ABSTRACT
BACKGROUND: This study aimed to determine the prevalence and factors associated with susceptibility to hepatitis B virus (HBV) among cisgender men who have sex with men (MSM) on HIV pre-exposure prophylaxis (PrEP) in Northeastern Brazil. METHODS: This was a cross-sectional, analytical study conducted between September 2021 and June 2023. Participants underwent structured interviews to collect sociodemographic and clinical information, including hepatitis B vaccination history, HIV PrEP use and sexual health history. Blood samples were collected for hepatitis B serologic testing: HBV surface antigen (HBsAg), HBV surface antibody (anti-HBs), total and IgM HBV core antibody (anti-HBc). HBV susceptibility was defined as nonreactive results for all these serological markers. RESULTS: A total of 287 participants were enrolled into the study. The median age of the individuals was 31 years (interquartile range: 27; 36). HBV susceptibility was found in 58 out 286 individuals (20.3%; 95% CI: 15.9-25.2). Seventy-six percent of the participants reported completing the three-dose hepatitis B vaccine schedule. Susceptibility was significantly associated with a monthly income ≤ 5 minimum wages (PR: 2.02; 95% CI: 1.01-4.05), lack of complete hepatitis B vaccination schedule (PR: 4.52; 95% CI: 2.89-7.06), initiation of HIV PrEP (PR: 2.18; 95% CI: 1.21-3.94), duration of six months of HIV PrEP (PR: 2.16; 95% CI: 1.19-3.91), absence of tattoos (PR: 1.55; 95% CI: 1.00-2.40) and no history of sexually transmitted infections (PR: 1.65; 95% CI: 1.07-2.54). CONCLUSION: Our findings highlight the significant burden of HBV susceptibility among MSM on HIV PrEP in Northeastern Brazil. Socioeconomic factors, vaccination status, PrEP use and sexual health behaviors play critical roles in determining susceptibility to HBV. Integrating hepatitis B screening and vaccination into PrEP services is critical for identifying and addressing HBV susceptibility among MSM. Interventions aimed at increasing vaccination coverage and promoting safer sexual practices are essential for mitigating the burden of HBV infection in this population.
Subject(s)
HIV Infections , Hepatitis B , Homosexuality, Male , Pre-Exposure Prophylaxis , Humans , Male , Cross-Sectional Studies , Brazil/epidemiology , Adult , Pre-Exposure Prophylaxis/statistics & numerical data , HIV Infections/epidemiology , HIV Infections/prevention & control , Hepatitis B/prevention & control , Hepatitis B/epidemiology , Homosexuality, Male/statistics & numerical data , Prevalence , Hepatitis B virus/immunology , Disease Susceptibility , Young Adult , Risk Factors , Hepatitis B Antibodies/blood , Hepatitis B Surface Antigens/blood , Hepatitis B Surface Antigens/immunology , Hepatitis B Vaccines/administration & dosage , Hepatitis B Vaccines/immunologyABSTRACT
Hepatitis A virus (HAV) infection has disproportionately affected more men who have sex with men (MSM), occurring in outbreaks, despite being vaccine-preventable. We determined the prevalence and factors associated with HAV susceptibility among cisgender MSM on HIV pre-exposure prophylaxis (PrEP) in Northeastern Brazil. From September 30, 2021 to June 19, 2023, 282 cisgender MSM receiving HIV PrEP were enrolled into this cross-sectional study. Sociodemographic and clinical information were collected. Blood samples were collected for screening of sexually transmitted infections (STIs) and serum samples were tested for IgM and total anti-HAV antibodies. Non-reactive results for total anti-HAV antibodies were found in 106 of 282 (37.6%) participants. Factors associated with HAV susceptibility included age <30 years (prevalence ratio [PR]: 2.02; 95% confidence interval [95% CI]: 1.61-2.53), having health insurance (PR: 1.39; 95% CI: 1.19-1.64), sex only with cisgender men (PR: 1.52; 95% CI: 1.23-1.89), non-steady partner (PR: 1.20; 95% CI: 1.01-1.43) and no lifetime history of STIs (PR: 1.25; 95% CI: 1.03-1.53). Identifying clinical correlates of HAV susceptibility in key populations is a fundamental step towards development of public policy focused on prevention, especially following the recent hepatitis A outbreak in Brazil.
Subject(s)
HIV Infections , Hepatitis A virus , Hepatitis A , Pre-Exposure Prophylaxis , Sexual and Gender Minorities , Sexually Transmitted Diseases , Male , Humans , Adult , Homosexuality, Male , Hepatitis A/epidemiology , Hepatitis A/prevention & control , HIV Infections/epidemiology , HIV Infections/prevention & control , Pre-Exposure Prophylaxis/methods , Cross-Sectional Studies , Hepatitis A Antibodies , Brazil/epidemiology , Sexually Transmitted Diseases/epidemiology , Sexually Transmitted Diseases/prevention & controlABSTRACT
A vacinação é uma medida exitosa de prevenção primária em termos de custo-eficácia, entretanto, persistem entraves para vacinação infantil nas famílias brasileiras. Este plano de ação é uma atividade educativa sobre vacinação infantil objetivando promover discussão entre docentes, pais e profissionais de saúde. A ação foi dividida em três etapas: discussão sobre vacinação infantil, apresentação do calendário nacional de vacinação e análise dos cartões vacinais dos alunos. Os pais esclareceram suas dúvidas sobre vacinação infantil e consolidaram conhecimentos, permitindo a construção de um saber coletivo sobre o tema. Apresentou-se o calendário nacional de vacinação da criança, possibilitando o empoderamento sobre o calendário vacinal dos filhos. Analisaram-se 60 cartões de vacinas, destes, 16 alunos tinham pendências vacinais, sendo encaminhados à UBS para regularização. A escola é um cenário oportuno para incentivo à vacinação e identificação de pendências vacinais, destacando a intersetorialidade das ações, mediante parcerias com as UBS.