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Psychosocial Predictors of Hepatitis B Vaccination Among Young African-American Gay Men in the Deep South


Sexually Transmitted Diseases: May 2003 - Volume 30 - Issue 5 - p 449-454

Background Despite recommendations for vaccination against hepatitis B virus (HBV) of men who have sex with men (MSM), most remain unvaccinated.

Goal The goal of this study was to identify attitudes and beliefs associated with vaccination against HBV among black MSM.

Study Design The Birmingham Vaccine Acceptance Questionnaire was used to collect data from gay bar patrons.

Results Of the 143 participants, nearly 42% reported at least one dose of HBV vaccine. In multivariable analysis, characteristics associated with vaccination were a decreased perception of barriers to HBV vaccination (odds ratio [OR], 0.37; 95% confidence interval [CI], 0.22–0.61;P = 0.001); increased perceived medical severity (OR, 5.34; 95% CI, 2.38–11.96;P = 0.001) and personal severity (OR, 2.22; 95% CI, 1.38–3.56;P = 0.006) of HBV infection; and increased perceived general medical self-efficacy (OR, 9.22; 95% CI, 3.52–24.11;P = 0.0001) and personal self-efficacy (OR, 2.3; 95% CI, 1.14–4.63;P = 0.008) to complete the three-dose series.

Conclusions Our findings underscore the need to increase vaccination through innovative approaches to reduce perceived barriers to vaccination while increasing perceived severity of HBV infection and self-efficacy to complete the vaccine series.

African American gay men in Alabama who perceived fewer barriers to vaccination, believed infection to be severe, and had confidence in their ability to complete the 3-dose series were more likely to be vaccinated against hepatitis B.

*Department of Public Health Services, Wake Forest University School of Medicine, Winston-Salem, North Carolina; and Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Department of Medicine, Division of Infectious Diseases, School of Medicine, and §Emory Center for AIDS Research, Emory University, Atlanta, Georgia

Human subject review and oversight were provided by the Institutional Review Board of the University of Alabama at Birmingham.

Manuscript preparation was supported in part by the Community Health Scholars Program, funded by the W.K. Kellogg Foundation (to Scott D. Rhodes).

Reprint requests: Scott D. Rhodes, PhD, MPH, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157–1063. E-mail:

Received September 9, 2002,

revised December 23, 2002, and accepted December 30, 2002.

© Copyright 2003 American Sexually Transmitted Diseases Association