The American Social Health Association (ASHA) supports the integration of viral hepatitis education and prevention services into sexually transmitted disease (STD) public health programs on the local, state and national level. Hepatitis B is 100 times more infectious by sexual transmission than HIV. While not the most prevalent means of transmission, hepatitis A and C can be transmitted sexually as well. Moreover, viral hepatitis infection often goes undetected; managing the spread is problematic.
Those individuals at increased risk of contracting hepatitis A, B or C, such as men who have sex with men (MSM), injection drug users (IDU) and those with multiple sex partners, are often at increased risk for other sexually transmitted diseases as well. Since hepatitis A and B are both classified as "vaccine preventable STDs," the overlaps in education, screening, and preventive intervention are inherent. With so much misunderstanding about viral hepatitis among health care providers and the general public, the need for effective national public awareness campaigns and collaborative and integrative programs is considerable.
Hepatitis A, B and C can result in liver failure and even death. Among persons with acute hepatitis B, up to 70% have previously received care in settings where they could have been vaccinated (e.g., STD clinics, drug treatment programs, and correctional facilities).2 According to the CDC, the most effective means of preventing HCV infection and its consequences is to integrate hepatitis C prevention activities into existing clinical services and public health programs, such as those for the prevention and treatment of HIV/AIDS, STDs and drug abuse. 3
ASHA supports the following recommendations:
Adult Immunization
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According to the CDC STD Treatment Guidelines 2002, every person
seeking treatment for an STD should be considered a candidate for hepatitis
B vaccination, and some persons (e.g., MSM and injection-drug users)
should be considered for hepatitis A vaccination. 2
- Despite financial barriers such as lack of vaccine and personnel
to administer immunizations, initiating hepatitis B vaccination of high-risk
adults is an attainable goal for many STD and HIV/AIDS clinics. 1
- All pregnant women receiving STD services should be tested for
the hepatitis B virus, regardless of whether they have been previously
tested. 2
Non-Vaccine Prevention Measures
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Health care professionals in primary care, specialty, and public health settings should routinely question patients about risk factors for HCV infection. 4
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The best way to prevent any sexually transmitted disease (STD)
is to not have sex. For those individuals who do have sex, especially
with a partner who may have hepatitis A, B or C, prevention strategies
include: practicing outercourse, limiting number of sex partners, using
latex condoms and moisture barriers, communicating with partners about
condoms and safer sex, and being checked by a doctor for STDs every
6 months. 5
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To prevent the risk of infection from hepatitis A, B, or C, those
using injection drugs should avoid sharing works (needles, syringes,
cookers, or cottons). For those who choose to share works, those individuals
should clean them with water and bleach, filling syringes for at least
30 seconds. 5
The American Social Health Association offers progressive Web-based information
concerning hepatitis A through E, distinct patient education literature
on hepatitis A through C, comprehensive prevention and disease management
information through its contact centers, cooperative research initiatives
with the CDC, and a long history of patient advocacy.
CDC - Spotlight on Hepatitis Integration
MMWR Article
CDC Hepatitis C Plan
CDC Hepatitis C Prevention and Control
Position as of March 20, 2003
*The provision of Web site links on this page are provided for information purposes only. The list should not be viewed as comprehensive, and is not necessarily an endorsement of any particular organization.
