As Secretary of Health and Human Services (HHS) Kathleen Sebelius noted in her recent statement, observing Lesbian, Gay, Bisexual and Transgender (LGBT) Pride Month in June spotlights HHS’s commitment to addressing the special health needs of LGBT Americans which includes reducing health disparities for them and members of other vulnerable communities.

Among those disparities is viral hepatitis, which is of particular concern to the Office of HIV/AIDS and Infectious Disease Policy (OHAIDP) and our Federal partners who are working to implement The Action Plan for the Prevention, Care and Treatment of Viral Hepatitis. In fact, the Action Plan identifies gay, bisexual and other men who have sex with men (MSM) as one of its priority populations.

Vaccine-Preventable Hepatitis A and B
Gay, bisexual, and other men who have sex with men (MSM) are at elevated risk for certain sexually transmitted infections (STIs), including HIV/AIDS, syphilis, gonorrhea, chlamydia, hepatitis A and hepatitis B. According to the CDC, approximately 10% of new hepatitis A virus (HAV) infections and approximately 15%–25% of all new hepatitis B virus (HBV) infections among adults in the United States are among MSM.

Despite the availability of safe and effective vaccines that can prevent both HAV and HBV infection, many gay and bisexual men have not been adequately vaccinated against viral hepatitis—even though there is a high prevalence of these infections among MSM. Although the HHS Advisory Committee on Immunization Practices recommends hepatitis A and hepatitis B vaccination for MSM, data available from CDC indicates that only about 30 percent of gay men are vaccinated. These statistics make it clear that we need to work together to improve both awareness of and vaccination for HAV and HBV among gay and bisexual men in the United States.

The hepatitis A and B vaccines can be given separately or in a combination vaccine. The vaccines are safe, effective, and require 2-3 shots within a six-month period, depending on the type of vaccine given. To ensure long-term protection, a person should complete all shots in the series. Gay and bisexual men: if you are not sure whether you have been vaccinated for HAV and HBV, ask your healthcare provider at your next appointment. Also, you can find health centers and other community organizations near you that provide hepatitis B vaccine services by visiting this CDC website.

Gay Men and Hepatitis C
Gay and bisexual men are also at increased risk for hepatitis C virus infection if they are involved in high-risk behaviors. This includes sharing needles or other injection drug equipment, which puts a person at risk for both HIV and hepatitis C virus (HCV). Overall, CDC estimates that of all people with HIV infection in the U.S. approximately 25% also have hepatitis C. In addition, new research shows that sexual transmission of HCV can occur, especially among HIV-infected gay men and CDC has reported outbreaks of hepatitis C among HIV-positive gay men in recent years. Good preventive care requires that gay and bisexual men who are HIV-positive also be screened for HCV (and HBV). Routine HCV screening should also be considered for other men who have sex with men with high-risk sexual behaviors including those with STIs. Unfortunately, there is no vaccine to prevent hepatitis C; though there have been recent advances in our ability to treat those living with the infection.

Action Needed
We have the tools to reduce the health impact of viral hepatitis among gay and bisexual men. Safe and effective vaccines are available for hepatitis A and hepatitis B. Accurate tests are available to diagnose chronic hepatitis B and hepatitis C and treatments can control or eliminate these viruses. But increased awareness is critical, among both MSM populations and the providers who deliver their healthcare. My colleagues from across the Department of Health and Human Services as well as the Departments of Veterans Affairs and Justice are working to raise this awareness and decrease the viral hepatitis health disparities experienced by gay and bisexual men.

By Ronald Valdiserri, M.D., M.P.H., Deputy Assistant Secretary for Health, Infectious Diseases, and Director, Office of HIV/AIDS Policy, U.S. Department of Health and Human Services