Increasing hepatitis B vaccination among young African-American men who have sex with men: simple answers and difficult solutions.

Using a bar-based sample, we identified factors associated with hepatitis B virus (HBV) vaccination among young African American men who have sex with men (MSM). The mean (+/- standard deviation [SD]) age of the 170 participants was 26 +/- 6.5 years. Nearly 40% reported at least one dose of vaccine; the remainder were completely unvaccinated. Approximately 22% (37) reported having never heard of HBV. Less than 7% of participants reported using condoms the majority of the time during oral intercourse within the past 3 months, and approximately 50% reported using condoms the majority of the time during anal intercourse within the past 3 months. In multivariable analysis, variables associated with vaccination were younger age (odds ratio [OR], 0.44 per 10-year increase in age; 95% confidence interval [CI]: 0.21-0.93, p = 0.032), higher educational attainment (OR, 4.6; 95% CI: 1.17-12.59, p = 0.003), homosexual as opposed to bisexual behavior (OR, 0.15; 95% CI: 0.06-0.41, p = 0.0001), and recent visits to a health care provider (OR, 4.31; 95% CI: 2.08-8.94, p = 0.0001). Our findings underscore the need to reach MSM for HBV vaccination. Innovative approaches are necessary to ensure the prevention of infection, transmission and disease among individuals with limited education, bisexual MSM, and men who have limited access to health care.