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What the LGBTQ community should know about Hepatitis A

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What is Hepatitis A?

Hepatitis A is a contagious infection caused by the hepatitis A virus. Hepatitis A, like other hepatitis viruses, causes liver inflammation and affects its ability to function. Most hepatitis A infections are mild to severe, and almost everyone recovers fully with a lifelong immunity thereafter. However, a safe and effective hepatitis A vaccine is available for prevention. 

Symptoms of hepatitis A can include fever, malaise, loss of appetite, diarrhea, nausea, dark-colored urine, and jaundiceโ€”a yellowing of the skin and eyes. These symptoms range from mild to severe and not everyone will have the same symptoms. Most of the time, rest and a balanced diet including healthy food and lots of fluids are enough to treat the symptoms of hepatitis A. 

How is Hepatitis A Spread?

Hepatitis A is primarily spread when an uninfected and unvaccinated person ingests food or water thatโ€™s contaminated with the hepatitis A virus, or through direct contact with an infectious person. The virus is found in the stool (feces) of HAV-infected people, so hepatitis A can easily spread if something that has been contaminated with the stool of a person with hepatitis A is put in another personโ€™s mouth. This can happen when people do not wash their hands and then touch or prepare other peopleโ€™s food, or through oral and anal sex

Who is At Risk for Hepatitis A?

Anyone who has not been vaccinated or previously infected with hepatitis A can get infected with the hepatitis A virus. Among poor sanitation and a lack of safe water, being the sexual partner or someone who is infected and sex between men are risk factors for contracting the hepatitis A virus. 

What LGBTQ+ People Should Know About Hepatitis A

Rates of hepatitis A (and B) are disproportionately high among gay and bisexual men and transgender women. 

Among adults, an estimated 10% of new hepatitis A cases occur in gay and bisexual men. Since hepatitis A can be spread by ingesting even microscopic, unseeable fecal matter, men who have sex with men can pass the virus through direct anal-oral contact or contact with fingers or objects that were in or near the anus. 

Who Should Get Vaccinated For Hepatitis A?

The Centers for Disease Control and Prevention (CDC) recommends hepatitis A vaccination for all children in the United States when they are one year of age. The CDC also recommends the hepatitis A vaccine if a child has not been previously vaccinated and they are not yet 18.

The hepatitis A vaccine is also recommended for adults in certain risk groups, which include:

  • People traveling to or working in areas outside the United States where hepatitis A is common
  • People with HIV infection
  • Men who have sex with men
  • People who use injectable and non-injectable street drugsย 

The hepatitis A vaccine is made from the inactive virus and is safe and effective. There are few side effects, but the most common include soreness around the injection site, mild headache, loss of appetite, and fatigue.

Experts recommend that gay and bisexual men get vaccinated for hepatitis A and B, which can be given separately or as a combination. There is no vaccine for hepatitis C.

LGBTQ+ People and the Hepatitis A Vaccine

Recent studies published by Fenway Health and MPact Global Action have highlighted the need to LGBTQ-affirming health care settings in order for vaccination rates among LGBTQ groups to increase. The studies found that LGBTQ-identifying people had a fear of being stigmatized in a health care setting due to previous negative experiences, which contributed to low vaccination rates. 

Some of the studiesโ€™ participants reported feeling judged by health care providers for their sexual orientation, gender identity, and/or sexual practice. 

โ€œMany of our focus group participants described interactions with health care providers that were judgmental and even voyeuristic,โ€ said Jonathan Hill-Rorie, a mental health practitioner and co-author of both studies. โ€œAt the same time, many gay and bisexual men and transgender people are open to getting vaccinated against hepatitis infection. If we can address the structural and institutional barriers to care and leverage the positive attitudes LGBTQ people have toward vaccines, we have a real opportunity to improve health outcomes and protect gay and bisexual men and transgender people against hepatitis A and B.โ€

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