Discussion
acute infection, deaths, hepatitis, HBV infection
ACUTE INFECTION, NAIROBI, HIV INFECTION, RECRUITMENT, HEPATITIS B, HEPATITIS
Overall, we found that HBV prevalence and immunity due to Hepatitis B vaccination were low among participants who were screened for SiVET studies in Uganda and Kenya with two thirds of participants having test results suggesting no prior HBV infection. We did observe significant heterogeneity among study populations, with a higher prevalence of persons living with HBV in Uganda than in Kenya. This prevalence we report is lower than that seen from recent surveys among various KPs in South Africa [A high proportion of our participants had no prior exposure to Hepatitis B with only 9 out of every 100 participants having immunity due to Hepatitis B vaccination. Despite this, they had continued sexual exposure which increases the risk of acute infection in adults and is shown to contribute 23.5% of hepatitis related deaths [Older individuals (≥25 years) had a lower likelihood of having no prior HBV infection. As with HIV infection, older age has been associated with higher HBV prevalence among KPs [Overall, being from Kampala or Nairobi irrespective of main occupation was associated with a higher likelihood of having no prior HBV infection. The likelihood of having no prior HBV infection was up to 2.5 times higher among individuals whose main job was categorized as informal high risk if they were from Kampala and Nairobi compared to their counterparts in Entebbe. A similar pattern was seen among individuals from Kampala with informal low risk jobs whose likelihood of having no prior HBV infection was higher than individuals from Entebbe with informal high-risk jobs. These findings suggest that site rather than occupation is associated with the odds of having no prior HBV infection and could be explained by the different site recruitment procedures. Entebbe recruited directly from two fishing communities, Kampala recruited from the Good Health for Women Project (GHWP) clinic serving FSWs while Nairobi recruited from the Sex Workers Outreach Program (SWOP-Kenya) clinics serving FSWs and MSM. The GHWP and SWOP-Kenya clinics had been in existence since 2008 [