HEPATITIS B THE ONLY STD WITH A VACCINE WHAT IS HEPATITIS B?

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WHAT IS HEPATITIS B? HEPATITIS B THE ONLY STD WITH A VACCINE A disease caused by a virus that affects the liver and can make you very sick The virus is spread through *blood *semen *vaginal fluids It is easier to catch than HIV Every year more than 5,000 people in the U.S. die WHY DO I NEED THE VACCINE? YOU NEED THE VACCINE IF YOU ARE: Having sex with more than one person Currently have a STD or had one in the past Not using a condom during sex Sharing needles Living in the same house with a person who has Hepatitis B HOW CAN I PROTECT MYSELF? Get the vaccine, it can keep you from getting really sick You need all 3 shots to be totally protected Use condoms during sex Don t share razors or toothbrushes with anyone Make sure any needles for drugs, body piercing or tattooing are sterilized (cleaned with bleach) Wear gloves when touching or cleaning up blood IS THE SHOT SAFE? YES There are almost no side effects Your arm may get a little sore or red at the point where the shot is given Getting the hepatitis B virus will cause more problems than getting 3 SHOTS IS ALL IT TAKES START THE VACCINE SERIES TODAY! County of San Diego, Department of Health Services

LA HEPATITIS B LA ÚNICA ETS CON UNA VACUNA B QUÉ ES LA HEPATITIS B? Una enfermedad grave El virus se transmite a través de sangre contaminada y contacto íntimo con personas infectadas Hepatits B NO se transmite por agua o alimento Es más contagiosa que VIH/SIDA POR QUÉ NECESITO LA VACUNA? NECESITA LA VACUNA SI: Tiene sexo con más de una persona No usa condones durante el sexo Comparte agujas Vive en la misma casa que una persona infectada con la Hepatitis B Use guantes cada vez que tenga contacto con sangre CÓMO PUEDO PROTEGERME? Tome la vacuna Necesita 3 dosis de la vacuna para estar totalmente protegido Use condones durante el sexo No comparta navajas de afeitar o cepillos de dientes Limpie con blanqueador (cloro) agujas que usa para drogas, tatuajes y para perforar el cuerpo LA VACUNA ES SEGURA? Sí, la vacuna para la Hepatitis B es una de las vacunas más seguras Puede tener un poco de dolor en su brazo y una leve fiebre despues de tomar la vacuna Ofrecemos aquí las inyecciones Pregunta hoy al doctor o a la enfermera por la primera inyeccion de hepatitis B

FREE VACCINE YOU ARE AT RISK IF YOU HAVE Hepatitis B THE ONLY STD WITH A VACCINE Don t think you re at risk? Keep reading... Don t risk your life Start the vaccine series today HEPATITIS B IS A SERIOUS DISEASE Ever had an STD Think you have an STD now Sex with more than one person Ever injected drugs COMPLICATIONS Liver Cancer It damages your liver The virus is spread through *blood *semen *vaginal fluids PROTECT YOURSELF Get the vaccine here today Use condoms during sex Don t share razors or toothbrushes Clean all needles with bleach Cirrhosis Liver Transplant Death More than 6,000 people/year die in the U.S. THE SHOT IS SAFE Almost no side effects Redness or soreness of the arm

FREE* Hepatitis B & C Blood Testing Available Here WHAT ARE HEPATITIS B and C? Liver diseases caused by a virus that gets in the blood You get hepatitis B & C by contact with the blood or body fluids of an infected person, for example: Injecting drugs Having multiple sex partners Sharing intranasal (nose) straws when snorting drugs Getting unsafe tattoos Receiving a blood transfusion or organ donation before 1992 WHY SHOULD I GET TESTED TODAY? Because you may be infected without feeling sick If you are infected you should make some lifestyle changes to decrease the amount of stress on your liver The offer for FREE TESTING is limited, take advantage today! County of San Diego (9/1/99)

Information Counseling Review Risk Assessment 1) Introduce Self a) Hello my name is and I am going to take a few minutes before you are called in to see the clinician to talk to you about hepatitis and explain to you some of the new services we are offering in the clinic. 2) Purpose/ Consequences a) Hepatitis B & C are viruses that infect the liver and cause inflammation. They may cause serious permanent damage to the liver even leading to the need for a liver transplant or death. b) Both hepatitis B & C can cause serious liver damage. Getting the virus can lead to cirrhosis, liver cancer, a liver transplant and even death. 3) Transmission/Risk Factors a) Hepatitis B & C are both transmitted by infected blood or body fluids entering a person s blood stream through a break in the skin or mucous membrane (e.g. gums, vagina, etc.) b) The same high-risk behaviors that put you at risk of getting other STDs or HIV may also put you at risk for hepatitis B and C. c) These risk factors include injection drug use, having multiple sex partners, engaging in unprotected sex and men having sex with men. 4) Vaccination a) Fortunately we have a vaccine that can protect you from hepatitis B and you can get it here today FREE of charge. It is given in 3 doses over several months. You can get the first dose today, one month later you ll get the second dose and 3 months after that the 3 rd dose. You need to get all 3 doses to be protected. b) The bad news about hepatitis C is that there is no vaccine and it is unlikely that there will be a vaccine any time soon. The only way to protect yourself from hepatitis C is by avoiding behaviors that put you at risk for getting the virus.

5) Testing a) We are also offering testing for both hepatitis B and C to see if you have been exposed to either virus. b) During Universal Screening period, offer hepatitis C testing to everyone. c) Looking at your risk assessment, I would/would not recommend that you be tested for hepatitis B/C because of (List high-risk behaviors that client has self-identified - optional). 6) Treatment a) It is important to know that if you are infected you can take steps to keep your liver as healthy as possible, and there are medical treatments that can also help. 7) Questions a) Do you have any questions regarding hepatitis B or C? 8) Recommendations/Forms a) Check list on risk assessment form i) Vaccination ii) Testing b) Give patient VIS statement to read c) Document in chart that counseling session was done, i.e., hepatitis counseling done by worker #.. 9) Other Services As part of your STD check up today we also offer urine testing for chlamydia and gonorrhea, as well as a blood test for syphilis. We also recommend that you get an HIV test. If you have any questions about these other tests you can discuss them with the clinician.

Potential Questions and Issues Patient wants to be screened for hepatitis B but they aren t high risk. Testing is only available to those that indicated risk factors on the risk assessment form If patient insists it is a clinician decision Patient asks, What if I test positive? If you decide to be tested and turn out to be positive there are some treatments for both B & C. But it is important to remember that the treatments are not always effective; the important thing is that you be followed by a medical provider on a regular basis to monitor your health. If you test positive you will need to change some behaviors that could make you even sicker. These include: drinking alcohol, using illegal drugs, and even using legal, prescription drugs. If you do test positive then we can provide you with a list of physicians that treat hepatitis patients. However, you may not be eligible for the services or may have to pay out of pocket. We will want to keep in touch with you and provide assistance in giving you the services that you need. Risk Factor for Hepatitis B Testing Men who have sex with men, #6 Injection drug user (past or present), #11 Commercial sex workers, #8 Sex partners of IDUs and chronic carriers, #3 & 10

County of San Diego Information Counseling Hepatitis B and C What you need to know What Are Hepatitis B & C? Diseases caused by viruses that infect the blood The viruses cause inflammation of the liver Can lead to major liver damage and even death How is the Hepatitis B Virus Spread? Through contact with blood & body fluids of an infected person Multiple sex partners Unprotected sex Men having sex with men Injecting drugs Intranasal drug use Unsafe Tattooing MOM How is the Hepatitis C Virus Spread? Through contact with blood of an infected person Injecting drugs / sharing works Sex partner of an injection drug user Intranasal drug use Blood transfusion before 1992 Unsafe Tattooing MO M Are Hepatitis B & C Serious? What Should I Do? YES! They are easier to catch than HIV Both cause serious liver damage Cirrhosis Liver cancer Liver transplant Death Everyone should get the vaccine for hepatitis B Dose 1, get today Dose 2, in one month Dose 3, three months later No additional cost

County of San Diego Information Counseling How Do I Keep Myself Safe? What Should I Do? Don t use drugs If you do, don t share needles, works, or straws Practice safer sex Use condoms Limit your number of sex partners If you re at high-risk for Hep C you should get tested No additional cost Make sure needles used for tattooing or piercing have been sterilized (cleaned with bleach) What If My Test Is Positive? Referral list of doctors Treatment may be available through your private physician