title: Predictors of acceptance of hepatitis B vaccination in an urban sexually transmitted diseases clinic.
abstract: BACKGROUND
  Individuals who use sexually transmitted disease (STD) clinics are at high risk for hepatitis B virus (HBV). While HBV vaccine is frequently offered to clients in this setting, reported vaccination rates are low. More information is needed about HBV vaccine knowledge, attitudes, beliefs, and behavior among high risk populations. The current study assesses these issues at an urban STD clinic.
  
  
  METHODS
  A survey assessing knowledge, attitudes, and beliefs concerning HBV vaccine was administered to individuals seeking services at an STD clinic before seeing the physician. Immediately after the clinical visit these individuals were interviewed and asked whether they had accepted vaccination and their reasons for acceptance or rejection.
  
  
  RESULTS
  Fifty percent of unvaccinated study subjects elected to receive an HBV vaccine dose at the current visit. Significant predictors in a multiple logistic regression model for choosing to be vaccinated were: having a vaccinated acquaintance, perceived risk of disease, perceived healthfulness of vaccine, and clinician's recommendation. Knowledge regarding hepatitis B risks and outcomes was not related to vaccine choices. Patients expressed concern about vaccine safety and provider motivation.
  
  
  CONCLUSIONS
  The role of acquaintances and the physician are central to the decision to be vaccinated, as are risk perception and familiarity with the vaccine. Mistrust of the medical establishment and of vaccines is a barrier to acceptance of HBV vaccine.
authors.affiliation: New York City Department of Public Health, NY 10013, USA.
authors.forename: Erika
authors.initials: E
authors.lastname: Samoff
authors.forename: Alan
authors.initials: A
authors.lastname: Dunn
authors.forename: Nancy
authors.initials: N
authors.lastname: VanDevanter
authors.forename: Susan
authors.initials: S
authors.lastname: Blank
authors.forename: Isaac B
authors.initials: IB
authors.lastname: Weisfuse
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006509:Hepatitis B / Q000517:prevention & control*; D017325:Hepatitis B Vaccines; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City; D010342:Patient Acceptance of Health Care; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D014504:Urban Health; D014611:Vaccination
chemical_list: D017325:Hepatitis B Vaccines