BACKGROUND:
Infection with hepatitis A virus (HAV) disproportionately affects the men who have sex with men (MSM) population. Despite recommendations from CDC for (MSM) to receive hepatitis immunization, vaccination rates remain low and disease incidence high. A different approach to getting vaccine into the community clearly is necessary.

OBJECTIVE:
To promote and administer hepatitis A and B immunizations to the MSM community.

METHOD:
The Immunization Program and the Mazzoni Center instituted a hepatitis A immunization program in the fall of 2000 for MSM. In January of 2002 a monthly hepatitis immunization outreach activity was added. Advertising and community based volunteers were used to promote the program. The PDPH provided vaccine, clinical expertise and training to facilitate administration of vaccines in the at-risk population. Advertisements placed in the Philadelphia Gay News and volunteer recruiters went to local “gay bars” on Friday nights with flyers to encourage participation.

RESULT:
The proportion of hepatitis A cases in MSM in Philadelphia increased from 27.8% (27/97) in 2001 to 34.2% (24/70) in 2002. However, the proportion of MSM infections decreased from 46.6% (21/45) in the first six months of 2002 to 12% (3/25) in the last six months of 2002. This indicates a significant decrease in the proportion of MSM related hepatitis A infections for the second half of the year. Preliminary data for 2003 show only 1 case of hepatitis A in MSM.

CONCLUSION:
By integrating hepatitis immunization in an STD clinic and providing monthly clinics, hundreds of at-risk people received immunizations. Completion rates for doses are 70%. Continuation of this project is planned as long as resources are available. These partnerships are a vital link to increasing public health awareness about hepatitis.

LEARNING OBJECTIVES:
Describe how to coordinate and implement a community based hepatitis program among high-risk segments of the population.