Willingness to accept COVID-19 vaccination among people living with HIV in a high HIV prevalence community

• Published in: BMC public health 2022-06, Vol.22 (1), p.1239-11, Article 1239
• Main Authors: Govere-Hwenje, Sabina, Jarolimova, Jana, Yan, Joyce, Khumalo, Anele, Zondi, Gugulami, Ngcobo, Marcia, Wara, Nafisa J, Zionts, Dani, Bogart, Laura M, Parker, Robert A, Bassett, Ingrid V
• Format: Article
• Language: English
• Subjects: Acceptance; Adult; Age; Analysis; Antiretroviral agents; Antiretroviral therapy; Care and treatment; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 - prevention & control; COVID-19 Vaccines; Cross-Sectional Studies; Data collection; Demographics; Evaluation; Female; Health behavior; Health Knowledge, Attitudes, Practice; HIV; HIV patients; Human immunodeficiency virus; Humans; Immunization; Influenza Vaccines; Influenza, Human - epidemiology; Information sources; Interviews; Male; Pandemics; Patient Acceptance of Health Care; Population; Prevalence; Prospective Studies; Public health; Questionnaires; Side effects; South Africa; Stigma; Trust; Vaccination; vaccine hesitancy; Vaccines
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-022-13623-w

People living with HIV (PLWH) may have a poorer prognosis with COVID-19 infection and are an important population for COVID-19 vaccination. We assessed the willingness and reasons for COVID-19 vaccine acceptance or hesitancy among PLWH in South Africa. We conducted a cross-sectional study consisting of telephone interviews with a randomly selected subset of participants enrolled in a prospective observational cohort study evaluating a decentralized antiretroviral therapy (ART) delivery program in South Africa. Questions assessed willingness to accept a future COVID-19 vaccine, concerns regarding COVID-19 vaccination, and overall vaccine confidence. Interviews were conducted between September 2020 and January 2021. We evaluated participant demographics, sources of COVID-19 information, stigma and medical mistrust, uptake of non-pharmaceutical interventions, and socioeconomic impacts of the COVID-19 pandemic as potential covariates of willingness to accept vaccination. We completed interviews with 213 participants; 153 (72%) were female, median age 35y, and 100 (47%) had completed secondary school. Among the participants, 121 (57%) were willing to accept future vaccination, 46 (22%) were unsure, and 45 (21%) stated they did not intend to be vaccinated. Fear of side effects, reported by 42 (20%), was the most common concern about COVID-19 vaccination. Older age was associated with willingness to accept vaccination (aOR 1.75 for every 10-year increase in age, 95% CI 1.10-2.78, p = 0.02), while higher medical mistrust related to COVID-19 (aOR 0.21, 95% CI 0.093-0.45, p