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OUCH
(Organizing Up Communities against Hepatitis)
OUCH is a project of Nexus Men’s Health Collective (NMHC), a grassroots organization founded in San Francisco in 2001. Nexus activists, artists, doctors, and students work together on a variety of projects to better educate men in our community about their health and to advocate on behalf of men’s health issues in San Francisco and beyond.
The OUCH project involves outreach by Nexus peer educators at street fairs, bars, and dance clubs. We educate patrons about Hepatitis A and Hepatitis B and offer free vaccinations for hepatitis to eligible persons. Our main target group is gay men ages 21-30, who are at high risk of developing hepatitis and the least likely to have gotten vaccinated for these preventable illnesses.
OUCH has been greatly supported in this project by the Communicable Disease Prevention Unit of the San Francisco Department of Public Health, who have donated free vaccine to our effort.
For more information on hepatitis A and hepatitis B, click the links below.
HEPATITIS A: http://www.cdc.gov/ncidod/diseases/hepatitis/a/index.htm
HEPATITIS B: http://www.cdc.gov/ncidod/diseases/hepatitis/b/index.htm
For information on how hepatitis affects gay men, and what they can do about it:
http://www.immunize.org/catg.d/p4115.htm
For a description of how hepatitis affects men in San Francisco, and why Nexus created OUCH, see our project rationale:
click here
For information on OUCH medical privacy policies:
click here
If you’d like to contact OUCH about a donation or to join us as a volunteer:
click here to contact us
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 San Francisco has approximately 55,000 gay and bisexual men, and research suggests many of them have not been vaccinated for hepatitis. For example, one study found that among 3600 MSM (men who have sex with men) seeking HIV testing services in S.F. in 2001, less than 16% had been vaccinated for hepatitis A, and less than 20% had been vaccinated for hepatitis B.
Why have gay men not been vaccinated for hepatitis? Reasons may include 1) men’s lack of personal knowledge of their need for vaccination, 2) men’s lack of medical insurance and knowledge of low- or no-cost options for medical services, 3) men’s reluctance to disclose their sexual orientation to medical providers or insurance programs in order to qualify for vaccination, or 4) medical providers’ ignorance of the need to vaccinate gay men as a high-risk group.
Who gets hepatitis in San Francisco? According to statistics from the San Francisco Department of Public Health, in May 2002, 72% of hepatitis A cases were in men who voluntarily identified themselves as men with male sex partners. Another 23% of cases were in men who did not disclose their sexual orientation, so the total number of cases in gay men may be as high as 95%. For hepatitis B, 60% of cases were in men with male sex partners, with another 25% in men of unknown sexual orientation, for a total of up to 85% of HBV infections in San Francisco in gay men. An estimated 30% of adults infected with hepatitis A and 60% of those with hepatitis B are without symptoms, but they are still infectious and can pass on the infection to sex partners. Most cases of hepatitis A and B occur in the 21-to-44 age group.
Given the information above, an obvious goal of vaccination efforts is to reach young gay men as early as possible in their sexually-active years. However, those most needing vaccination (gay men ages 21-30) appear to be least likely to have contact with medical services. Evidence cited above suggests that when men do get vaccinated, they do so closer to age 40 than to age 20. The success of the San Francisco Department of Public Health’s StopHep project at Gold’s Gym suggested that offering low-cost vaccinations in community settings outside of medical clinics could be an effective way to reach target populations. That is why OUCH is taking vaccines “where the boys are”—to the neighborhoods, streets, and clubs.
References:
Pine A, Zola J, Fu P, Fernyak S. StopHep in San Francisco – Impact of a Non-Traditional Hepatitis A and B Vaccination Clinic The 37th National Immunization Conference
Chicago, IL, Mar 17-20, 2003.
Zola J, presentation at Nexus Men’s Health Collective, Thurs July 7, SF DPH- STD prevention offices.
NEXUS Men’s Health Collective/Organizing up communities against hepatitis (OUCH)
NOTICE OF PRIVACY PRACTICES
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The types of uses and disclosures of my PHI that will occur in my treatment or in the performance of health care operations performed by Nexus Men’s Health Collective:
By signing my consent, I am giving members of the Nexus Men’s Health Collective and specifically their project Organizing Up Communities against Hepatitis (OUCH) permission to record my Protected Health Information (PHI) in a Registration Form. This information will be used by Nexus volunteers and physicians and medical staff to verify the appropriateness of my vaccination, and to provide appropriate documentation of my vaccination to me. It will also allow Nexus to contact me with reminders of my need for follow-up vaccinations or other care related to my receipt of the vaccination. These reminders will be provided in the form of a confidential mailed card, as well as by telephone or email messages as per my preference.
My PHI will be inspected by trained Nexus volunteers and medical personnel only. At no time will my PHI be released or in custody of non-Nexus personnel. When not in the direct custody of Nexus personnel, documents with PHI will be stored in the secured medical records of the private practice of Dr. Richard A. Loftus, 45 Castro Street, Suite 325, San Francisco, CA 94114.
I understand that my PHI will be entered by Dr. Loftus or other Nexus-authorized medical personnel into the HERO electronic charting system. HERO charts are maintained by the Positive Health Practice of San Francisco General Hospital, and are also made accessible to staff at San Francisco City Clinic and Magnet health center. I understand that personnel at these clinics have been trained under the Health Insurance Portability and Accountability Act (HIPAA) to maintain the confidentiality of my PHI, and will obtain access my PHI under the HERO chart only to ensure appropriate follow-up care to me in relation to my vaccination |
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My rights and the duties of Nexus Men’s Health Collective and specifically their project Organizing Up Communities against Hepatitis (OUCH) with respect to my PHI:
I understand that I have the right to a copy of this notice of privacy practices, and have a right to make requests for how Nexus is to handle my PHI, including, for example, deferring mailing, phone, or email contacts. I also understand, however, that while Nexus will do its best to accommodate any reasonable requests, Nexus is not obligated to honor such requests.
I also understand that while Nexus will do its best to ensure my privacy in the provision of medical services, I acknowledge that by the nature of the outreach events at which Nexus and OUCH conduct vaccinations, perfect privacy will not be ensured. I understand that if I have significant concerns about my privacy in receiving at vaccination at a Nexus outreach, I may always defer vaccination.
It is the duty of Nexus to ensure that PHI is only ever in the custody of Nexus personnel, and that once PHI is entered into a HERO electronic chart, such information is accessed only by HIPAA-authorized medical personnel for the specific purpose of ensuring adequate health services to me related to my vaccination. |
For further information regarding Nexus Men’s Health Collective and Organizing Up Communities against Hepatitis (OUCH) and their policies related to PHI, please see the Nexus website at:
http://groups.yahoo.com/group/nexusSF/.com
or contact
Dr. Richard A. Loftus at 45 Castro Street
Suite 325
San Francisco, CA 94114
(415) 863-3366.
rickloftus@yahoo.com |
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