title: The reach of a hepatitis B vaccination programme among men who have sex with men.
abstract: BACKGROUND
  Homosexual contact is a major risk factor for acute hepatitis B infection. This study explores how many and which men who have sex with men (MSM) are reached by the ongoing hepatitis B vaccination programme in The Netherlands (started in 2002), and investigate reasons for non-participation and non-compliance.
  
  
  METHODS
  In this cross-sectional study, on the basis of ethnographic mapping and targeted sampling, 320 MSM were interviewed at different venues in three regions in The Netherlands.
  
  
  RESULTS
  Of the sample, 74% reported to be aware of the opportunity to obtain free hepatitis B vaccination, and 50% reported to be vaccinated (received at least one injection). Compliance with the three-dose vaccination schedule was 84%. The most important reason for non-participation in the vaccination programme was a low perceived risk of getting infected with the virus. A personal approach by STD-prevention workers, the recruitment region and having sex with casual partners were positively associated with vaccination uptake. Being bisexual was negatively associated with, and visiting gay bars/discos was positively associated with, awareness of the opportunity to obtain free hepatitis B vaccination.
  
  
  CONCLUSIONS
  This study shows a large proportion of MSM is aware that they could opt for free hepatitis B vaccination. Future vaccination programmes should focus on a personal approach, since the use of STD prevention workers was shown to be a successful tool for participation in the vaccination programme. The personal information should focus on perceived risk of infection, since this was a major reason for vaccine refusal.
authors.affiliation: IVO: Addiction Research Institute, Rotterdam, The Netherlands. baars@ivo.nl
authors.forename: Jessica E
authors.initials: JE
authors.lastname: Baars
authors.forename: Brigitte J
authors.initials: BJ
authors.lastname: Boon
authors.forename: Henk F
authors.initials: HF
authors.lastname: Garretsen
authors.forename: Dike
authors.initials: D
authors.lastname: van de Mheen
mesh_terms: D003142:Communication; D003430:Cross-Sectional Studies; D007722:Health Knowledge, Attitudes, Practice; D006509:Hepatitis B / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D006515:Hepatitis B virus; D018451:Homosexuality, Male; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D008297:Male; D009426:Netherlands; D010349:Patient Compliance; D012306:Risk
chemical_list: D017325:Hepatitis B Vaccines