High Hepatitis B Prevalence and Vaccination Needs Among Transgender Women and Men Sex Workers in Barcelona, Spain
Author:
Antuori Adrián12ORCID, Not Anna12ORCID, Mesías-Gazmuri Jocelyn345, González Victoria136, Montoro-Fernandez Marcos3, Folch Cinta346, Saludes Verónica16, Villar Marta7, Meroño Mercè8, Paytubi Sonia910, Alemany Laia910, Casabona Jordi3456, Martró Elisa16ORCID, , Folch C, Ferrer L, González V, Muñoz R, Mesías-Gazmuri J, Egea L, Casabona J, Martró E, Saludes V, Antuori A, Not A, González-Gómez S, Alemany L, Pavón M A, Paytubi S, Esteban A, Vergara M, Rodríguez V, Morey F, Tous S, Montoliu A, de Sanjosé S, Villegas L, Villar M, Adell H, Santander K, Meroño M, Cebrián M, Carrascal C, Longares E, Martínez L, Almirall R, Mansilla R, Lletjós P, Drou-Roget G, Álvarez-Vargas A
Affiliation:
1. Microbiology Department, Laboratori Clínic Metropolitana Nord (LCMN), Hospital Universitari Germans Trias i Pujol, Institut d’Investigació Germans Trias i Pujol (IGTP) , Badalona (Barcelona) , Spain 2. Genetics and Microbiology Department, Universitat Autònoma de Barcelona (UAB) , Bellaterra (Barcelona) , Spain 3. Centre d’Estudis Epidemiològics sobre Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Agència de Salut Pública de Catalunya , Barcelona , Spain 4. Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti , Badalona , Spain 5. Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine, Universitat Autònoma de Barcelona (UAB) , Bellaterra (Barcelona) , Spain (Jocelyn, Jordi) 6. Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII) , Madrid , Spain 7. STOP , Barcelona , Spain 8. Fundació Àmbit Prevenció , Barcelona , Spain 9. Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, L’Hospitalet de Llobregat , Barcelona , Spain 10. Consortium for Biomedical Research in Epidemiology and Public Health—CIBERESP, Carlos III Institute of Health , Madrid , Spain
Abstract
Abstract
Background
Transgender women sex workers (TWSWs) and men sex workers (MSWs) are especially vulnerable to acquiring hepatitis B virus (HBV) infection. We aimed to describe HBV prevalence (hepatitis B surface antigen [HBsAg] and core antibody [HBcAb]) and associated risk factors for HBV exposure (HBcAb), to assess vaccination status and risk factors for no prior vaccination, and to compare HBV prevalence and vaccination status between TWSWs and MSWs.
Methods
The SexCohort study was advertised to TWSWs and MSWs through several communication channels. At cohort entry through 2 community-based organizations in Barcelona, the study population was screened for HBV and other sexually transmitted infections, and an epidemiological questionnaire was administered (n = 271).
Results
Overall, 93.0% of participants were migrants, mostly from South and Central American countries. HBsAg prevalence was 1.9% (TWSWs, 2.4%; vs MSWs, 0.9%; P = .42), and previous exposure to HBV was 31.8% (TWSWs, 38.5%; vs MSWs, 20.8%; P = .002). Over 5 years of sex work (adjusted odds ratio [aOR], 9.35), prior exposure to Treponema pallidum (aOR, 3.49), and treatment with anxiolytic drugs (aOR, 3.23) were associated with HBV exposure. Overall, 33.7% of participants exhibited immunity from vaccination (TWSWs, 30.8%; vs MSWs, 38.61%; P < .001), while 34.4% were candidates to HBV vaccination (TWSWs, 30.8%; vs MSWs, 40.6%; P < .001). Never having been on pre-exposure prophylaxis for HIV (odds ratio [OR], 4.23) and non-Spanish origin (OR, 5.00) were associated with no prior HBV vaccination.
Conclusions
There is a need to reinforce screening and vaccination programs aimed at TWSWs and MSWs as integrated services offered at the community centers commonly accessed by these populations.
Funder
CIBERESP Instituto de Salud Carlos III European Regional Development Fund
Publisher
Oxford University Press (OUP)
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