Factors Associated with Self-Reported Non-Completion of the Hepatitis B Vaccine Series in Men Who Have Sex with Men in Brazil

Among the population groups considered highly vulnerable to the hepatitis B virus (HBV), men who have sex with men (MSM) stand out, according to a population survey conducted with this group in Brazil. A number of intrinsic factors may be associated with increased vulnerability of MSM to HBV, such as sociocultural characteristics and sexual behaviour, as well as external factors related to difficulty accessing health services, denial of basic health rights, and institutionalised homophobia. The objective of this study was to analyse the factors associated with non-completion of the hepatitis B vaccine series among MSM who use geosocial dating apps in Brazil.

This was a cross-sectional, population survey-based, analytical study, conducted exclusively online in all the regions of Brazil, with a sample of 1,855 MSM. The data were collected between November 2016 and February 2017, using the social networking website Facebook.

Multivariate analysis indicated that the odds of non-completion of the HBV series were high among those with less than university level education: "This would indicate that level of education is related to the search for protection and has a direct impact on the percentage of new cases of hepatitis B." Being HIV negative (odds ratio (OR)=2.3; confidence interval (CI) 95%=1.6-3.3) and not knowing one's status (OR=3.7; CI 95%=2.3-5.8) increased the likelihood of an incomplete vaccine series. In terms of access to health information and services, not seeking information from health professionals increased the probability of an incomplete vaccine series (OR=1.5: CI 95%=1.1-1.9), while searching for another source of information other than the internet proved to be a protection factor for the occurrence of an incomplete vaccine series (OR=0.4; CI 95%=0.3-0.6). The lower the frequency of seeking health services, the higher the odds of an incomplete vaccine series.

From the researchers' perspective, the finding that participants who reported going to health units more frequently had a better vaccination history demonstrates the importance of health units being prepared to receive lesbian, gay, bisexual, and transgender (LGBT) individuals. This result is further supported by evidence that not seeking information from health professionals increases the odds of non-completion of the vaccine series. This reinforces the argument that a structure that drives away the LGBT community worsens their access to the health system and, consequently, vaccination coverage.

It is suggested that tailored strategies implemented in places frequented by MSM could significantly improve vaccination rates. The use of technologies, especially geosocial apps, could serve as a channel to access the MSM population and disseminate information and health services for their use.