A simple lifesaving measure for people with HIV largely is being missed, and in places where you might not expect: Private-pay provider offices.
How could they be missing out on a simple, safe and effective way to improve the health of their patient? They don’t receive Ryan White HIV/AIDS Program funding.
So, they just don’t know, according to a study published Christmas night in Annals of Internal Medicine.
Check out the study for yourself by clicking here. It explains that more than a third of people with HIV in the U.S. have not been vaccinated against Hepatitis B.
Hepatitis B is a disease of the liver. It can be serious and even chronic, particularly among people with HIV, who already are at greater risk of infection
The good news is that there is a vaccination for Hepatitis B.
Hepatitis B is transmitted sexually (semen), as well as by sharing needles (blood).
Gay men are among those at greatest risk. Like HIV, hepatitis causes inflammation in the body. The two diseases, HIV and Hepatitis B, create an entourage effect that can wreak havoc inside the body.
When all of this happens, viral loads undoubtedly spike, particularly among those with HIV who are untested and untreated. That results in increased HIV transmission rates.
The study looked at more than 18,000 people with HIV participating in the Medical Monitoring Project between 2009 and 2012. More than a third of these people being treated for HIV had not received the Hepatitis B vaccination.
“Although vaccination prevalence was low across all facility types, it was substantially higher among patients at RWHAP-funded facilities, which is consistent with other indicators that patients who receive care at such facilities have better clinical outcomes than those at facilities without RWHAP funding,” the researchers concluded.
“Vaccination prevalence was marginally higher among patients with social determinants of poor health, at least partially because vulnerable patients disproportionately receive HIV care at RWHAP-funded facilities,” they concluded.
People with HIV are reeling over all but certain healthcare cuts that could impact their treatment.
People who don’t have HIV need to be reeling, too.
Not giving people with diseases such as HIV, Hepatitis C or any communicable infection the treatment they need is a public health disaster for all of us.
Write the researchers in their paper, “Several factors might contribute to failure of clinicians to vaccinate HIV patients for hepatitis B, including deferral of vaccination because of reports of reduced immunogenicity among such patients, inconsistency of recommendations for timing and dosage of vaccination within and across guidelines, deficiency of robust systems within health care facilities to support vaccination, and lack of access to affordable vaccines for some HIV patients.”
In a report I penned in 2015 for HIV Equal, I explained how Hepatitis B infections had dipped among gay men, even HIV-positive gay men in treatment with undetectable virus levels. But, the good news came with a catch:
Even in the modern era of HIV medication, Hepatitis B infection rates did not dip among people with HIV who did not reach undetectable levels. Plenty of research has shown that the best way to achieve undetectable levels is to get tested regularly and into treatment as soon as possible.
In their research, the authors stress that a vaccination against Hepatitis B has been around and recommended for men who have sex with men since 1982, yet few get it. The vaccine is 95 percent effective.
While two to three doses of the vaccine are recommended to reach 95 percent efficacy, the researchers said in their study just one dose reduced the risk of HBV infection by up to 70 percent.
It is important to remember there also is a vaccine for Hepatitis A, which has higher prevalence among gay and bisexual men. The U.S. Centers for Disease Control and Prevention suggests men who have sex with men receive both vaccinations.
Communities should (and many do) offer free Hepatitis B vaccinations and have effective messaging campaigns in the place to reach populations most at risk.
An investment in public health is taxpayer money well spent. If it’s not allocated for vaccinations in matters related to HIV, Hepatitis C, and other dangerous communicable diseases, there are only two outcomes:
People die; and/or
Pharma profits skyrocket when people become infected and do seek treatment, which in the end comes with a much heavier cost to taxpayers than a simple vaccination.
Until next time.
You can find me on Twitter @DavidHeitz