{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:20:44Z","timestamp":1790076044768,"version":"4.0.1"},"reference-count":18,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2009,11,1]],"date-time":"2009-11-01T00:00:00Z","timestamp":1257033600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Public Health Rep"],"published-print":{"date-parts":[[2009,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives.<\/jats:title>\n                    <jats:p>Homeless adults have an increased risk of infectious diseases due to sexual and drug-related behaviors and substandard living conditions. We investigated the prevalence and risk factors for presence of hepatitis A virus (HAV) antibodies among homeless and marginally housed adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods.<\/jats:title>\n                    <jats:p>We analyzed serologic and questionnaire data from a study of marginally housed and homeless adults in San Francisco from April 1999 to March 2000. We tested seroprevalance for total antibodies to HAV (anti-HAV) and analyzed data using Chi-square tests and logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results.<\/jats:title>\n                    <jats:p>Of the 1,138 adults in the study, 52% were anti-HAV positive. The anti-HAV prevalence in this study population was 58% higher than the expected prevalence based on age-specific prevalence rates from the general population. Number of years of homelessness (\u22641, 2-4, and \u22655 years) was associated with anti-HAV prevalence (46%, 50%, and 61%, respectively, p&lt;0.001). We found other differences in anti-HAV prevalence (p&lt;0.05) for ever having injected drugs (63% vs. 42% for non-injectors), being foreign-born (75% vs. 51% among U.S.-born), race\/ethnicity (72%, 53%, and 45% for Hispanic, white, and black people, respectively), and increasing age (38%, 49%, and 62% among those aged &lt;35, 35-45, and &gt;45 years, respectively). These variables all remained significant in a multivariate model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions.<\/jats:title>\n                    <jats:p>We found overall anti-HAV prevalence elevated in this San Francisco homeless population compared with the general U.S. population. These data show that anti-HAV was associated with homelessness independent of other known risk factors, such as being foreign-born, race\/ethnicity, and injection drug use. This increase indicates an excess risk of HAV infection and the potential need to offer hepatitis A vaccination as part of homeless services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/003335490912400608","type":"journal-article","created":{"date-parts":[[2017,7,3]],"date-time":"2017-07-03T01:54:40Z","timestamp":1499046880000},"page":"813-817","source":"Crossref","is-referenced-by-count":28,"title":["Hepatitis A Seroprevalence and Risk Factors among Homeless Adults in San Francisco: Should Homelessness Be Included in the Risk-Based Strategy for Vaccination?"],"prefix":"10.1177","volume":"124","author":[{"given":"Karen A.","family":"Hennessey","sequence":"first","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Bangsberg","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School, Harvard Initiative for Global Health, Cambridge, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy","family":"Weinbaum","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith A.","family":"Hahn","sequence":"additional","affiliation":[{"name":"University of California San Francisco, San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2009,11,1]]},"reference":[{"issue":"15","key":"bibr1-003335490912400608","first-page":"1","volume":"45","year":"1996","journal-title":"MMWR Recomm Rep"},{"issue":"3","key":"bibr2-003335490912400608","first-page":"1","volume":"56","author":"Wasley A","year":"2007","journal-title":"MMWR Surveill Summ"},{"issue":"7","key":"bibr3-003335490912400608","first-page":"1","volume":"55","author":"Fiore AE","year":"2006","journal-title":"MMWR Recomm Rep"},{"key":"bibr4-003335490912400608","first-page":"33","volume":"29","year":"2001","journal-title":"Disease Control Newsletter"},{"key":"bibr5-003335490912400608","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-200308000-00011"},{"key":"bibr6-003335490912400608","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.20464"},{"key":"bibr7-003335490912400608","doi-asserted-by":"publisher","DOI":"10.1097\/00004836-200204000-00021"},{"key":"bibr8-003335490912400608","doi-asserted-by":"publisher","DOI":"10.1258\/0956462001916416"},{"key":"bibr9-003335490912400608","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199801293380503"},{"key":"bibr10-003335490912400608","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2005.065094"},{"key":"bibr11-003335490912400608","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1497.2006.00493.x"},{"key":"bibr12-003335490912400608","volume-title":"SAS\u00ae: Version 9.1","author":"SAS Institute, Inc.","year":"2002"},{"key":"bibr13-003335490912400608","first-page":"293","volume":"165","author":"Ochnio JJ","year":"2001","journal-title":"CMAJ"},{"key":"bibr14-003335490912400608","doi-asserted-by":"publisher","DOI":"10.1007\/BF03404552"},{"key":"bibr15-003335490912400608","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-842X.2007.00056.x"},{"key":"bibr16-003335490912400608","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2005.03.060"},{"key":"bibr17-003335490912400608","doi-asserted-by":"publisher","DOI":"10.1086\/593675"},{"key":"bibr18-003335490912400608","doi-asserted-by":"publisher","DOI":"10.1086\/513757"}],"container-title":["Public Health Reports\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/003335490912400608","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/003335490912400608","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T09:28:08Z","timestamp":1777627688000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/003335490912400608"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,11]]},"references-count":18,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2009,11]]}},"alternative-id":["10.1177\/003335490912400608"],"URL":"https:\/\/doi.org\/10.1177\/003335490912400608","relation":{},"ISSN":["0033-3549","1468-2877"],"issn-type":[{"value":"0033-3549","type":"print"},{"value":"1468-2877","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,11]]}}}