Knowledge of Viral Hepatitis Among Puerto Rican Adults: Implications for Prevention

Abstract

Although primary prevention of HAV and HBV can be achieved through vaccination, the burden of HCV can only be reduced through behavioral interventions to reduce its risk factors. This study evaluated knowledge regarding transmission, clinical manifestations and prevention of viral hepatitis in Puerto Rico. We assessed the level of knowledge about HAV (six questions), HBV (12 questions) and HCV (eight questions) among non-institutionalized Puerto Rican adults aged 21–64 years. Demographic characteristics and self-reported knowledge of these infections were determined through a face-to-face interview. A mean knowledge score was computed by summing correct responses to each scale. Mean knowledge scores according to demographics were compared using ANOVA or the Kruskal–Wallis test. Mean knowledge scores for HAV, HBV and HCV infections were 2.6 ± 1.5, 6.1 ± 2.4, and 3.6 ± 1.1, respectively. For HAV and HBV infections, the mean knowledge score significantly (P < 0.05) increased with age, level of counseling received and number of sources of information. However, for HCV infection the mean knowledge score significantly increased with decreasing age, increased educational level and increased annual family income. Contrary to HBV, a higher HAV and HCV knowledge score was observed among individuals with history of vaccination for HAV and HBV, seropositive status for HAV and HCV, and history of drug use. A sizeable proportion of adults in this study demonstrated an inadequate level of knowledge, especially about transmission routes. Health education must be focused on transmission and prevention methods, including the availability of a vaccine for HAV and HBV, especially among those with chronic liver disease.

Risk Factors for Liver Disease and Associated Knowledge and Practices Among Mexican Adults in the US and Mexico

“…This proportion is consistent with the findings reported by other studies with Asian populations (47.5-69%) [24,27] and is lower than the results of a recent study in Puerto Rico (74.4%) [30]. Less than 10% of the respondents correctly indicated that HBV is more easily spread than HIV, which is also lower than the range of 19-27% reported in other studies [24,30]. A mere 36% of study subjects correctly reported that a HBV vaccine exists, which is substantially lower than the finding of 52.5% reported by Soto-Salgado et al [30].…”

“…Only 53% of the participants responded correctly that HBV and HCV can be spread during sexual intercourse with an infected person. This proportion is consistent with the findings reported by other studies with Asian populations (47.5-69%) [24,27] and is lower than the results of a recent study in Puerto Rico (74.4%) [30]. Less than 10% of the respondents correctly indicated that HBV is more easily spread than HIV, which is also lower than the range of 19-27% reported in other studies [24,30].…”

“…Although nearly all of the participants correctly reported that drinking alcohol in excess is a risk factor for liver disease, only 60% correctly identified being overweight or obese, or having diabetes as risk factors for liver disease. Our results confirm those of other studies that report inadequate levels of knowledge about HBV and HCV, especially with regard to transmission mechanisms [24,27,30,38]. Only 53% of the participants responded correctly that HBV and HCV can be spread during sexual intercourse with an infected person.…”

“…Less than 10% of the respondents correctly indicated that HBV is more easily spread than HIV, which is also lower than the range of 19-27% reported in other studies [24,30]. A mere 36% of study subjects correctly reported that a HBV vaccine exists, which is substantially lower than the finding of 52.5% reported by Soto-Salgado et al [30]. Regarding the long-term consequences of infection with HBV or HCV, two-thirds of the participants correctly reported that infection with HBV or HCV can cause liver cancer and can be fatal (81%); with a lower proportion responding correctly that infection can be incurable (20%) and last a lifetime (41%).…”

“…These studies report that the rates of HBV vaccination and the knowledge about how to prevent infection with HBV and HCV are very low [25][26][27]. There are few published studies that focus on other risk factors for liver disease, such as alcohol abuse, obesity, and diabetes [28,29], and very few have been conducted among Latino populations [30]. Furthermore, there is no published data about the liver disease risk factors, knowledge, and prevention practices among Mexicans in the US and Mexico.…”