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Ssekamatte T, Isunju JB, Mutyoba JN, Tetui M, Mugambe RK, Nalugya A, Kansiime WK, Kitchen C, Brenda W, Oputan P, Bukenya JN, Buregyeya E, Kibira SPS. Predictors of Hepatitis B screening and vaccination status of young psychoactive substance users in informal settlements in Kampala, Uganda. PLoS One 2022; 17:e0267953. [PMID: 35588113 PMCID: PMC9119510 DOI: 10.1371/journal.pone.0267953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 04/19/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Young psychoactive substance users exhibit high-risk behaviours such as unprotected sexual intercourse, and sharing needles and syringes, which increases their risk of Hepatitis B infection. However, there is limited evidence of screening, and vaccination status of this subgroup. The aim of this study was to establish the predictors of screening and completion of the hepatitis B vaccination schedule. METHODS A cross-sectional study using respondent driven sampling was used to enrol respondents from twelve out of fifty-seven informal settlements in Kampala city. Data were collected using an electronic structured questionnaire uploaded on the KoboCollect mobile application, and analysed using Stata version 14. A "modified" Poisson regression analysis was done to determine the predictors of screening while logistic regression was used to determine the predictors of completion of the Hepatitis B vaccination schedule. RESULTS About 13.3% (102/768) and 2.7% (21/768) of the respondents had ever screened for Hepatitis B, and completed the Hepatitis B vaccination schedule respectively. Being female (aPR 1.61, 95% CI: 1.11-2.33), earning a monthly income >USD 136 (aPR 1.78, 95% CI: 1.11-2.86); completion of the Hepatitis B vaccination schedule (aPR 1.85, 95% CI: 1.26-2.70); lack of awareness about the recommended Hepatitis B vaccine dose (aPR 0.43, 95% CI: 0.27-0.68); and the belief that the Hepatitis B vaccine is effective in preventing Hepatitis B infection (aPRR 3.67, 95% CI: 2.34-5.73) were associated with "ever screening" for Hepatitis B. Knowledge of the recommended Hepatitis B vaccine dose (aOR 0.06, 95% CI: 0.01-0.35); "ever screening" for hepatitis B (aOR 9.68, 95% CI: 2.17-43.16) and the belief that the hepatitis B vaccine is effective in preventing Hepatitis B infection (aOR 11.8, 95% CI: 1.13-110.14) were associated with completion of the hepatitis B vaccination schedule. CONCLUSIONS Our findings indicate a low prevalence of Hepatitis B screening and completion of the Hepatitis B vaccination schedule among young psychoactive substance users in informal settings. It is evident that lack of awareness about Hepatitis B is associated with the low screening and vaccination rates. We recommend creation of awareness of Hepatitis B among young people in urban informal settlements.
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Affiliation(s)
- Tonny Ssekamatte
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Joan Nankya Mutyoba
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda
| | - Moses Tetui
- Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda
| | - Richard K. Mugambe
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Aisha Nalugya
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Winnifred K. Kansiime
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Chenai Kitchen
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
| | - Wagaba Brenda
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Patience Oputan
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Justine Nnakate Bukenya
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Esther Buregyeya
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Simon P. S. Kibira
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
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Khouzam N, Gelberg L, Guo R, Tseng CH, Bhattacharya D. Opiate Dependence: A Risk Factor for Hepatitis B Virus Exposure in Homeless Adults. FAMILY & COMMUNITY HEALTH 2020; 43:161-169. [PMID: 32079972 DOI: 10.1097/fch.0000000000000246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The prevalence of hepatitis B virus (HBV) in the homeless population is underestimated despite multiple behavioral risks. Data from a sample of 534 homeless adults from downtown Los Angeles were analyzed to examine the prevalence and predictors of HBV infection in this community. The prevalence of HBV was 7 to 10 times higher than in the US general population rate. Opiate dependence, injection and noninjection use, was an independent predictor of HBV exposure. Testing and counseling occurred at significantly lower rates for HBV than for human immunodeficiency virus. Findings emphasize the need to enhance screening and counseling in homeless communities and other populations with opiate use.
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Affiliation(s)
- Nour Khouzam
- Departments of Medicine, Division of Infectious Diseases (Drs Khouzam and Bhattacharya), Family Medicine (Dr Gelberg), and Biomathematics (Ms Guo and Dr Tseng), David Geffen School of Medicine, University of California, Los Angeles; and Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles (Dr Gelberg)
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How Adequate Social Media Management Supports the Viral Hepatitis Elimination Program. HEPATITIS MONTHLY 2018. [DOI: 10.5812/hepatmon.69791] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Santa Maria D, Hernandez DC, Arlinghaus KR, Gallardo KR, Maness SB, Kendzor DE, Reitzel LR, Businelle MS. Current Age, Age at First Sex, Age at First Homelessness, and HIV Risk Perceptions Predict Sexual Risk Behaviors among Sexually Active Homeless Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E218. [PMID: 29373568 PMCID: PMC5858287 DOI: 10.3390/ijerph15020218] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 01/13/2018] [Accepted: 01/24/2018] [Indexed: 11/16/2022]
Abstract
While HIV disproportionately impacts homeless individuals, little is known about the prevalence of HIV risk behaviors in the southwest and how age factors and HIV risk perceptions influence sexual risk behaviors. We conducted a secondary data analysis (n = 460) on sexually active homeless adults from a cross-sectional study of participants (n = 610) recruited from homeless service locations, such as shelters and drop-in centers, in an understudied region of the southwest. Covariate-adjusted logistic regressions were used to assess the impact of age at homelessness onset, current age, age at first sex, and HIV risk perceptions on having condomless sex, new sexual partner(s), and multiple sexual partners (≥4 sexual partners) in the past 12 months. Individuals who first experienced homelessness by age 24 were significantly more likely to report condomless sex and multiple sexual partners in the past year than those who had a later onset of their first episode of homelessness. Individuals who were currently 24 years or younger were more likely to have had condomless sex, new sexual partners, and multiple sexual partners in the past 12 months than those who were 25 years or older. Those who had low perceived HIV risk had lower odds of all three sexual risk behaviors. Social service and healthcare providers should consider a younger age at homelessness onset when targeting HIV prevention services to youth experiencing homelessness.
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Affiliation(s)
- Diane Santa Maria
- Department of Nursing Systems, School of Nursing, University of Texas Health Science Center, Houston, TX 77030, USA.
| | - Daphne C Hernandez
- Department of Health and Human Performance, University of Houston, Houston, TX 77204, USA.
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX 77204, USA.
| | - Katherine R Arlinghaus
- Department of Health and Human Performance, University of Houston, Houston, TX 77204, USA.
- Department of Health Promotion and Behavioral Sciences School of Public Health, University of Texas Health Science Center, Houston, TX 77030, USA.
| | - Kathryn R Gallardo
- Department of Health Promotion and Behavioral Sciences School of Public Health, University of Texas Health Science Center, Houston, TX 77030, USA.
| | - Sarah B Maness
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK 73019, USA.
| | - Darla E Kendzor
- Health Sciences Center, University of Oklahoma, Oklahoma City, OK 73104, USA.
| | - Lorraine R Reitzel
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX 77204, USA.
| | - Michael S Businelle
- Health Sciences Center, University of Oklahoma, Oklahoma City, OK 73104, USA.
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5
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Carvalho PMRDS, Matos MAD, Martins RMB, Pinheiro RS, Caetano KAA, Souza MMD, Carneiro MADS, Teles SA. Prevalence, risk factors and hepatitis B immunization: helping fill the gap on hepatitis B epidemiology among homeless people, Goiânia, Central Brazil. CAD SAUDE PUBLICA 2017; 33:e00109216. [PMID: 28792993 DOI: 10.1590/0102-311x00109216] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 09/22/2016] [Indexed: 12/26/2022] Open
Abstract
Data are limited in Brazil on hepatitis B infection among homeless individuals, a marginalized population with high risk of sexually transmissible infections (STI), including hepatitis B. The aim of this study was to investigate hepatitis B epidemiology in homeless persons lodged in a public shelter in Goiânia, Central Brazil. From August 2014 to June 2015, 353 individuals were interviewed and tested for markers of HBV infection. Overall HBV prevalence was 21.8% (95%CI: 17,82-26,41), and 19,5% (95%CI: 15,75-24,0) showed a serological profile of previous HBV vaccination. Older individuals (> 50 years), blacks, and homosexuals or bisexuals showed increased exposure to HBV. The low frequency of individuals immunized against HBV, high social vulnerability, and risk behaviors emphasize the need for health services administrators to provide more opportunities for HBV vaccination in this target population.
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Nyamathi A, Reback CJ, Shoptaw S, Salem BE, Zhang S, Yadav K. Impact of Tailored Interventions to Reduce Drug Use and Sexual Risk Behaviors Among Homeless Gay and Bisexual Men. Am J Mens Health 2017; 11:208-220. [PMID: 26130725 PMCID: PMC5675281 DOI: 10.1177/1557988315590837] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A randomized controlled trial was conducted with homeless gay and bisexual men to assess the impact of two culturally sensitive intervention programs on reduction of drug use and risky sexual behavior. In this study, gay and bisexual men between 18 and 46 years of age were randomly assigned to one of two culturally sensitive behavioral intervention programs: a Nurse Case Management Plus Contingency Management (NCM + CM; n = 204) or a Standard Education Plus Contingency Management (SE + CM; n = 210) program. Regardless of group assignment, significant and clinically relevant reductions were observed in stimulant use over time. Multivariable predictors of stimulant use at 4- and 8-month follow-up evaluations were recent injection drug use, tested positive for HIV, or for use of amphetamine. Data revealed a significant linear decline over time for those who had sex with multiple partners. Furthermore, being HIV positive was associated with reporting multiple partners, while higher homophobia scores and having children were inversely related to reports of having sex with multiple partners at follow-up. Culturally sensitive approaches are needed to successfully reduce drug use and risky sexual activities among gay and bisexual populations.
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Nyamathi AM, Reback CJ, Shoptaw S, Salem BE, Zhang S, Farabee D, Khalilifard F. Impact of Community-Based Programs on Incarceration Outcomes Among Gay and Bisexual Stimulant-Using Homeless Adults. Community Ment Health J 2016; 52:1037-1042. [PMID: 25549923 PMCID: PMC4490143 DOI: 10.1007/s10597-014-9792-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Accepted: 12/06/2014] [Indexed: 11/30/2022]
Abstract
This study was part of a randomized controlled trial designed to improve hepatitis knowledge and health promoting behaviors and subsequently decrease stimulant use and incarceration with 422 (G/B) homeless men between 18 and 46 years of age. Findings revealed that no significant program differences on incarceration in the 4 months following the intervention. However, younger participants (p = .010), and those with prior incarceration (p = .001) were at greater risk for incarceration at 4 months. An additional factor associated with incarceration at 4 months included living on the street for at least 1 week (p = .049).
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Affiliation(s)
- Adeline M Nyamathi
- School of Nursing, University of California, Los Angeles, Room 2-250, Factor Building, Los Angeles, CA, 90095-1702, USA.
| | - Cathy J Reback
- Friends Research Institute, Inc., Los Angeles, CA, USA.,Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Steven Shoptaw
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Benissa E Salem
- School of Nursing, University of California, Los Angeles, Room 2-250, Factor Building, Los Angeles, CA, 90095-1702, USA
| | - Sheldon Zhang
- Department of Sociology, San Diego State University, Los Angeles, CA, USA
| | - David Farabee
- Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles, CA, USA
| | - Farinaz Khalilifard
- School of Nursing, University of California, Los Angeles, Room 2-250, Factor Building, Los Angeles, CA, 90095-1702, USA
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Dombrowski K, Sittner K, Crawford D, Welch-Lazoritz M, Habecker P, Khan B. Network Approaches to Substance Use and HIV/Hepatitis C Risk among Homeless Youth and Adult Women in the United States: A Review. Health (London) 2016; 8:1143-1165. [PMID: 28042394 PMCID: PMC5193114 DOI: 10.4236/health.2016.812119] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
During the United States economic recession of 2008-2011, the number of homeless and unstably housed people in the United States increased considerably. Homeless adult women and unaccompanied homeless youth make up the most marginal segments of this population. Because homeless individuals are a hard to reach population, research into these marginal groups has traditionally been a challenge for researchers interested in substance abuse and mental health. Network analysis techniques and research strategies offer means for dealing with traditional challenges such as missing sampling frames, variation in definitions of homelessness and study inclusion criteria, and enumeration/population estimation procedures. This review focuses on the need for, and recent steps toward, solutions to these problems that involve network science strategies for data collection and analysis. Research from a range of fields is reviewed and organized according to a new stress process framework aimed at understanding how homeless status interacts with issues related to substance abuse and mental health. Three types of network innovation are discussed: network scale-up methods, a network ecology approach to social resources, and the integration of network variables into the proposed stress process model of homeless substance abuse and mental health. By employing network methods and integrating these methods into existing models, research on homeless and unstably housed women and unaccompanied young people can address existing research challenges and promote more effective intervention and care programs.
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Affiliation(s)
- Kirk Dombrowski
- Department of Sociology, University of Nebraska-Lincoln, Lincoln, USA
| | - Kelley Sittner
- Department of Sociology, Oklahoma State University, Stillwater, USA
| | | | | | - Patrick Habecker
- Department of Sociology, University of Nebraska-Lincoln, Lincoln, USA
| | - Bilal Khan
- Department of Sociology, University of Nebraska-Lincoln, Lincoln, USA
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Prevalence, Risk Behaviors, and Virological Characteristics of Hepatitis B Virus Infection in a Group of Men Who Have Sex with Men in Brazil: Results from a Respondent-Driven Sampling Survey. PLoS One 2016; 11:e0160916. [PMID: 27508385 PMCID: PMC4980030 DOI: 10.1371/journal.pone.0160916] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 07/27/2016] [Indexed: 12/20/2022] Open
Abstract
Background Men who have sex with men (MSM) are at increased risk of exposure to hepatitis B virus (HBV) compared with the general population. This study aims to assess the epidemiological and virological characteristics of HBV infection in a sample of MSM in Brazil, where data are scarce. Methods A cross-sectional study was conducted among MSM in the City of Goiânia, Central Brazil, from March to November 2014, using Respondent-Driven Sampling (RDS). After signing the consent form, participants were interviewed and a blood sample collected. All samples were tested for HBV serological markers and HBV DNA. HBV nucleotide sequence analysis was also performed. Results A total of 522 MSM were recruited in the study. The prevalence of HBV infection (current or past [presence of anti-HBc marker]) was 15.4% (95% CI: 8.7–25.8) and the rate of HBsAg carriers was 0.6% (95% CI: 0.2–1.6). About 40% (95% CI: 32.3–48.8) of the participants had serological evidence of previous HBV vaccination (reactive for isolated anti-HBs). In addition, 44.3% (95% CI: 36.1–52.9) were seronegative for all HBV markers. Age over 25 years old, receptive anal intercourse, previous sex with women, and history of sexually transmitted infections (STIs) were factors associated with HBV infection. HBV DNA was detected only in HBsAg-positive individuals. HBV isolates were classified into genotype A (subgenotypes A1 and A2), and some mutations were identified throughout the genome. Therefore, occult HBV infection was not observed in the study population. Conclusions Public health strategies should be improved for the MSM population in order to prevent HBV and other STIs, as well as to provide appropriate management of patients with active infections.
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Nyamathi AM, Salem BE, Farabee D, Zhang S. Differential reporting of drug use among gay, bisexual and transgender stimulant-using homeless adults post intervention. JOURNAL OF SUBSTANCE USE 2016. [DOI: 10.1080/14659891.2016.1179805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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11
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Nyamathi A, Salem BE, Farabee D, Hall E, Zhang S, Faucette M, Bond D, Yadav K. Impact of an intervention for recently released homeless offenders on self-reported re-arrest at 6 and 12 months. J Addict Dis 2016; 36:60-71. [PMID: 26849409 DOI: 10.1080/10550887.2016.1147796] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
A randomized controlled trial was conducted with 600 paroled men, homeless prior to incarceration, to assess varying levels of peer-coach and nurse-partnered interventions on re-arrest at 6 and 12 months. Findings revealed that positive predictors of re-arrest at 12 months included having received social support from drug users and non-drug users, as well as having used marijuana at least once a week prior to their most recent incarceration. In terms of protective factors, those who participated in a substance abuse program contract within a residential drug treatment program or spent 90 days or greater in a residential drug treatment program were less likely to have been re-arrested within 12 months.
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Affiliation(s)
- Adeline Nyamathi
- a School of Nursing , University of California , Los Angeles , California , USA
| | - Benissa E Salem
- a School of Nursing , University of California , Los Angeles , California , USA
| | - David Farabee
- b Integrated Substance Abuse Program , University of California , Los Angeles , California , USA
| | - Elizabeth Hall
- b Integrated Substance Abuse Program , University of California , Los Angeles , California , USA
| | - Sheldon Zhang
- c Department of Sociology , San Diego State University , San Diego , California , USA
| | - Mark Faucette
- d Amistad de Los Angeles, Amity Foundation , Los Angeles , California , USA
| | - Doug Bond
- d Amistad de Los Angeles, Amity Foundation , Los Angeles , California , USA
| | - Kartik Yadav
- a School of Nursing , University of California , Los Angeles , California , USA
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12
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Salem BE, Nyamathi Anp A, Reback C, Shoptaw S, Zhang S, Nudelman O. Unmet physical and mental healthcare needs among stimulant-using gay and bisexual homeless men. Issues Ment Health Nurs 2015; 36:685-92. [PMID: 26440871 PMCID: PMC4801108 DOI: 10.3109/01612840.2015.1021938] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of this study was to gain a greater understanding of predictors of the unmet physical and mental healthcare needs of homeless, stimulant-using, gay and bisexual (G/B) men. This study correlated baseline self-reported unmet physical and mental healthcare needs among stimulant-using homeless G/B men (n = 422, 18-46 years of age). A structured questionnaire was administered at baseline and data were collected from October 2009 to January 2013. The study was approved by the University of California Human Subjects' Protection committee and the Friends Research Institute Human Research Protection Committee. Logistic regression revealed that those who self-reported ever being married, being in fair or poor health and in moderate-to-very severe pain, were more likely to experience unmet needs for physical health care. In terms of unmet mental health needs, those who self-reported moderate-to-very severe pain and/or those reporting having sex while high, were more likely to report unmet needs for mental health care. In contrast, those reporting receiving social support from others were less likely to have an unmet mental healthcare need. Research implications are discussed as they relate to access to healthcare needs among this vulnerable population.
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Affiliation(s)
| | | | - Cathy Reback
- b Friends Research Institute; University of California; Integrated Substance Abuse Programs and Semel Institute for Neuroscience and Human Behavior , Los Angeles , California , USA
| | - Steven Shoptaw
- c University of California , Los Angeles , California , USA
| | - Sheldon Zhang
- d San Diego State University , Los Angeles , California , USA
| | - Olga Nudelman
- a UCLA School of Nursing , Los Angeles , California , USA
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Carmo RA, Melo APS, Dezanet LNC, de Oliveira HN, Cournos F, Guimarães MDC. Correlates of hepatitis B among patients with mental illness in Brazil. Gen Hosp Psychiatry 2014; 36:398-405. [PMID: 24725973 DOI: 10.1016/j.genhosppsych.2014.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 03/02/2014] [Accepted: 03/04/2014] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To assess correlates of hepatitis B among adults with mental illness under care in Brazil. METHOD Cross-sectional national multicenter study of 2206 patients with mental illnesses randomly selected from 26 public mental health services. Sociodemographic and behavioral data were obtained from face-to-face interviews and psychiatric diagnoses from medical charts. Serology testing was conducted, and prevalence rate ratios were estimated by log-binomial regression. RESULTS The weighted prevalence rates of current hepatitis B virus (HBV) infection (HBsAg+) and previous HBV exposure (anti-HBc+) were 2.0% [95% confidence interval (CI): 1.5%-2.7%] and 17.1% (95% CI: 16.0%-19.0%), respectively. Correlates of HBsAg+ included male gender, younger age (18-29 years), unstable place of residence, intellectual disability, main psychiatric diagnosis of dementia, presence of other medical comorbitidy, use of alcohol/drugs during sex, more than one sexual partner and use of cocaine. Correlates of anti-HBc+ included male gender, older age (≥30 years), black skin color, lower education, unstable place of residence, currently hospitalized, intellectual disability, history of any sexually transmitted disease or syphilis, poor HIV knowledge, history of imprisonment and sexual violence. CONCLUSIONS Hepatitis B is an important comorbidity among psychiatric patients in Brazil. Screening for HBV, effective prevention and intervention strategies, including universal HBV immunization, should be routine practices in these mental health services.
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Affiliation(s)
- Ricardo Andrade Carmo
- Infectious Diseases Reference Center CTR-DIP Orestes Diniz, Municipal Health Division/Federal University of Minas Gerais, Belo Horizonte, Brazil; Research Group in Epidemiology and Health Service Evaluation, Belo Horizonte, Brazil.
| | - Ana Paula Souto Melo
- Research Group in Epidemiology and Health Service Evaluation, Belo Horizonte, Brazil; School of Medicine, Federal University of São João Del-Rei, Divinópolis, Brazil
| | - Lorenza Nogueira Campos Dezanet
- Research Group in Epidemiology and Health Service Evaluation, Belo Horizonte, Brazil; Eduardo de Menezes Hospital, State Health Department of Minas Gerais, Belo Horizonte, Brazil
| | - Helian Nunes de Oliveira
- Research Group in Epidemiology and Health Service Evaluation, Belo Horizonte, Brazil; Raul Soares Hospital, State Health Department of Minas Gerais, Belo Horizonte, Brazil
| | - Francine Cournos
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Mark Drew Crosland Guimarães
- Research Group in Epidemiology and Health Service Evaluation, Belo Horizonte, Brazil; School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
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