KEYWORDS:
Vaccination, Hepatitis A, Hepatitis B, Men Who Have Sex with Men, Gay Men

BACKGROUND:
Hepatitis A and B infection rates have been falling steadily among almost all adults groups but have remained stubbornly high for men who have sex with men (MSM). A better understanding of vaccination rates for MSM and the factors that affect them is needed to plan and execute programs to promote hepatitis A and B vaccination for this population.

OBJECTIVE:
Determine current vaccination rates and the factors that affect them, including healthcare access and usage, disclose of sexual orientation, and utilization of STD clinics.

METHOD:
Self-administered brief survey forms administered in the summer of 2002 to gay and bisexual men at Gay Pride festivals (30 sites in 25 cities). Over 4,000 surveys completed and analyzed.

RESULT:
There is a wide range in vaccination rates across the country and a clear correlation between vaccination and access to and usage of healthcare. MSM who have visited an STD clinic are only slightly more likely to be vaccinated; men who do not disclose their sexual orientation are less likely to be vaccinated.

CONCLUSION:
Even among men with healthcare coverage and a regular healthcare provider, vaccination rates for MSM are far too low. Public health and private providers both need to be more proactive in identifying MSM patients and recommending vaccination. Integrated, long-term public health programs can be successful in raising vaccination rates, and need to take into account the importance of the private provider in vaccination. Vaccination programs for MSM need to address men without insurance and men who are wary of disclosing their sexual orientation.

LEARNING OBJECTIVES:
What is the hepatitis A/B vaccination rate in your service area? How does it compare to other areas of the country? How many MSM have healthcare coverage? A private provider? Are “out” to their provider? How many have visited an STD clinic, and are they more or less likely to be vaccinated? What factors may you need to take into account in promoting vaccination to your MSM population?