Barriers to Hepatitis B Screening and Prevention for African Immigrant Populations in the United States: A Qualitative Study.

Catherine Freeland,Udara Perera,Chari Cohen,Sierra Bodor

doi:10.3390/v12030305

Abstract

Chronic hepatitis B infection (HBV) disproportionately affects African Immigrant (AI) communities in the U.S., with a reported infection rate of 15%. HBV screening rates within these communities are low. This study sought to better understand the socio-cultural determinants associated with low HBV screening among AI communities and identify potential strategies to help inform the development of effective HBV education and screening interventions. Seventeen in-depth interviews were conducted with community health experts working in AI communities throughout the U.S. Interviews explored the potential impact of culture, perception of health, awareness of HBV, religious practices, current screening practice, provider relationship, and behaviors towards general prevention. Interview data were analyzed using thematic analysis. Religious preferences and cultural norms affect health care access, perceptions towards prevention, awareness of HBV, and contribute to myths and stigma within this population. Participants reported a lack of HBV knowledge and awareness and barriers to health care access including, cost, language, racism, understanding of Western Medicine, and usage of traditional medicine. This study elucidates the role of religious and cultural beliefs as barriers to HBV screening and care. Results can contribute to public health efforts to increase awareness, screening and vaccination efforts within AI communities.

Highlights

Chronic hepatitis B virus (HBV) is a significant global health concern, with an estimated 292 million individuals affected worldwide [1]
While this study focused on assessing barriers related to HBV testing, more emphasis should be placed on improving prevention strategies and improving awareness and knowledge related to HBV vaccination in the African Immigrant (AI) community
The World Health Organization (WHO) and National Academies of Science Engineering and Medicine (NASEM) recognize the global burden of HBV and has called for the elimination of HBV and hepatitis C by 2030 [13]

Summary

Introduction

Chronic hepatitis B virus (HBV) is a significant global health concern, with an estimated 292 million individuals affected worldwide [1]. While the actual burden of HBV in the U.S is unknown due to lack of routine screening and disease surveillance, estimates suggest up to 2.2 million chronically infected individuals reside in the U.S [5,6]. Asian Americans and Pacific Islanders (AAPIs) are estimated to make up 50% of this infected population, while those from Africa and the Caribbean may make up an additional 15% [4,5,6,7,8,9,10,11,12]. Limited research has focused on African Immigrant (AI) communities in the U.S, contributing to inadequate prevalence data, prioritization, and awareness of HBV as a health burden for AI.

Methods

Discussion

Conclusion