 4;87(3A):11S–13S. doi: 10.1016/0002-9343(89)90524-x. [DOI] [PubMed] [Google Scholar]
  9. Kingsley L. A., Rinaldo C. R., Jr, Lyter D. W., Valdiserri R. O., Belle S. H., Ho M. Sexual transmission efficiency of hepatitis B virus and human immunodeficiency virus among homosexual men. JAMA. 1990 Jul 11;264(2):230–234. [PubMed] [Google Scholar]
  10. Koziol D. E., Saah A. J., Odaka N., Muñoz A. A comparison of risk factors for human immunodeficiency virus and hepatitis B virus infections in homosexual men. Ann Epidemiol. 1993 Jul;3(4):434–441. doi: 10.1016/1047-2797(93)90073-d. [DOI] [PubMed] [Google Scholar]
  11. Kripke C. C., Vaias L. The importance of taking a sensitive sexual history. JAMA. 1994 Mar 2;271(9):713–713. doi: 10.1001/jama.271.9.713. [DOI] [PubMed] [Google Scholar]
  12. MacKellar D., Valleroy L., Karon J., Lemp G., Janssen R. The Young Men's Survey: methods for estimating HIV seroprevalence and risk factors among young men who have sex with men. Public Health Rep. 1996;111 (Suppl 1):138–144. [PMC free article] [PubMed] [Google Scholar]
  13. Margolis H. S., Coleman P. J., Brown R. E., Mast E. E., Sheingold S. H., Arevalo J. A. Prevention of hepatitis B virus transmission by immunization. An economic analysis of current recommendations. JAMA. 1995 Oct 18;274(15):1201–1208. [PubMed] [Google Scholar]
  14. Mast E. E., Mahoney F. J., Alter M. J., Margolis H. S. Progress toward elimination of hepatitis B virus transmission in the United States. Vaccine. 1998 Nov;16 (Suppl):S48–S51. doi: 10.1016/s0264-410x(98)00294-1. [DOI] [PubMed] [Google Scholar]
  15. McCusker J., Hill E. M., Mayer K. H. Awareness and use of hepatitis B vaccine among homosexual male clients of a Boston community health center. Public Health Rep. 1990 Jan-Feb;105(1):59–64. [PMC free article] [PubMed] [Google Scholar]
  16. McFarland W., Fischer-Ponce L., Katz M. H. Repeat negative human immunodeficiency virus (HIV) testing in San Francisco: magnitude and characteristics. Am J Epidemiol. 1995 Oct 1;142(7):719–723. doi: 10.1093/oxfordjournals.aje.a117702. [DOI] [PubMed] [Google Scholar]
  17. McQuillan G. M., Coleman P. J., Kruszon-Moran D., Moyer L. A., Lambert S. B., Margolis H. S. Prevalence of hepatitis B virus infection in the United States: the National Health and Nutrition Examination Surveys, 1976 through 1994. Am J Public Health. 1999 Jan;89(1):14–18. doi: 10.2105/ajph.89.1.14. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Osmond D. H., Charlebois E., Sheppard H. W., Page K., Winkelstein W., Moss A. R., Reingold A. Comparison of risk factors for hepatitis C and hepatitis B virus infection in homosexual men. J Infect Dis. 1993 Jan;167(1):66–71. doi: 10.1093/infdis/167.1.66. [DOI] [PubMed] [Google Scholar]
  19. Phillips K. A., Paul J., Kegeles S., Stall R., Hoff C., Coates T. J. Predictors of repeat HIV testing among gay and bisexual men. AIDS. 1995 Jul;9(7):769–775. doi: 10.1097/00002030-199507000-00015. [DOI] [PubMed] [Google Scholar]
  20. Rabeneck L., Risser J. M., Murray N. G., McCabe B. K., Lacke C. E., Lucco L. J. Failure of providers to vaccinate HIV-infected men against hepatitis B: a missed opportunity. Am J Gastroenterol. 1993 Dec;88(12):2015–2018. [PubMed] [Google Scholar]
  21. Schreeder M. T., Thompson S. E., Hadler S. C., Berquist K. R., Zaidi A., Maynard J. E., Ostrow D., Judson F. N., Braff E. H., Nylund T. Hepatitis B in homosexual men: prevalence of infection and factors related to transmission. J Infect Dis. 1982 Jul;146(1):7–15. doi: 10.1093/infdis/146.1.7. [DOI] [PubMed] [Google Scholar]
  22. Shapiro C. N. Epidemiology of hepatitis B. Pediatr Infect Dis J. 1993 May;12(5):433–437. doi: 10.1097/00006454-199305000-00036. [DOI] [PubMed] [Google Scholar]
  23. Sikkema K. J., Bissett R. T. Concepts, goals, and techniques of counseling: review and implications for HIV counseling and testing. AIDS Educ Prev. 1997 Jun;9(3 Suppl):14–26. [PubMed] [Google Scholar]
  24. Szmuness W., Much I., Prince A. M., Hoofnagle J. H., Cherubin C. E., Harley E. J., Block G. H. On the role of sexual behavior in the spread of hepatitis B infection. Ann Intern Med. 1975 Oct;83(4):489–495. doi: 10.7326/0003-4819-83-4-489. [DOI] [PubMed] [Google Scholar]
  25. Unger T. F., Strauss A. Individual-specific antibody profiles as a means of newborn infant identification. J Perinatol. 1995 Mar-Apr;15(2):152–155. [PubMed] [Google Scholar]
  26. Valleroy L. A., MacKellar D. A., Karon J. M., Rosen D. H., McFarland W., Shehan D. A., Stoyanoff S. R., LaLota M., Celentano D. D., Koblin B. A. HIV prevalence and associated risks in young men who have sex with men. Young Men's Survey Study Group. JAMA. 2000 Jul 12;284(2):198–204. doi: 10.1001/jama.284.2.198. [DOI] [PubMed] [Google Scholar]
  27. Weinstock H. S., Bolan G., Moran J. S., Peterman T. A., Polish L., Reingold A. L. Routine hepatitis B vaccination in a clinic for sexually transmitted diseases. Am J Public Health. 1995 Jun;85(6):846–849. doi: 10.2105/ajph.85.6.846. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Weinstock H., Sweeney S., Satten G. A., Gwinn M. HIV seroincidence and risk factors among patients repeatedly tested for HIV attending sexually transmitted disease clinics in the United States, 1991 to 1996. STD Clinic HIV Seroincidence Study Group. J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Dec 15;19(5):506–512. doi: 10.1097/00042560-199812150-00010. [DOI] [PubMed] [Google Scholar]
  29. Williams L. A., Klausner J. D., Whittington W. L., Handsfield H. H., Celum C., Holmes K. K. Elimination and reintroduction of primary and secondary syphilis. Am J Public Health. 1999 Jul;89(7):1093–1097. doi: 10.2105/ajph.89.7.1093. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Yusuf H. R., Coronado V. G., Averhoff F. A., Maes E. F., Rodewald L. E., Battaglia M. P., Mahoney F. J. Progress in coverage with hepatitis B vaccine among US children, 1994-1997. Am J Public Health. 1999 Nov;89(11):1684–1689. doi: 10.2105/ajph.89.11.1684. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES