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Correlates of Susceptibility to Hepatitis B among People Who Inject Drugs in Sydney, Australia

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Abstract

Despite a safe, effective vaccine, hepatitis B virus (HBV) vaccination coverage remains low among people who inject drugs (PWID). Characteristics of participants screened for a trial investigating the efficacy of financial incentives in increasing vaccination completion among PWID were examined to inform targeting of vaccination programs. Recruitment occurred at two health services in inner-city Sydney that target PWID. HBV status was confirmed via serological testing, and questionnaires elicited demographic, drug use, and HBV risk data. Multinomial logistic regression was utilized to determine variables independently associated with HBV status. Of 172 participants, 64% were susceptible, 17% exposed (HBV core antibody-positive), and 19% demonstrated evidence of prior vaccination (HBV surface antibody ≥ 10 mIU/ml). Compared with exposed participants, susceptible participants were significantly more likely to be aged less than 35 years and significantly less likely to be receiving current opioid substitution therapy (OST) and to test hepatitis C antibody-positive. In comparison to vaccinated participants, susceptible participants were significantly more likely to be male and significantly less likely to report daily or more frequent injecting, current OST, and prior awareness of HBV vaccine. HBV vaccination uptake could potentially be increased by targeting younger, less frequent injectors, particularly young men. In addition to expanding vaccination through OST, targeting “at risk” youth who are likely to have missed adolescent catch-up programs may be an important strategy to increase coverage. The lack of an association between incarceration and vaccination also suggests increasing vaccination uptake and completion in adult and juvenile correctional facilities may also be important.

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Acknowledgments

We thank participants and staff from the Kirketon Road Centre and the Redfern Primary Health Clinic, including Ann White, John Kearley, and Charlene Murdock, and HAVIT research assistant M. Mofizul Islam. HAVIT is funded by NHMRC Project Grant number 510104. Carolyn Day is supported by a National Health and Medical Research Council (NHMRC) Public Health Post Doctoral Fellowship. Paul Haber is supported by an NHMRC Practitioner Fellowship and Lisa Maher by a NHMRC Senior Research Fellowship. The Kirby Institute (formerly the National Centre in HIV Epidemiology and Clinical Research) is funded by the Australian Government Department of Health and Ageing and is affiliated with the Faculty of Medicine, The University of New South Wales. The views expressed in this publication do not necessarily represent the position of the Australian Government.

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Authors and Affiliations

  1. Sydney Medical School, The University of Sydney, Sydney, NSW, Australia and the Kirby Institute (formerly the National Centre in HIV Epidemiology and Clinical Research), University of New South Wales, Sydney, NSW, Australia

    Rachel M. Deacon

  2. Kirby Institute, University of New South Wales, Sydney, NSW, Australia

    Libby Topp, Handan Wand & Lisa Maher

  3. Sydney Medical School, The University of Sydney, Sydney, NSW, Australia

    Carolyn A. Day & Paul S. Haber

  4. Kirketon Road Centre, Sydney, NSW, Australia

    Craig Rodgers & Ingrid van Beek

  5. Royal Prince Alfred Hospital, Sydney, NSW, Australia

    Paul S. Haber

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  1. Rachel M. Deacon
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  8. Lisa Maher
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Correspondence to Rachel M. Deacon.

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Deacon, R.M., Topp, L., Wand, H. et al. Correlates of Susceptibility to Hepatitis B among People Who Inject Drugs in Sydney, Australia. J Urban Health 89, 769–778 (2012). https://doi.org/10.1007/s11524-012-9680-z

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  • DOI: https://doi.org/10.1007/s11524-012-9680-z

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