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Health Care Access and Sociodemographic Factors Associated with Hepatitis B Testing in Vietnamese American Men
Authors:John H. Choe MD   MPH  Victoria M. Taylor  Yutaka Yasui  Nancy Burke  Tung Nguyen  Elizabeth Acorda  J. Carey Jackson
Affiliation:(1) Department of Medicine, University of Washington, Seattle, Washington;(2) Harborview Medical Center, Seattle, Washington;(3) Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington;(4) Department of Health Services, University of Washington, Seattle, Washington;(5) Department of Public Health Sciences, University of Alberta, Edmonton, Alberta, Canada;(6) Comprehensive Cancer Center, University of California, San Francisco, California;(7) Department of Medicine, University of California, San Francisco, California;(8) Division of General Internal Medicine, Harborview Medical Center, 325 Ninth Avenue, Seattle, Washington, 98104
Abstract:Chronic hepatitis B viral (HBV) infection greatly increases the risk for cirrhosis and hepatocellular carcinoma. HBV serologic testing is important for the identification of chronically infected individuals, who may benefit from antiviral treatment and regular monitoring for disease sequelae. Elevated rates of cirrhosis and hepatocellular carcinoma among Vietnamese American men can largely be attributed to high rates of chronic HBV infection. We surveyed 509 Vietnamese men aged 18–64 years in Seattle, Washington and examined sociodemographic and health care access factors associated with HBV serology testing. Nearly two-thirds (65%) reported past testing. The following were among those factors associated with HBV testing in bivariate comparisons: older age; short proportion of life in the US; low English fluency; private health insurance; identifying a regular source of medical care; reporting no long waits for medical appointments; and having access to interpreter services. The following were independently associated with HBV testing in multiple logistic regression analysis: older age; college education; low English fluency; private health insurance; having a regular medical provider; and reporting no long waits for medical appointments. Younger and less educated men, and those with difficulty accessing medical care may be at particular risk for never having had HBV testing. Programs to reduce HBV transmission and sequelae should make special effort to target these vulnerable Vietnamese Americans.
Keywords:hepatitis B  hepatocellular carcinoma  liver cirrhosis  serologic tests  Vietnamese Americans
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