Hepatitis education and vaccine drive targets gay and bisexual men

KING COUNTY, WASHINGTON - Today, Public Health - Seattle & King County in collaboration with Northwest AIDS Foundation, Gay City Health Project, and Seattle's Commission for Sexual Minorities , launches a new program aimed at preventing the spread of hepatitis A and B among gay and bisexual men in Seattle. This program (known as the Hepatitis Initiative) urges gay and bisexual men to address their increased risk for hepatitis A and B by getting vaccinated against both diseases.

Exterior bus signs will deliver the message "Hepatitis Hurts. Get the Shots". In addition, the project will reach gay and bisexual men with messages about hepatitis vaccination through volunteer peer educators, workshops, and distribution of materials at gay bars and community events. Free vaccine is available at a network of Public Health and community clinics for those who are low income or lack adequate insurance coverage.

Public Health's STD Hotline (206) 205-7837 will serve as a resource center, helping gay and bisexual men assess their risk for hepatitis and referring them to an appropriate clinic for hepatitis testing and/or vaccination. The STD Hotline is open weekdays from 8 a.m. to 5 p.m.

"All gay and bisexual men should get vaccinated against hepatitis A and B unless they have a history of these infections", said Dr. Alonzo Plough, Director of Public Health - Seattle & King County. "These vaccines are proven safe and are, by far, the most effective means of preventing these contagious diseases".

The campaign also includes a provider education component. Dr. Jeff Duchin, Public Health's Chief of Communicable Disease and Epidemiology, noted that, "hepatitis vaccine coverage can be greatly improved if health care providers routinely recommend hepatitis A and B vaccines to their high-risk patients, including gay and bisexual men".

A survey of gay and bisexual men at local Gay Pride events last year found that those whose providers had recommended hepatitis A or B vaccine were far more likely to have been immunized than those who did not receive a recommendation.

Vaccine grant to improve access

Dr. Plough also announced today that SmithKline Beecham Pharmaceuticals has given additional grant support to Public Health to help assure a limited period of comprehensive access to vaccine for low-income and/or uninsured persons at risk for hepatitis A and B.

Larry Barge from SmithKline Beecham noted that Seattle's Hepatitis Initiative was chosen for this grant because "it represents the cutting edge for hepatitis education. Encouraging immunization for hepatitis A and B will have a positive effect on the public's health in Seattle and will serve as a model to other cities".

Hepatitis A and B vaccines for high-risk adults are reimbursable by most health plans. Providers who do not offer immunization are strongly encouraged to direct their patients to Public Health's STD Hotline (206-205-7837) where they can be referred to appropriate clinics.

Hepatitis trends

Cyclical outbreaks of hepatitis A among gay and bisexual men occur regularly in urban areas of the United States. The last such outbreak in Seattle peaked in 1998 and led the Seattle Commission for Sexual Minorities to lobby the City Council to target funds for educating gay men about their increased risk for the disease and the availability of vaccine. Moreover, while universal childhood immunizations have led to a decline in infection rates of hepatitis B nationally, rates are still disproportionately high among gay and bisexual men. Gay men in King County have a risk of acquiring hepatitis B infection that is up to seven times that of the general population.

Between 1990 and 1998, approximately 25% of hepatitis A cases in King County have been among men with same-sex partners; for the years 1997 through 1998, the figure was 38%. The rate of hepatitis A among men with same-sex partners in King County between 1990 and 1998 was approximately 17 times greater than for the U.S. population as a whole and ranged from six to 30 times greater depending on the year.

The Centers for Disease Control and Prevention Advisory Committee on Immunization Practices (ACIP) recommends that sexually active gay and bisexual men not already exposed to hepatitis A and B should be vaccinated against both diseases. "Unfortunately, more than half of gay and bisexual men in King County have not been fully immunized against hepatitis B even though the vaccine has been widely available for over a decade", noted Dr. Plough. "A third or less have received hepatitis A vaccine even though this vaccine has been available for five years. Clearly, the missing ingredient is educational activities targeted to those at risk".

The Hepatitis Initiative