Factors Associated With Hepatitis B Exposure Among People Who Report Using Methamphetamine: National Health and Nutrition Examination Survey 2009–2016

Abstract Background With the nation’s focus on the opioid crisis, methamphetamine has made a comeback, potentially increasing risk for hepatitis B. We examined factors associated with hepatitis B virus (HBV) exposure among people who reported ever using methamphetamine in a nationally representative survey. Methods We used the National Health and Nutrition Examination Survey to examine factors associated with HBV exposure among participants who reported ever using methamphetamine using bivariate and multivariable logistic regression. Results Overall, 847 participants met the study inclusion criteria. In multivariable logistic regression, female sex (adjusted odds ratio, 3.83; 95% confidence interval, 1.65–8.90), living below the poverty threshold (3.17; 1.39–7.21), injection drug use (4.89; 1.95–12.26), active hepatitis C virus infection (3.39; 1.10–12.26), and identifying as men who have sex with men (28.21; 5.19–153.38) were significantly associated with HBV exposure. Conclusions The odds of HBV exposure for female participants who reported using methamphetamine were 4 times than that for male participants. Poverty, injection drug use, and hepatitis C virus infection were also associated. As methamphetamine use increases, it is critical to identify those at risk of acquiring HBV infections in order to target testing and vaccination. Factors associated with hepatitis B exposure among National Health and Nutrition Examination Survey participants who reported ever using methamphetamine include female sex, injection drug use, living below the poverty level, and active hepatitis C infection.