Em. Alderman et al., ARE THERE RISK-FACTORS FOR HEPATITIS-B INFECTION IN INNER-CITY ADOLESCENTS THAT JUSTIFY PREVACCINATION SCREENING, Journal of adolescent health, 22(5), 1998, pp. 389-393
Purpose: This study was undertaken to determine if homelessness could
serve as a marker for previous hepatitis B infection (HBI), and thus j
ustify prevaccination screening. Methods: One hundred sexually active
13-21-year-olds (mean = 17 years), 74% female, attending an inner-city
hospital-based adolescent clinic (HOSP), and 48 sexually active 13-21
-year-olds (mean = 19 years), 40% female, attending a clinic based at
an urban drop-in center (UDC) for street youth were consecutively enro
lled, screened for HBI serum markers and administered a structured int
erview about sexual practices, sexual abuse, prior sexually transmitte
d diseases (STDs), and injection drug use. Results: For the HOSP group
, 7% were homeless and 4% were HBI positive. In the UDC group, 96% wer
e homeless and 23% were HBI positive. Homelessness was significantly a
ssociated with HBI (p < 0.001), and this was corroborated by logistic
regression analysis (p < 0.01). Other factors significantly associated
with HBI in adolescents included a history of anal sex (p less than o
r equal to 0.002), anal-receptive sex (p less than or equal to 0.01),
genital Chlamydia (p less than or equal to 0.03), prostitution (p less
than or equal to 0.03), and sexual abuse (p less than or equal to 0.0
02). For both populations, gender, sexual orientation, intravenous dru
g use, and genital sex were not related to HBI. Conclusion: These data
indicate that homelessness and associated high-risk sexual practices
may be indications for prevaccination screening for HBI in adolescents
. (C) Society for Adolescent Medicine, 1998.