Factors associated with uptake and offer of Hepatitis B vaccines among people who use drugs: A scoping review.

Abstract

Background: Hepatitis B vaccination uptake among high-risk populations, especially people who use drugs, is crucial for preventing and controlling hepatitis B virus (HBV) infection. However, there are significant barriers to vaccine acceptance and accessibility within this population, leading to low vaccine coverage rates and increased vulnerability to HBV infection. Therefore, this scoping review aimed to explore the factors influencing hepatitis B vaccination uptake among high-risk populations, with a specific focus on people who use drugs. The objectives were to identify the key barriers and facilitators of vaccine uptake, examine the strategies employed to improve vaccine acceptance and accessibility and highlight any gaps in the existing research.

Methods: A comprehensive search of electronic databases, including PubMed, Embase, and Scopus, was conducted to identify relevant studies published between 2002 and 2022. The search strategy utilized a combination of keywords related to people who use drugs, hepatitis B, vaccination, and related concepts. A total of 92 articles were initially identified, and after the screening process, 9 studies were included in the scoping review. The selected studies encompassed a range of research designs, including cross-sectional surveys, qualitative interviews, and intervention studies, conducted in diverse geographical locations.

Results: The scoping review identified several factors hindering hepatitis B vaccine uptake among people who use drugs. Access barriers, including limited access to healthcare facilities, conflicts in scheduling vaccine appointments, and language and racism factors, emerged as common themes. Affordability barriers, such as financial limitations and high vaccine costs, were also prominent. Acceptance barriers, including fear, stigma, and discrimination, significantly influenced vaccine uptake. Limited awareness and knowledge about hepatitis B and its prevention were identified as important barriers. Activation barriers, related to fear-based advertising and lack of convincing messages, also affected vaccine acceptance.

Conclusion: The findings of this scoping review highlight the need for targeted interventions and strategies to improve hepatitis B vaccine acceptance and accessibility among high- risk populations, particularly people who use drugs. Integration of vaccination services within existing healthcare systems, tailored interventions that address the specific needs of these populations, and efforts to improve access, affordability, awareness, and acceptance of the vaccine are crucial. Strengthening healthcare provider engagement, enhancing provider education and communication skills, and addressing socioeconomic and logistical barriers are recommended. Further research is needed to validate these findings and evaluate the effectiveness of specific interventions in diverse populations.