Innovative prevention & wellness efforts to address chronic hepatitis b in African immigrant communities in Philadelphia: Lessons from a pilot community program

Chronic hepatitis B (HBV) is the world's most common liver infection and leading cause of primary liver cancer, affecting 400 million individuals worldwide. HBV causes up to 1 million annual global deaths. In the US, HBV disproportionately affects Asian and Pacific Islander (API) and African immigrants. Prevalence rates range from 5-15% in US APIs, but very little is known about HBV prevalence in African immigrants. In Philadelphia, an innovative campaign focused around a community-based multi-disciplinary coalition was developed to promote hepatitis B prevention and wellness through improving awareness, screening and linkage to care. Initially, local resources and barriers to screening and vaccination were assessed. Education and screening were integrated into existing cultural and community events. Of 98 African immigrants screened for HBV, 32% were in the US 5 years or less, 29% listed English as their primary language, 33% had a medical home, and 23% had health insurance. HBV prevalence was 10%, and 45% were protected from HBV, either through vaccination or recovery from infection. Barriers to screening and vaccination included low awareness, language and financial barriers, and lack of convenient resources for culturally appropriate services. There are potentially high rates of HBV infection in the Philadelphia African immigrant community, which also has limited access to care and low HBV awareness. Further research is necessary to address this disparity, including assessing resources and addressing barriers, improving awareness, promoting screening and vaccination, and linking to appropriate health services. Multi-disciplinary, culturally competent community programs can play an important role in this process.