Are there risk factors for hepatitis B infection in inner-city adolescents that justify prevaccination screening?

Elizabeth M. Alderman, Alan Shapiro, Ilya Spigland, Susan M. Coupey, Mohammed Bashir, Amy S. Fox

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Purpose: This study was undertaken to determine if homelessness could serve as a marker for previous hepatitis B infection (HBI), and thus justify prevaccination screening. Methods: One hundred sexually active 13-21-year- olds (mean = 17 years), 74% female, attending an inner-city hospital-based adolescent clinic (HOSP), and 48 sexually active 13-21-year-olds (mean = 19 years), 40% female, attending a clinic based at an urban drop-in center (UDC) for street youth were consecutively enrolled, screened for HBI serum markers and administered a structured interview about sexual practices, sexual abuse, prior sexually transmitted diseases (STDs), and injection drug use. Results: For the HOSP group, 7% were homeless and 4% were HBI positive. In the UDC group, 96% were homeless and 23% were HBI positive. Homelessness was significantly associated with HBI (p < 0.001), and this was corroborated by logistic regression analysis (p < 0.01). Other factors significantly associated with HBI in adolescents included a history of anal sex (p ≤ 0.002), anal-receptive sex (p ≤ 0.01), genital Chlamydia (p ≤ 0.03), prostitution (p ≤ 0.03), and sexual abuse (p ≤ 0.002). For both populations, gender, sexual orientation, intravenous drug use, and genital sex were not related to HBI. Conclusion: These data indicate that homelessness and associated high-risk sexual practices may be indications for prevaccination screening for HBI in adolescents.

Original languageEnglish (US)
Pages (from-to)389-393
Number of pages5
JournalJournal of Adolescent Health
Issue number5
StatePublished - May 1 1998


  • Adolescents
  • Chlamydia
  • Hepatitis B vaccination
  • Homelessness
  • Prevaccination screening
  • Sexual abuse
  • Sexual behaviors

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


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