Understanding cultural barriers in hepatitis B virus infection
ABSTRACT The prevalence of hepatitis B virus (HBV) infection in the Asian American population is disproportionately high compared with the US population as a whole. Effective management is difficult because of cultural barriers, which can be better understood with recognition of the diversity of the Asian continent in terms of language and spiritual beliefs. Barriers to care among the Asian American population include educational deficits, low socioeconomic status, lack of health insurance, noncitizenship, inability to communicate in English, negative perceptions of Western medicine, and underrepresentation among health care professionals. Given the diversity of the population, some subpopulations may be more directly affected by certain barriers than others. The resulting delays in seeking care can lead to poor outcomes and risk of HBV transmission to household members. Health care providers are obligated to educate themselves regarding cultural sensitivity and to advocate for improved access to care.
Article: Hepatitis B in Pregnancy[Show abstract] [Hide abstract]
ABSTRACT: Hepatitis B remains a global health issue, despite an effective vaccine. Mother to child transmission (MTCT) of hepatitis B has become increasingly recognized, especially in those patients with high maternal viremia. In a woman of childbearing age, carefully assessing disease status and urgency of treatment is key, along with discussion of family planning, timing and choice of therapy. In a pregnant patient with chronic hepatitis B, treatment in the third trimester may be considered in those with HBV DNA levels >107 copies (2 × 106 IU/ml) and may reduce the perinatal transmission rate, but a thorough discussion of the risks and benefits is essential. Duration of antiviral therapy depends upon the indication for treatment as those individuals treated for active disease from the hepatitis B would need long term therapy, while those treated in the third trimester only to prevent MTCT may have therapy discontinued.Current Hepatitis Reports 03/2013; 12(1). DOI:10.1007/s11901-012-0154-2
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ABSTRACT: The diagnosis and treatment of STDs is a common problem in primary care practice; however, newer diagnostic and therapeutic alternatives require physicians to be aware of evidence-based guidelines that are continuing to evolve. The treatment of STDs in men, in particular, is an area of evolving evidence because much of what is known is based on the treatment of STDs in women. Men represent unique challenges in diagnosis, evaluation, and follow-up that need to be considered in the treatment of urethritis, epididymitis, herpes genitalis, condyloma, prostatitis, and other syndromes. Screening for asymptomatic STDs is currently not recommended in the general population, but selected criteria can be used to identify a target population for screening in high-risk areas.Primary Care Clinics in Office Practice 04/2003; 30(1):173-91. DOI:10.1016/S0095-4543(02)00073-8 · 0.83 Impact Factor