Prevalence of chronic hepatitis B virus infection, sexual risk behaviors, and hepatitis B vaccination among heterosexual men at sexually transmitted infections clinic, Bangkok, Thailand

  • เอกชัย แดงสอาด Bangrak Sexually Transmitted Infections Cluster, Department of Disease Control
  • ปณิธี ธัมมวิจยะ Bureau of Epidemiology, Department of Disease Control
  • นัทธวิทย์ สุขรักษ์ Bangrak Sexually Transmitted Infections Cluster, Department of Disease Control
  • ปิยะวดี ทองโปร่ง Faculty of Nursing, Ratchathani University
  • นพนัฐ จำปาเทศ Faculty of Nursing, Huachiew Chalermprakiet University
  • ยศพล เหลืองโสมนภา Phrapokklao Nursing college, Chanthaburi
Keywords: prevalence, hepatitis B virus, vaccination, sexually transmitted infections clinic


Hepatitis B virus (HBV) infection remains a health problem among people in many regions worldwide. The disease can be prevented by vaccination. Risk factors for infection include unprotected sexual intercourse and permucosal exposure to infected blood or other fluid. The objectives of this study were to (1) estimate  prevalence of chronic HBV infection (2) describe sexual risk behaviors, and (3) estimate coverage of HBV vaccination among male patients attending STIs clinic. We conducted a retrospective descriptive study using 827 medical records sampled from male patients visiting the clinic between October 2013 and September 2016. Descriptive statistics, 95% Confidence Interval, and Chi-square test were employed for data analysis. The finding indicated that chronic HBV infection among male patients attending STIs clinic was 3.3% (95% CI 2.3-4.7). Mean age was 36.8 years (SD = 12.7). In this study, 56.6% of the male patients were diagnosed with STIs. Consistent condom use in the past 3 months was 14.0%. Among those with no history of HBV infection, 17.8% received three doses of compulsory HBV vaccination. Age of patients (25≥ years) has been found to have statistically significant association  with having higher HBV immunity (either from past infection or getting HBV vaccination). Therefore, interventions to promote HBV vaccination among male patients attending STIs clinics with the emphasis on a lower age group or those having sexual risk behaviors is highly recommended.


Download data is not yet available.


1. Lavanchy D. Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J Viral Hepat 2004;11:97-107.

2. Hou J, Liu Z, Gu F. Epidemiology and prevention of hepatitis B virus infection. Int J Med Sci 2005;2:50-7.

3. Chongsrisawat V, Yoocharoen P, Theamboonlers A, Tharmaphornpilas P, Warinsathien P, Sinlaparatsamee S, et al. Hepatitis B seroprevalence in Thailand: 12 years after hepatitis B vaccine integration into the national expanded programme on immunization. Trop Med Int Health 2006;11:1496-502.

4. Sungkanuparph S, Vibhagool A, Manosuthi W, Kiertiburanakul S, Atamasirikul K, Aumkhyan A, et al. Prevalence of hepatitis B virus and hepatitis C virus co-infection with Human Immunodeficiency virus in Thai patients: a tertiary-care-based study. J Med Assoc Thai 2004;87:1349-54.

5. Liaw YF, Chu CM. Hepatitis B virus infection. Lancet 2009;373:582-92.

6. Samoff E, Dunn A, Vandevanter N, Blank S, Weisfuse IB. Predictors of acceptance of hepatitis B vaccination in an urban sexually transmitted diseases clinic. Sex Transm Dis 2004;31:415-20.

7. Chokephaibulkit K, Lapphra K, Mekmullika J, Narkbunnam T, Tangsathapornpong A. Vaccine and immunization 2013. 3rd ed. Bangkok: Suansunandha Rajabhat University; 2015. (in Thai)

8. Harris JL, Jones TS, Buffington J. Hepatitis B vaccination in six STD clinics in the United State committed to integrating viral hepatitis prevention services. Public Health Rep 2007;122:42-7.

9. Chirawatkul A. Statistics for health science research. 3rd ed. Bangkok: Witthayaphat; 2013. (in Thai)

10. Leroi C, Adam P, Khamduang W, Kawilapat S, Ngo-Giang-Huang N, Ongwandee S, et al. Prevalence of chronic hepatitis B virus infection in Thailand: a systematic review and meta-analysis. Int J Infect Dis 2016;51:36-43.

11. Eric EM, Harold SM, Anthony EF, Edward WB, Susan TG, Susan AW, et al. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States. MMWR 2005;54:1-34.

12. Otta JJ. Stevens GA, Groeger J. Wiersma, ST. Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg seroprevalence and endemicity. Vaccine 2012;30:2212-9

13. Risbud A, Mehendale S, Basu S, Kulkarni S, Walimbe A, Arankalle, et al. Prevalence and incidence of hepatitis B infection in STD clinic attendees in Peru, India. Sex Transm Infect 2002;78:169-73.

14. Duynhoven YT van, Laar MJW van de, Schop WA, Rothbarth WI, Rothbarth PhH, Loon AM van, et al. Prevalence and risk factors for hepatitis B virus infections among visitors to an STD clinic. Genitourin Med 1997;73:488-92.

15. Bureau of Epidemiology, Department of Disease Control. The report of surveillance behavior related HIV infection among military conscripts, male and female sex workers in brothel, Thailand 2017 [Internet]. [cited 2018 Apr 6]. Available from:รายงานผลการเฝ้าระวังพฤติกรรมที่สัมพันธ์กับการติดเชื้อเอชไอวี.pdf (in Thai)

16. Hechter RG, Jacobsen SJ, Luo Y, Nomura JH, Towner WJ, Tartof SY, et al. Hepatitis B testing and vaccination among adult with sexually transmitted infections in a large managed care organization. Clin Infect Dis 2014;58:1739-45.

17. Wasley A, Kruszon-Moran D, Kujnert W, Simard EP, Finelli L, McQuillan G, et al. The prevalence of hepatitis B virus infection in the United States in the era of vaccination. J Infect Dis 2010;202(2):192-201.

18. Boyd A, Bottero J, Carrat F, Gozlan J, Rougier H, Girard PM, et al. Testing for hepatitis B virus alone does not increase vaccine coverage in non-immunized person. World J Gastroenterol 2017;23:7037-46.

19. Udomluck S, Pinitchan A, Aunng MN, Thaveepuk P, Langrak C. Vaccination, knowledge and awareness to prevent Hepatitis B infection among nursing students of Boromarajonani College Nursing, Chainat. Nursing Journal of the Ministry of Public Health 2014;4;92-104. (in Thai)
Original Article