Factors affecting awareness of Hepatitis B status among Bhutanese, Karen, Somali, and Central African Refugee populations in Tarrant County: Building Bridges Initiative (BBI)

Background: Hepatitis B Virus is reported to be the leading cause of liver cancer in the United States, and 90% are foreign born. The CDC recommends HBV screening for newly arrived refugees who have lived in countries with a high prevalence of chronic HBV infection. Nearly 14,000 refugees resettled in Texas in 2014. Currently, limited data is available on refugee awareness of HBV. This study aims to investigate what factors influence their awareness of HBV status. Methods: Four community health workers conducted outreach and baseline assessments in their respective communities (i.e. Bhutanese, Burmese, Somali and Central African). Means, t-tests, and chi-square tests evaluated the influence of time in the US, education, and group on awareness of self-reported Hepatitis B status at baseline. Results: Approximately 350 women have participated in BBI. 60% had heard of hepatitis B. Only 26% were aware of their Hepatitis B status. The bivariate analysis showed nearly half of the central African women were aware for their HBV status (47.3%) in comparison with Somali (30.8%), Burmese (18.7%), Bhutan (3.3%). On average, participants lived in the US for approximately 5 years. Education and region were not significantly associated with awareness of HBV status. Conclusion: Majority (74%) of refugees are unaware of their Hepatitis B status. Time in the U.S., nor formal education influence HBV status awareness. However, awareness between regions shows that the differences within ethnic groups (traditions, health care beliefs) need to be considered. Refugee populations remain in need of culturally and linguistically appropriate cancer prevention programs.