Abstract：
Screening for viral hepatitis is considered a high-priority area in the Veterans Health Administration (VHA). Yet, few studies have examined viral hepatitis screening test use among low-income veterans who are considered high-risk with limited healthcare access. Using cross-sectional data from 933 participants in the 2021-2022 National Veteran Homeless and Other Poverty Experiences (NV-HOPE) study, we examined rates and correlates of lifetime screening for hepatitis B (HBV) and hepatitis C (HCV) infections. Multivariable logistic regression models evaluated characteristics associated with HBV/HCV screening. Nearly 16% and 21% reported lifetime HBV and HCV screening, respectively. These rates are considerably lower than HBV (47.3%) and HCV (92.9%) screening rates documented among contemporaneous veterans in VHA electronic health records. In the NV-HOPE data, veterans 50-79 years were more likely than those ≥80 years of age to ever-screen for HBV/HCV. Whereas, household income was inversely related to lifetime screening behaviours, veterans reporting \'other\' employment types (vs. full-time/part-time employment) were more likely to ever-screen for HBV/HCV. Ever-screening for HBV was more likely among veterans reporting non-Hispanic \'other\' (vs. non-Hispanic \'white\') race, housing instability, Medicaid insurance, as well as drug use and cognitive disorder histories. Living with ≥5 members (vs. alone), histories of alcohol use, cancer, and liver disorders were also correlated with ever-screening for HCV. HIV/AIDS history correlated with ever-screening for HBV/HCV. In conclusion, fewer than one-third of low-income US veterans ever-screened for HBV/HCV, with lower screening rates among those less likely to be exposed to viral hepatitis, thereby informing interventions aimed at promoting available screening, treatment and vaccinations for HBV/HCV.
摘要：
病毒性肝炎的筛查被认为是退伍军人健康管理局（VHA）的高度优先领域。然而，很少有研究在低收入退伍军人中检查病毒性肝炎筛查测试的使用情况,这些退伍军人被认为是高风险人群,医疗服务有限.使用2021-2022年国家退伍军人无家可归和其他贫困经历（NV-HOPE）研究中933名参与者的横截面数据，我们检查了乙型肝炎（HBV）和丙型肝炎（HCV）感染的终生筛查率和相关性。多变量逻辑回归模型评估与HBV/HCV筛查相关的特征。近16％和21％报告终身HBV和HCV筛查，分别。这些比率远低于HBV（47.3％）和HCV（92.9％）筛查率，在VHA电子健康记录中同期退伍军人中记录。在NV-HOPE数据中,50-79岁的退伍军人比年龄≥80岁的退伍军人更有可能筛查HBV/HCV。然而,家庭收入与终生筛查行为成反比，退伍军人报告“其他”就业类型(与全职/兼职工作）更有可能筛查HBV/HCV。在报告非西班牙裔“其他”的退伍军人中，HBV筛查的可能性更大(与非西班牙裔\'白人\')种族，住房不稳定，医疗补助保险,以及吸毒和认知障碍史。与≥5名成员一起生活(vs.单独),饮酒史,癌症,肝脏疾病也与HCV筛查相关.HIV/AIDS病史与HBV/HCV筛查相关。总之,不到三分之一的低收入美国退伍军人曾经筛查过HBV/HCV，在那些不太可能接触病毒性肝炎的人群中，筛查率较低，从而告知旨在促进可用筛查的干预措施，HBV/HCV的治疗和疫苗接种。
