Culturally Sensitive and Targeted Interventions Needed to Enhance Hepatitis A Vaccination Among LGBTQ+ Adults

The highly contagious, vaccine-preventable disease inflames the liver and has seen rising outbreaks among men who have sex with men

A new study from Rutgers School of Public Health researchers underscores disparities in hepatitis A vaccination among men who have sex with men, particularly among racial and ethnic minority groups.

The study, published in the International Journal of STD & AIDS, is one of the first to examine vaccine uptake and medical mistrust as it relates to hepatitis A vaccination among men who have sex with men.

While most recover fully from hepatitis A, a vaccine-preventable and highly contagious infectious disease, outbreaks have increased in recent years among communities of men who have sex with men. The virus attacks liver cells and leads to inflammation, which can impact liver function.

The Centers for Disease Control and Prevention recommends routine hepatitis A vaccination for populations at higher risk of acquiring hepatitis A, including men who have sex with men. Despite these recommendations, the Rutgers study found that only 60% of their sample of 222 gay, bisexual and other identifying men who have sex with men were fully vaccinated.

Vaccination uptake rates varied based on age, race/ethnicity, and employment status. Additionally, the researchers found higher levels of medical mistrust among those who weren’t vaccinated against hepatitis A, and among Black, Hispanic and Latine individuals.

“Despite public health recommendations, we see a significant gap in hepatitis A vaccination among men who have sex with men, particularly among those who are Black and multiracial,” said Tiffany Guo, lead study author and Rutgers School of Public Health doctoral student.

The researchers also found the most common reason that study participants cited for not being vaccinated included believing the vaccine was unnecessary and lacking the knowledge about its availability.

“Our findings highlight the need for targeted intervention strategies that address both vaccine accessibility and medical mistrust,” said Kristen Krause, an assistant professor at the Rutgers School of Public Health and deputy director of the Center for Health, Identity, Behavior and Prevention Studies.

Krause added that the work was done as part of a larger study, the QVax study, in which researchers sought to understand vaccine uptake among several different vaccine-preventable diseases, including COVID-19, human papillomavirus, hepatitis A and B, RSV, meningitis B and seasonal influenza in LGBTQ+ adults in New Jersey and New York.

The researchers said the disparities highlighted in the study point to broader systemic health care issues around access and trust.