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Predictors of acceptance of hepatitis B vaccination in an urban sexually transmitted diseases clinic.
Sexually Transmitted Diseases 2004;31(7):415-420.
Samoff E, Dunn A, Vandevanter N, Blank S, Weisfuse IB.
Abstract
BACKGROUND: Individuals who use sexually transmitted disease (STD) clinics
are at high risk for hepatitis B virus (HBV). While HBV vaccine is frequently
offered to clients in this setting, reported vaccination rates are low. More
information is needed about HBV vaccine knowledge, attitudes, beliefs, and
behavior among high risk populations. The current study assesses these issues
at an urban STD clinic. METHODS: A survey assessing knowledge, attitudes,
and beliefs concerning HBV vaccine was administered to individuals seeking
services at an STD clinic before seeing the physician. Immediately after
the clinical visit these individuals were interviewed and asked whether they
had accepted vaccination and their reasons for acceptance or rejection. RESULTS:
Fifty percent of unvaccinated study subjects elected to receive an HBV vaccine
dose at the current visit. Significant predictors in a multiple logistic
regression model for choosing to be vaccinated were: having a vaccinated
acquaintance, perceived risk of disease, perceived healthfulness of vaccine,
and clinician's recommendation. Knowledge regarding hepatitis B risks and
outcomes was not related to vaccine choices. Patients expressed concern about
vaccine safety and provider motivation. CONCLUSIONS: The role of acquaintances
and the physician are central to the decision to be vaccinated, as are risk
perception and familiarity with the vaccine. Mistrust of the medical establishment
and of vaccines is a barrier to acceptance of HBV vaccine.