Strategies for Prevention of Hepatitis B as a Sexually Transmitted Disease

In industrialized western nations where sexual contact is a predominant mechanism of transmitting hepatitis B, benefiticost models can be developed to indicate when testing of immunity (for susceptibility) would be worthwhile in order to target immunization to high-risk groups and extend the supplies of vaccine. Promiscuous male homosexuals illustrate one end of the spectrum in priority for immunization and screening tests. They are at high risk and at least 50% will be found seropositive for a marker of prior infection and thus do not need immunization. At the other end of the spectrum are populations of typical volunteer blood donors with neither sufficient risk to justify immunization nor a high enough prevalence of seropositive individuals (