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Missed Opportunities for Hepatitis A Vaccination Among MSM Initiating PrEP

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Abstract

The incidence of Hepatitis A virus (HAV) among the general population in the United States has decreased by over 95% since the introduction of HAV vaccination in 1995. However, 10% of all new HAV infections occur among men who have sex with men (MSM). However routine HAV is not part of standard of care for provision of PrEP services. Retrospective cohort analysis of MSM assessed for HIV prevention services between 1/1/2016 and 6/30/2017 to evaluate the rates of screening for anti-HAV seroprevalence and subsequent vaccination. HAV IgG was drawn on 96% (96/100) of the patients with 58% (56/96) of patients demonstrating serologic immunity. Of the 40 patients without evidence of immunity, 77% (29/40) returned for a subsequent visit, 48% (14/29) were provided HAV vaccination, and 29% (4/14) received at least two doses. Only 35% (14/40) of patients without documented immunity received HAV vaccination. Visits for PrEP initiation and monitoring in MSM patients are potential opportunities for ensuring HAV vaccination among this high-risk patient population. Public health agencies could optimize HAV vaccination of the high risk MSM by incorporating HAV screening into national PrEP guidelines.

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Funding

Dr. Zucker is supported by the training grant “Training in Pediatric Infectious Diseases” (National Institute of Allergy and Infectious Diseases T32AI007531)

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Correspondence to Jason Zucker.

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The authors declare that they have no conflict of interest.

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This study was approved by the Columbia University Medical Campus Institutional Review Board. As no identifying information was used informed consent was not obtained.

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Cohall, A., Zucker, J., Krieger, R. et al. Missed Opportunities for Hepatitis A Vaccination Among MSM Initiating PrEP. J Community Health 45, 506–509 (2020). https://doi.org/10.1007/s10900-019-00768-w

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