Hepatitis A vaccination in a racially and sexually diverse population of gay,bisexual,and other men who have sex with men: Findings from the QVax study
Restricted accessResearch articleFirst published online November, 2024
Hepatitis A vaccination in a racially and sexually diverse population of gay,bisexual,and other men who have sex with men: Findings from the QVax study
Previous studies found vaccination uptake of vaccine-preventable diseases (VPD) to be associated with race/ethnicity and medical mistrust among key populations, however, few studies examine Hepatitis A vaccination uptake.
Methods
This cross-sectional study used online survey data collected from NJ and NY residents identifying as lesbian, gay, bisexual, transgender, queer (LGBTQ+) from October 2021 through November 2022.
Results
This study used a subsample of 222 gay, bisexual, and other cisgender men, 66.7% White, with mean age 41.22 years (SD = 15.23), and 60% fully vaccinated for Hepatitis A. Overall, average group-based medical mistrust scores did not differ among non-vaccinated participants compared to fully or partially vaccinated participants. However, higher group-based medical mistrust scores were associated with non-White identifying participants, and were highest among Hispanic/Latinx (2.68, sd = 0.43) and Black non-Hispanic (2.58, sd = 0.50) participants (p < .001). Vaccination patterns did not differ among fear or vaccine confidence-based items.
Conclusions
Our results contribute to the limited knowledge of differences in Hepatitis A vaccination uptake among men who have sex with men, and support the need for targeted intervention programs that acknowledge the diverse population of LGBTQ + identifying individuals and their associated health behaviors.
HafeezHZeshanMTahirMA, et al.Health care disparities among lesbian, gay, bisexual, and transgender youth: a literature review. Cureus2017; 9: e1184.
5.
NadarzynskiTFrostMMillerD, et al.Vaccine acceptability, uptake and completion amongst men who have sex with men: a systematic review, meta-analysis and theoretical framework. Vaccine2021; 39: 3565–3581. DOI: 10.1016/j.vaccine.2021.05.013.
6.
NelsonNPWengMKHofmeisterMG, et al.Prevention of hepatitis A virus infection in the United States: recommendations of the advisory committee on immunization practices, 2020. MMWR Recomm Rep (Morb Mortal Wkly Rep)2020; 69: 1–38. DOI: 10.15585/mmwr.rr6905a1.
7.
WhiteheadJShaverJStephensonR. Outness, stigma, and primary health care utilization among rural LGBT populations. PLoS One2016; 11: e0146139. DOI: 10.1371/journal.pone.0146139.
8.
FosterMAHofmeisterMGAlbertsonJP, et al.Hepatitis A virus infections among men who have sex with men - eight U.S. States, 2017-2018. MMWR Morb Mortal Wkly Rep2021; 70: 875–878. DOI: 10.15585/mmwr.mm7024a2.
9.
BurrellSVodstrcilLAFairleyCK, et al.Hepatitis A vaccine uptake among men who have sex with men from a time-limited vaccination programme in Melbourne in 2018. Sex Transm Infect2020; 96: 110–114. DOI: 10.1136/sextrans-2019-054132.
10.
MigueresMLhommeSIzopetJ. Hepatitis A: epidemiology, high-risk groups, prevention and research on antiviral treatment. Viruses2021; 13: 1900. DOI: 10.3390/v13101900.
11.
AulicinoGFacciniMLambertiA, et al.Hepatitis A epidemic in men who have sex with men (MSM) in Milan, Italy. Acta Biomed2020; 91: 106–110. DOI: 10.23750/abm.v91i3-S.9457.
12.
YinSBarkerLLyKN, et al.Susceptibility to hepatitis A virus infection in the United States, 2007–2016. Clin Infect Dis2020; 71: e571–e579. DOI: 10.1093/cid/ciaa298.
13.
HooverKWButlerMWorkowskiKA, et al.Low rates of hepatitis screening and vaccination of HIV-infected MSM in HIV clinics. Sex Transm Dis2012; 39: 349–353. DOI: 10.1097/OLQ.0b013e318244a923.
14.
GriffinMMartinoRJLoSchiavoC, et al.Ensuring survey research data integrity in the era of internet bots. Qual Quantity2022; 56: 2841–2852. DOI: 10.1007/s11135-021-01252-1.
15.
ThompsonHSValdimarsdottirHBWinkelG, et al.The Group-Based Medical Mistrust Scale: psychometric properties and association with breast cancer screening. Prev Med2004; 38: 209–218. DOI: 10.1016/j.ypmed.2003.09.041.
16.
CoxABJaiswalJLoSchiavoC, et al.Medical mistrust among a racially and ethnically diverse sample of sexual minority men. LGBT Health2023; 10: 471–479. DOI: 10.1089/lgbt.2022.0252.
17.
LaVeistTAIsaacLAWilliamsKP. Mistrust of health care organizations is associated with underutilization of health services. Health Serv Res2009; 44: 2093–2105. DOI: 10.1111/j.1475-6773.2009.01017.x.
18.
GilkeyMBMagnusBEReiterPL, et al.The Vaccination Confidence Scale: a brief measure of parents' vaccination beliefs. Vaccine2014; 32: 6259–6265. DOI: 10.1016/j.vaccine.2014.09.007.
19.
SansomSRudyEStrineT, et al.Hepatitis A and B vaccination in a sexually transmitted disease clinic for men who have sex with men. Sex Transm Dis2003; 30: 685–688. DOI: 10.1097/01.Olq.0000079524.04451.4c.
20.
RudyETDetelsRDouglasW, et al.Factors affecting hepatitis vaccination refusal at a sexually transmitted disease clinic among men who have sex with men. Sex Transm Dis2003; 30: 411–418. DOI: 10.1097/00007435-200305000-00007.
21.
SiconolfiDEHalkitisPNRogersME. Hepatitis vaccination and infection among gay, bisexual, and other men who have sex with men who attend gyms in New York City. Am J Men's Health2009; 3: 141–149. DOI: 10.1177/1557988308315151.
22.
GilbertLKLevandowskiBAScanlonKE, et al.A comparison of hepatitis A and hepatitis B measures among vaccinated and susceptible online men who have sex with men. Int J STD AIDS2010; 21: 400–405. DOI: 10.1258/ijsa.2009.009010.
23.
MethenyNStephensonR. Disclosure of sexual orientation and uptake of HIV testing and hepatitis vaccination for rural men who have sex with men. Ann Fam Med2016; 14: 155–158. DOI: 10.1370/afm.1907.
24.
RhodesSDGrimleyDMHergenratherKC. Integrating behavioral theory to understand hepatitis B vaccination among men who have sex with men. Am J Health Behav2003; 27: 291–300. DOI: 10.5993/ajhb.27.4.1.
25.
RhodesSDHergenratherKC. Using an integrated approach to understand vaccination behavior among young men who have sex with men: stages of change, the health belief model, and self-efficacy. J Community Health2003; 28: 347–362. DOI: 10.1023/a:1025444629753.
26.
RhodesSDArceoR. Developing and testing measures predictive of hepatitis A vaccination in a sample of men who have sex with men. Health Educ Res2004; 19: 272–283. DOI: 10.1093/her/cyg026.
27.
RhodesSDHergenratherKC. Attitudes and beliefs about hepatitis B vaccination among gay men: the Birmingham Measurement Study. J Homosex2008; 55: 124–149. DOI: 10.1080/00918360802129386.
28.
FriedmanMSBlakePAKoehlerJE, et al.Factors influencing a communitywide campaign to administer hepatitis A vaccine to men who have sex with men. Am J Public Health2000; 90: 1942–1946. DOI: 10.2105/ajph.90.12.1942.
29.
SinghVCrosbyRAGratzerB, et al.Disclosure of sexual behavior is significantly associated with receiving a panel of health care services recommended for men who have sex with men. Sex Transm Dis2018; 45: 803–807. DOI: 10.1097/olq.0000000000000886.
30.
SrivastavAO'HalloranALuPJ, et al.Vaccination differences among U.S. adults by their self-identified sexual orientation, National Health Interview Survey, 2013-2015. PLoS One2019; 14: e0213431. DOI: 10.1371/journal.pone.0213431.
31.
JinFPrestageGPPellCM, et al.Hepatitis A and B infection and vaccination in a cohort of homosexual men in Sydney. Sex Health2004; 1: 227–237. DOI: 10.1071/sh04022.
32.
NgBEMooreDMichelowW, et al.Relationship between disclosure of same-sex sexual activity to providers, HIV diagnosis and sexual health services for men who have sex with men in Vancouver, Canada. Can J Public Health2014; 105: e186–e191. DOI: 10.17269/cjph.105.4212.
33.
ChenGJLinKYSunHY, et al.Incidence of acute hepatitis A among HIV-positive patients during an outbreak among MSM in Taiwan: impact of HAV vaccination. Liver Int2018; 38: 594–601. DOI: 10.1111/liv.13468.
34.
LinKYHsiehSMSunHY, et al.Serologic responses and effectiveness of hepatitis A vaccination among human immunodeficiency virus-positive individuals during the outbreak of acute hepatitis A. Hepatology2018; 68: 22–31. DOI: 10.1002/hep.29780.
35.
NadarzynskiTSmithHRichardsonD, et al.Men who have sex with men who do not access sexual health clinics nor disclose sexual orientation are unlikely to receive the HPV vaccine in the UK. Vaccine2018; 36: 5065–5070. DOI: 10.1016/j.vaccine.2018.06.075.
36.
RankCGilbertMOgilvieG, et al.Acceptability of human papillomavirus vaccination and sexual experience prior to disclosure to health care providers among men who have sex with men in Vancouver, Canada: implications for targeted vaccination programs. Vaccine2012; 30: 5755–5760. DOI: 10.1016/j.vaccine.2012.07.001.
37.
GerendMAMadkinsKPhillipsG2nd, et al.Predictors of human papillomavirus vaccination among young men who have sex with men. Sex Transm Dis2016; 43: 185–191. DOI: 10.1097/olq.0000000000000408.
38.
TianTWangDPapamichaelC, et al.HPV vaccination acceptability among men who have sex with men in Urumqi, China. Hum Vaccines Immunother2019; 15: 1005–1012. DOI: 10.1080/21645515.2018.1520591.
39.
JaiswalJLoSchiavoCMaiolatesiA, et al.Misinformation, gendered perceptions, and low healthcare provider communication around HPV and the HPV vaccine among young sexual minority men in New York city: the P18 cohort study. J Community Health2020; 45: 702–711. DOI: 10.1007/s10900-019-00784-w.
40.
PilishviliTGierkeRFleming-DutraKE, et al.Effectiveness of mRNA covid-19 vaccine among U.S. Health care personnel. N Engl J Med2021; 385: e90. DOI: 10.1056/NEJMoa2106599.
41.
CuschieriKKavanaghKMooreC, et al.Impact of partial bivalent HPV vaccination on vaccine-type infection: a population-based analysis. Br J Cancer2016; 114: 1261–1264. DOI: 10.1038/bjc.2016.97.
