Objective. To identify factors that predict and affect hepatitis A (HAV) and hepatitis B (HBV) vaccination refusals in an STD clinic population composed of men who have sex with men (MSM). Methods. Concurrent with an HAV and HBV vaccination demonstration project, a Knowledge, Attitudes and Behavior survey based on the expanded Health Belief Model (HBM) was administered to all patients eligible for the vaccines. Poisson regression analysis was used to approximate the risk ratios in the final explanatory and prediction models. Results. Thirty six percent (174) refused HAV vaccine and 38% (163) refused HBV vaccine. Fifty percent were not aware of an HAV vaccine and 43% were not aware of an HBV vaccine before attending the clinic. Factors that predict HAV and HBV vaccination refusal included older age, screening as reason for visit, and indicating a perceived barrier such as “not enough time this evening,” “wanting to test first for immunity,” and “wanting to talk to own doctor first”. Perceived susceptibility and vaccine beliefs had moderate associations in bivariate analyses. Perceived barriers had the most prominent affect and reduced the affect of other health belief constructs after its inclusion in the explanatory regression models. Conclusion. Perceived barriers should be identified and reduced to increase MSM’s HAV and HBV vaccination acceptance. “Not having enough time this evening” may be a socially acceptable response for individuals who do not want the vaccinations for less socially acceptable reasons. Further studies to identify these reasons are suggested.
Learning Objectives: 1. Identify factors that predict HAV and HBV vaccination refusal in a STD clinic for men who have sex with men. 2. Recognize perceived barriers to accepting HAV and HBV vaccinations in an STD clinic setting in order to develop effective ways to increase HAV and HBV vaccination acceptance. 3. Articulate the uses of explanatory and predictive models.
Keywords: Barriers to Care, Gay Men
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: SmithKline Beecham Havrix and Engerix-B vaccines
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.