Hep B Blog

Tag Archives: African immigrant

Raising Awareness about Hepatitis B in African Immigrant Communities in the US

Hepatitis B Foundation Health Outreach Coordinator and Guest Blogger Sierra Pellechio, B.S., CHES discusses her work with the African Immigrant community.   

Hepatitis B affects over 2 million people in the United States, disproportionately affecting Asian, Pacific Islander and African Immigrant (AI) communities in the U.S. Although partners around the U.S. have been trying to increase awareness and improve screening and linkage to care rates among high risk communities, there have been few programs designed to address the urgent need for intervention among U.S. AI communities. An estimated 5% to 18% of African immigrants in the U.S. are affected by hepatitis B, with less than 20% aware of their infection. However, since research and prevalence data specific to AIs are lacking, it has been difficult to understand the true burden of this disease. One thing we do know is that there are significant knowledge gaps and low screening and linkage to care rates in AI communities. If left undiagnosed, people with hepatitis B are at risk of developing liver complications, including cirrhosis and liver cancer, which can lead to premature death, making it vital to identify those affected. This is complicated by the fact that hepatitis B is a silent disease with few or no symptoms for decades.

Last year, the Hepatitis B Foundation, in collaboration with the Centers for Disease Control and Prevention (CDC) and CHIPO (Coalition Against Hepatitis for People of African Origin) launched a pioneering project to create a broad scale educational initiative to promote hepatitis B awareness and testing for AIs across the United States.  The project aims to increase awareness, testing, linkage to care and vaccination among AI’s to align with the goals of the March 2017 A National Strategy for the Elimination of Hepatitis B and C by the U.S. National Academies of Sciences, Engineering, and Medicine (NASEM). This strategy set the goal of eliminating hepatitis B as a public health threat in the U.S. by 2030.

Working with a diverse sixteen-member expert advisory committee comprised of African community leaders, providers, and public health experts from across the U.S., the first phase of this project assessed the individual, community, and society-level barriers that affect hepatitis B screening, vaccination, and linkage to care. Findings revealed that a potentially effective strategy for improving awareness and testing could involve first educating community health workers, who would then serve as trusted educators and advocates to promote education and testing in their communities. In collaboration with the advisory committee, the Hepatitis B Foundation is developing two training modules tailored to community health workers. The modules focus on providing basic hepatitis B information, addressing myths and stigma, and suggesting strategies for incorporating health messages into their work that are culturally and religiously relevant. These educational modules will have an accompanying audio recording, a comprehensive resource guide, and a flipchart for direct community education on hepatitis B. To ensure relevance and effectiveness, these materials will be pilot tested and revised prior to nationwide dissemination. Once the project concludes, resources and materials will be available on the Hepatitis B Foundation and CDC resource pages in early 2019.

If you are a community health worker working in the African Immigrant community and would like to connect, share resources, or learn more, please contact the manager of this project, Sierra Pellechio at sierra.pellechio@hepb.org.

2017 Commemoration of National African Immigrant and Refugee HIV & Hepatitis Awareness (NAIRHHA) Day

On Wednesday, September 13th, the Multicultural AIDS Coalition – Africans For Improved Access (AFIA) program, Hepatitis B Foundation, and Coalition Against Hepatitis for People of African Origin (CHIPO) commemorated NAIRHHA Day by hosting a webinar discussing “Barriers and Strategies to Addressing HIV and Hepatitis B among African Immigrants: A NAIRHHA Day Webinar.” More than 100 people participated in the webinar. The majority represented government agencies and community-based organizations. This year is particularly exciting because lead organizers also submitted a request to HIV.gov (formerly AIDS.gov) to officially recognize NAIRHHA Day on Sept. 9th as a federal HIV awareness day for African immigrants and refugees in the U.S.

As discussed during the commemorating webinar, there is growing data related to the disproportionate impact of hepatitis B, as well as HIV on African immigrants in the US. African immigrants are underdiagnosed due to lower screening rates and present at a later stage of the disease compared to the general US population. Stigma is seen as the major barrier. In addition, the lack of knowledge about transmission, disease prognosis and treatment are widespread, reducing the likelihood that individuals will seek out testing and treatment services.

NAIRHHA Day was launched in 2014 in an effort to address these issues. It is a joint venture organized by the Multicultural AIDS Coalition – Africans For Improved Access (AFIA) program, Hepatitis B Foundation, and Coalition Against Hepatitis for People of African Origin (CHIPO). As explained by Chioma Nnaji, Director at the Multicultural AIDS Coalition – Africans For Improved Access (AFIA) program, “Several of the current awareness days are inclusive of African immigrant communities, but do not comprehensively address their unique social factors, cultural diversity as well as divergent histories and experiences in the US.”

In addition to providing an overview on HIV and HBV epidemiological data, the webinar highlighted findings from two national initiatives. A recent project lead by The Hepatitis B Foundation and Coalition Against Hepatitis for People of African Origin (CHIPO) was funded by the Centers for Disease Control and Prevention (CDC) to better understand the individual, interpersonal, community, and society‐level barriers and facilitators associated with HBV screening, vaccination and linkage to care among African immigrant communities in the US. This project established a 14-member African Immigrant Advisory Board representing non‐profit leaders, community health educators, academics/researchers, government partners, clinicians across 8 states. Through focus groups, interviews and in-person meetings, the Advisory Board documented cultural and religious beliefs, and the complexity of the US healthcare system as major barriers to hepatitis B testing and linkage to care. The Advisory Board also identified approaches to help overcome these barriers, such as working with trusted community leaders, using storytelling, and finding ways to incorporate Western medicine into traditional medicine practices. Next steps will include working with coalition members around the U.S. to develop specific hepatitis education and screening projects that incorporate these strategies.

The webinar also highlighted the Tulumbe! Project. Tulumbe is a Luganda word (language spoken in Uganda) that means, “Let us engage.” The Tulumbe! Project is funded by the Pipeline to Proposals Award under Patient Centered Outcome Research Institute (PCORI) to engage diverse stakeholders in defining areas of need and priorities in HIV services for African immigrants, and identify research topics important to the African immigrant community, African immigrants living with HIV, providers and other stakeholders. Pipeline to Proposals Award funds three tiers of awards that help individuals or groups build community partnerships, develop research capacity, and hone a comparative effectiveness research question that could become the basis of a research funding proposal to submit to PCORI or other health research funders. For more info: https://www.pcori.org/research-results/2017/tulumbe-project-tier-ii

Overall, NAIRHHA Day provides a means for organizations, providers, communities, families, and individuals to:

  • Raise awareness about HIV/AIDS and viral Hepatitis to eliminate stigma
  • Learn about ways to protect against HIV, viral Hepatitis and other related diseases
  • Take control by encouraging screenings and treatment, including viral Hepatitis vaccination
  • Advocate for policies and practices that promote healthy African immigrant communities, families, and individuals

Recognizing September 9th as National African Immigrant & Refugee HIV/AIDS and Hepatitis Awareness Day (NAIRHHA Day) is an important step to addressing issues of HIV and viral hepatitis in the African immigrant community in a culturally and linguistically appropriate way. We are asking you to speak out and support federally recognizing NAIRHHA Day on Sept. 9th by contacting:

  • your local health departments
  • local and national HIV and hepatitis organizations
  • the HIV.gov Team at @HIVGov

Facebook: https://www.facebook.com/NAIRHHA

Twitter: @NAIRHHADay