Correlating Perceived Hepatitis B Status With Actual Status in Asian and Pacific Islander Americans in Rhode Island

Abstract

Introduction: Chronic hepatitis B (HBV) in the Asian and Pacific Islander (API) American population is an important, under-recognized health issue. Among foreign-born API Americans, the prevalence of chronic HBV is about 10% compared to less than 0.5% in the general population. No studies have quantified the prevalence of HBV in the more than 30,000 APIs in Rhode Island (RI) or assessed this population’s knowledge and attitudes about HBV. The study was to (1) explore the beliefs held by Chinese, Cambodian, and Laotian populations in RI about their personal HBV status, (2) examine selfreports of HBV status, and (3) compare self-report results with actual HBV status. Methods: We administered an investigator-designed 18-question survey, which assessed subjects’ perceived HBV status and knowledge and socioeconomic and health-related demographics such as insurance and employment status. We examined serologically confirmed HBV status of Chinese, Cambodian, and Laotian populations compared to their perception of HBV status. Written informed consent was obtained from each study subject in this IRB-approved study. Results: Of 59 participants, only 19 (32 %) correctly knew their hepatitis B status. Eighty-eight percent were foreign-born. Subjects who had at least 1 year of college and health insurance were 1.92 (p<0.05) times and 2.53 (p<0.05) times more likely, respectively, to have accurate perception than those who did not. Individuals who had “heard about HBV before” were 1.68 (p<0.05) times more likely to predict their status correctly. Six of 59 were HBV carriers (10.2%). Eighteen of 59 subjects (30.5%) were not immune and needed vaccination. College education, insurance, and prior HBV education increased the likelihood of correct perception. Conclusion: Our small pilot study suggests that community-wide public health initiatives, including increased statewide HBV screening, may have a positive impact on perception and health behaviors. We call for efforts to identify those APIs in need of medical attention or vaccination and increased education efforts to inform at-risk populations and encourage their participation in screenings. This data provides a potential framework for which the state of Rhode Island and similar settings can base large-scale culturally specific, HBV interventions to address this health disparity.