Outreach Hepatitis B Vaccination of Female Sex Workers in Central-West Brazil

Abstract

The present findings illustrate the benefits of using outreach strategies to overcome the difficulties of vaccinating hard-to-reach populations such as FSWs.

Prevalence, risk factors and hepatitis B immunization: helping fill the gap on hepatitis B epidemiology among homeless people, Goiânia, Central Brazil

“…In our study, only 19.5% of participants presented a serological profile of prior immunization, confirming the low frequency of hepatitis B vaccination among vulnerable populations in our region and elsewhere 16,19,20,21 . However, it should be noted the wide variation observed in the distribution by age group, with prevalence of 53.6% in individuals aged 18 to 30 years dropping to 1.4% among those aged above 50 years.…”

Low completion rate of hepatitis B vaccination in female sex workers

“…These characteristics seem common among female sex workers in Brazil and in other countries (9,(18)(19)(20)(21)(22) . In this study, as well as in others conducted with difficult to reach populations, adherence to the first dose was good, demonstrating this population's willingness for vaccination (9)(10)23) . However, the second and, especially, the third doses challenged the health workers.…”

“…Only 2.2% of women who worked at clubs received the three vaccine doses vs. 33.6% of those who worked at bars/streets and squares. A study conducted in MPS, midwestern Brazil, showed higher chance for completion of vaccination schedule for women who worked on streets or brothels, which suggests that the strategy of vaccination at the workplace reached the most vulnerable women (9) . Our results confirm this assumption.…”

“…Another research, also conducted in Belgium (23) , assessed 474 women who received the conventional schedule and observed a rate of 47.9% (95% CI: 43.43 -52.39). In Brazil, in a study conducted in two midwestern state capitals, 37.5% (95% CI: 32.84-42.44) of the 389 women who received the first dose completed the vaccination schedule (9) . Despite the high frequency of missed follow-ups, especially due to the participants geographical mobility, two factors remained independently associated with noncompletion of the schedule: use of illicit drugs and working at clubs.…”

“…Currently, it is offered for the whole population below the age of 50 and populations at higher risk, such as sex workers, drug users and men who have sex with men (MSM) (8) . Despite this policy, hepatitis B vaccination coverage is still low among its target demographics (5,(9)(10)(11)(12) . Thus, some strategies have been suggested for this population subgroups, such as the use of accelerated schedules and vaccination at the workplace (13)(14) .…”