Date of Award

Fall 1-8-2021

Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Heather Bradley, PhD

Second Advisor

Sheryl Strasser, PhD


INTRODUCTION: An estimated 115 million people worldwide and 2.4-3.5 million people in the United States are infected with Hepatitis C infection. The majority of these individuals are unaware of their infection due to the asymptomatic nature of the disease and are therefore at greater risk for advanced-staged complications such as cirrhosis or liver cancer.

AIM: This study aimed to measure changes over time in awareness of hepatitis C infection among a housed, non-institutionalized representative sample within the United States.

METHODS: National Health and Examination Survey (NHANES) data spanning years 2007 – 2018 were compiled into one dataset. After eligibility restrictions were applied the final dataset contained N=387 respondents. Bivariate and multivariate logistic regression models were conducted to explore the associations between our independent variables and awareness of HCV infection as well as to assess possible confounders and mediators of the relationship between time (primary exposure variable) and awareness of HCV infection (outcome variable). Bivariate linear regression was used to estimate linear trends to estimate linear trends in awareness of HCV infection over time. We also assessed the percent of those aware of their HCV infection to clearly define the outcome variable.

RESULTS: Awareness of one’s HCV infection increased from 24.53% in the 2007-2008 survey cycle to 63.48% in the 2017-2018 survey cycle (β for trend 0.09, p<0.0001). The odds of reporting a positive HCV diagnosis in the second survey period (2013-2018) was 3.71 times the odds in the first time period (p <0.0001).

CONCLUSION: Diagnosed hepatitis C is increasing, however, remains suboptimal in the US. Recent efforts may have contributed to these increases, bringing us closer to achieving DHHS and WHO goals of viral hepatitis elimination.


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