BACKGROUND:
In the late 1990s, Wake County reported increasing cases of hepatitis A. The majority of cases occurred in males. Investigations suggested cases were occurring among men who have sex with men.

An educational intervention was undertaken. Hepatitis A educational materials were distributed at locations frequented by the gay community and mailed to area physicians for patient education. After a decrease in 2000, the numbers began to increase—again the majority of cases were in males. By 2002 Wake County lead the state in cases. Another case in a food service worker that year resulted in prophylaxis of over 7,000 persons and cost over $63,000. The burden of disease on the worker, employer and health care system re-emphasized the need for education and increased vaccination coverage.

OBJECTIVE:
A task force of influential citizens in the gay community was formed to identify and implement effective outreach strategies.

METHOD:
Vaccine was offered at no charge by non-judgmental staff at “MSM-friendly” community locations at strategic times. Eight hepatitis vaccination “clinics” were held at a gay bar from 10 pm to 1 am, at two HIV test sites with late evening and Saturday hours as well as Wake County Human Services. Fliers, posters in gay bars, gay newspapers, email listservs and MSM outreach staff promoted the clinics.

RESULT:
By the end of November 2003, 334 doses of vaccine had been given with follow up doses still pending.

CONCLUSION:
Buy-in and support from the gay community was essential to this project’s acceptance. Offering the services where the population could be easily reached without being overtly singled out and by staff that was non-judgmental and accepting further ensured project success.

LEARNING OBJECTIVES:
The learner will identify strategies to increase hepatitis A vaccination rates among men having sex with men.