| Titre : | Hepatitis A Seroprevalence and Risk Factors Among Homeless Adults in San Francisco : Should Homelessness Be Included in the Risk-Based Strategy for Vaccination ? (2009) |
| Auteurs : | Karen-A HENNESSEY ; BANCSBERG (David-R) : USA. Massachusetts General Hospital. Harvard Medical School. Harvard Initiative for Global Health. Cambridge. MA. ; HAHN (Judith-A) : USA. University of California San Francisco. San Francisco. CA. ; Cindy WEINBAUM |
| Type de document : | Article |
| Dans : | Public health reports (vol. 124, n° 6, 2009) |
| Pagination : | 813-817 |
| Langues: | Anglais |
| Mots-clés : | Hépatite virale A ; Prévalence ; Epidémiologie ; Sérologie ; Facteur risque ; Sans domicile fixe ; Adulte ; Risque ; Stratégie ; Prévention santé ; Vaccination ; Virose ; Infection ; Homme ; Amérique ; Amérique du Nord |
| Résumé : | [BDSP. Notice produite par INIST-CNRS BR0xGG8C. Diffusion soumise à autorisation]. Objectives. Homeless adults have an increased risk of infectious diseases due to sexual and drug-related behaviors and substandard living conditions. We investigated the prevalence and risk factors for presence of hepatitis A virus (HAV) antibodies among homeless and marginally housed adults. Methods. We analyzed serologic and questionnaire data from a study of marginally housed and homeless adults in San Francisco from April 1999 to March 2000. We tested seroprevalence for total antibodies to HAV (anti-HAV) and analyzed data using Chi-square tests and logistic regression. Results. Of the 1,138 adults in the study, 52% were anti-HAV positive. The anti-HAV prevalence in this study population was 58% higher than the expected prevalence based on age-specific prevalence rates from the general population. Number of years of homelessness (<=1,2-4, and>=5 years) was associated with anti-HAV prevalence (46%, 50%, and 61%, respectively, p<0.001). We found other differences in anti-HAV prevalence (p<0.05) for ever having injected drugs (63% vs. 42% for non-injectors), being foreign-born (75% vs. 51% among U.S. - born), race/ethnicity (72%, 53%, and 45% for Hispanic, white, and black people, respectively), and increasing age (38%, 49%, and 62% among those aged<35,35-45, and>45 years, respectively). These variables all remained significant in a multivariate model. Conclusions. We found overall anti-HAV prevalence elevated in this San Francisco homeless population compared with the general U.S. population. These data show that anti-HAV was associated with homelessness independent of other known risk factors, such as being foreign-born, race/ethnicity, and injection drug use. This increase indicates an excess risk of HAV infection and the potential need to offer hepatitis A vaccination as part of homeless services. |
Service Documentation EHESP
Me connecter
PORTAIL DOCUMENTAIRE
École des hautes études en santé publique
Catalogue
Multi-bases
Accueil
Sélection de la langue
Adresse
Service Documentation EHESPBibliothèque Rennes Avenue du Professeur Léon Bernard – CS 74312 – 35043 Rennes Cedex Bibliothèque MSSH Paris 20 avenue George Sand - 93210 La Plaine Saint-Denis
France
Bibliothèque Rennes : 02 99 02 29 50 Bibliothèque MSSH Paris : 02 99 02 24 50
contact