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Journal of Correctional Health Care
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Hepatitis B Vaccination in Prison: The Perspectives of Formerly Incarcerated Men

Jessica M. Buck

Pritzker School of Medicine, University of Chicago, Illinois

Kathleen M. Morrow, PhD

Centers for Behavioral and Preventive Medicine, The Miriam Hospital and Brown Medical School, Providence, Rhode Island

Andrew Margolis, MPH

Centers for Disease Control and Prevention, Atlanta, Georgia

Gloria Eldridge, PhD

University of Alaska, Anchorage

James Sosman, MD

Department of Medicine, University of Wisconsin Medical School, Madison

Robin MacGowan, MPH

Centers for Disease Control and Prevention, Atlanta, Georgia

Diane Binson, PhD

University of California, San Francisco-CAPS

Deborah Kacanek, ScD

Tufts-New England Medical Center, Boston, Massachusetts

Timothy P. Flanigan, MD

Department of Medicine, The Miriam Hospital and Brown Medical School, Providence, Rhode Island, tflanigan{at}lifespan.org

The Project START Study Group

Nearly 30% of new hepatitis B virus (HBV) infections have been detected in people with a history of incarceration. Although a safe and effective HBV vaccine is available, it is not routinely provided to inmates. This is a significant missed public health opportunity. Barriers to routine vaccination include cost, difficulties completing vaccination series in a transient population, insufficient collaboration between public health organizations and correctional health systems, and inmate refusal. This study assessed inmates’ knowledge, attitudes, and perceptions of HBV and of HBV testing and vaccination. Hepatitis B virus testing and vaccination were offered. Interviews were conducted with 42 men, aged 18 to 29 years, recently released from prison. Of the 28 men who agreed to be tested, 71% were susceptible to HBV. Many had misconceptions about HBV or HBV vaccination, but most were willing to be vaccinated once informed. Barriers to vaccination during incarceration were fear of needles and distrust of prison staff; after release, barriers were time and cost. These findings support the need for education and routine HBV vaccination programs for inmates during incarceration.

Key Words: hepatitis B • vaccine • correctional health • prison inmates

Journal of Correctional Health Care, Vol. 12, No. 1, 12-23 (2006)
DOI: 10.1177/1078345806287937


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