A Community-Based Study of Hepatitis B Infection and Immunization Among Young Adults in a High-Drug-Use Neighborhood in New York City

In a New York City neighborhood characterized as a "drug supermarket," researchers conducted a community-based study of the prevalence and correlates of hepatitis B virus (HBV) infection and immunization among young adults.

From Bushwick, Brooklyn, the researchers recruited 489 adults ages 18-24 using multistage household probability sampling (332 subjects) and targeted sampling (157 participants). Participants were interviewed and tested for three hepatitis B markers (HBsAg, anti-HBc and anti-HBs). Serological evidence of HBV infection was found in 8 percent of the subjects (household sample: 6 percent; targeted sample: 12.1 percent). Serological evidence of hepatitis B immunization was found in 19.6 percent of participants (household sample: 22.6 percent; targeted sample: 13.4 percent). HBV infection was higher among those who had either used crack or injected drugs as well as among those who had bartered sex for money or drugs. Medicaid coverage was significantly associated with lower odds of infection in the household sample and higher odds of immunization in the targeted sample.

"Although adolescent hepatitis B immunization has been a public health priority in the United States since 1995, nearly three-quarters of young adults in this community did not have serological evidence of being either exposed or immunized," the authors concluded. "Whereas subsequent younger generations benefited from universal childhood hepatitis B immunization, this particular cohort of young adults who live in communities like Bushwick presents a unique group for prevention intervention."

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