可以透過疫苗預防的A型肝炎正在同性戀、雙性戀和跨性別者中傳播
Jack Harrison-Quintana, Emmett Patterson / aidsmap news/ 2019年10月4日/財團法人台灣紅絲帶基金會編譯
美國各地的醫療保健提供者正在為一場正迅速接近流行的疾病– A型肝炎展開一場寧靜而又不懈的戰鬥。
A型肝炎是一種會影響肝臟的病毒。它具有高度傳染性,通常通過食用受污染的食物或水傳播。但是,A型肝炎也可以透過肛交、舔肛或指交傳播。
美國許多州,尤其是中西部和東南部的州,A型肝炎發病率急劇上升。2015年,全國僅報告1,390例A型肝炎病例。但是,由於當前的爆發是在2016年底首次發現的,因此已經報告了超過26,000例病例。由於這些爆發滬流行的結果,全美範圍內的住院率很高,至少有260人死亡。
目前已改變的是誰正在感染A肝?為什麼?
過去,A型肝炎最常與食物和水的污染有關。對於無家可歸的人和注射毒品的人來說,該病毒是一個特殊的挑戰。但是,A型肝炎現正在男同性戀、雙性戀和跨性別者社區中以性傳播的方式迅速增長。
幸運的是,A型肝炎是可以預防的。已顯示一劑A型肝炎疫苗可控制爆發,並在健康成年人中提供長達11年且具95%的保護效果。
年齡較大,感染愛滋病毒,無家可歸和/或注射藥癮的LGBTQ人群可能更容易感染由A型肝炎引起的嚴重肝臟感染。多數人在經由醫療監督下可逐漸康復,但是,由於我們知道LGBTQ人們在醫療保健系統中會遭受虐待和拒絕照護,因此,即使不是不可能,獲得像疫苗一樣的常規預防性照護也可能具有挑戰性。
美國疾病控制和預防中心、衛生部門以及活躍於A型肝炎地區的社區組織一直在不懈地努力,以提高人們對這種疾病的認識並推廣這種疫苗。在Grindr的倡導部門「平等的Grindr」(Grindr for Equality,註)中,我們透過在受影響最嚴重的地區(包括維吉尼亞州,伊利諾伊州和西雅圖)提供有關Grindr應用程序中的爆發流行警示來提高意識,從而支持了他們的使命。
信息很明確:做愛的人都應該接種疫苗。
作為一個社區,我們需要繼續支持提供A型肝炎疫苗以及其他性健康服務(例如HIV檢測)的衛生部門和社區組織。我們敦促醫療保健提供者為所有顧客(尤其是那些LGBTQ的顧客)獲取精準和確認的性健康史。圍繞在肛交、舔肛和整個肛門健康上的污名,可能會阻止LGBTQ者公開分享準確的性健康史,從而可能阻止他們應該成為疫苗接種明顯的對象。不論是否發生性行為,藥物使用者或無家可歸的LGBTQ人群也應被告知有關疫苗的訊息。
如果您是LGBTQ且關心您的社區,那麼最好的方法就是與您的醫療保健提供者或當地衛生部門聯繫去接種A型肝炎疫苗。告訴您的伴侶和朋友接種疫苗。我們理應控制自己的性健康。大家一齊來,我們可以阻止這些流行爆發,並確保我們的社區保持健康。
註:Grindr for Equality:平等的Grindr,藉由該應用程式的全球性網絡,致力於為所有性取向和性別認同的人們提供一個安全,公正和包容的世界。
Hepatitis A, Preventable by a Vaccine, Is Spreading Among Gay, Bi and Trans People
Jack Harrison-Quintana, Emmett Patterson / aidsmap news / Oct. 4, 2019
FotoDuets via iStock
Health care providers across the United States are waging a quiet yet tireless battle over a disease that is quickly approaching epidemic status — hepatitis A.
Hepatitis A is a virus that impacts the liver. It is highly contagious and is usually transmitted by consuming contaminated food or water. However, hepatitis A can also be spread through anal sex, rimming, or fingering.
Many states, particularly in the Midwest and the Southeast, have seen a dramatic spike in hepatitis A rates. In 2015, there were only 1,390 reported cases of hepatitis A in the nation. However, since the current outbreaks were first identified in late 2016, more than 26,000 cases have been reported. High rates of hospitalization and at least 260 deaths have occurred nationwide as a result of these outbreaks.
What has changed is who is getting hepatitis A and why.
In the past, hepatitis A has most commonly been associated with food and water contamination. The virus has been a particular challenge for people experiencing homelessness and people who inject drugs. But hepatitis A is now growing rapidly in gay, bisexual, and transgender communities, transmitted during sex.
Fortunately, hepatitis A is preventable. One dose of hepatitis A vaccine has been shown to control outbreaks and provides up to 95% protection in healthy adults for 11 years.
LGBTQ people who are older, living with HIV, experiencing homelessness, and/or injecting drugs may be more vulnerable to a serious liver infection caused by hepatitis A. Most people typically recover from hepatitis A with medical supervision; however, because we know LGBTQ people experience mistreatment and denial of care in the health care system, getting routine preventive care like vaccines can be challenging, if not impossible.
The U.S. Centers for Disease Control and Prevention, health departments, and community-based organizations in areas with active hepatitis A have been working tirelessly to create awareness and promote vaccines for the disease. At Grindr for Equality, Grindr’s advocacy arm, we have supported their mission by working to generate awareness through outbreak alerts on the Grindr application in the most impacted areas, including Virginia, Illinois, and Seattle.
The message is clear: Anyone who is having sex should get vaccinated.
We as a community need to continue to support health departments and community organizations that are offering hepatitis A vaccines as well as other sexual health services, like HIV testing. We urge health care providers to take accurate and affirming sexual health histories for all clients, especially those who are LGBTQ. Stigma around anal sex, rimming, and anal health overall may discourage LGBTQ people from openly sharing an accurate sexual health history and thereby might prevent them from being obvious candidates for vaccination. LGBTQ people who use drugs or experience homelessness should also be informed about the vaccine regardless of how they have sex.
If you’re LGBTQ and concerned about your community, the best thing you can do is get vaccinated for hepatitis A with your health care provider or local health department. Tell your partners and friends to get vaccinated. We deserve to take control of our sexual health. Together, we can stop these outbreaks and ensure our community stays healthy.