Seroprevalence and Correlates of Hepatitis A Among HIV-Negative American Men Who Have Sex With Men

Noting that hepatitis A virus outbreaks among MSM have been well-documented, the current study examined the characteristics associated with HAV among a large group of young adult MSM in five US cities.

The Young Men's Survey was a cross-sectional HIV prevalence and behavioral risk factor study among MSM, ages 15-29, during 1994-2000. Serum specimens from HIV-negative participants were retrospectively tested for HAV antibodies (anti-HAV). Data were then stratified by ethnicity and analyzed with logistic regression.

Overall anti-HAV prevalence was 18.4 percent among the 2,708 participants, varying by ethnicity from 6.9 percent to 45.3 percent, with the highest rates among Hispanic and Asian men (P<0.001). Prevalence increased with age across all racial/ethnic groups. Among white men, anti-HAV positivity was associated with having 20 or more lifetime male sex partners for those ages 15-22 years (adjusted odds ratio=2.1, 95 percent confidence interval=1.0-4.1) and ever having had unprotected anal sex for those ages 23-29 years (AOR=2.4, 95 percent CI=1.2-4.5).

"Factors associated with a history of HAV infection among MSM in non-outbreak settings are probably similar to those among non-MSM," the study authors concluded. "MSM are still at risk for HAV infection as a result of HAV outbreaks occurring in MSM communities. Additional studies of hepatitis A vaccination coverage are needed to determine if strategies to vaccinate MSM are adequate."