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

Abstract

Background 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. Methods 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. Results 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 < 0.001) and use of social media for COVID-19 information (aOR 0.30, 95% CI 0.11–0.84, p = 0.02) were associated with lower willingness to accept vaccination. Conclusions In this cohort of PLWH in South Africa, over half were willing to accept COVID-19 vaccination, although a substantial proportion remained unsure or were not willing to be vaccinated. Public health messaging should emphasize the safety and efficacy of COVID-19 vaccination and address misinformation and medical mistrust among PLWH. Ongoing efforts to ensure access to COVID-19 vaccines for vulnerable populations are crucial.

Removal of antiretroviral drugs from wastewater using activated macadamia nutshells: Adsorption kinetics, adsorption isotherms, and thermodynamic studies

“…South Africa has the highest number of people infected by HIV, which is about 7.9 million or about 13.78 % of the country's population. In addition, about 19.5 % of the infected people are aged 15–49 (Govere‐Hwenje et al, 2022). About 4.9 million of the infected are already in the ARVDs program, thus may increase the volume of ARVDs received by water sources.…”

Patient and stakeholder perspectives on impacts of the COVID-19 pandemic on HIV and mental health care delivery in South Africa

“… 8 Since the start of the pandemic, the proportion of PWH reporting interrupted HIV care, which is associated with worse mortality than consistent engagement in care, has increased. 9 Medical mistrust following the onset of the pandemic has also been documented among PWH in South Africa, 10 possibly contributing to these care interruptions. Pandemic-related increases in poor mental health and substance use and on use of mental health services in South Africa 11 , 12 may also be affecting HIV care engagement.…”

Safety profiles of homologous and heterologous regimens containing three major types of COVID-19 vaccine among people living with HIV

“…11 In addition, hesitation was found to be associated with medical mistrust, feelings of vaccines being experimental, obtaining information from social media, political conservativeness, and lower education level. [8][9][10][11][12][13] Previous studies among PLHIV have demonstrated safety profiles of various COVID-19 vaccine types including inactivated, 8,14-18 viral vector, [19][20][21] and mRNA vaccines. [21][22][23][24] Overall, most common adverse effects (AEs) of the vaccines were local injection site reactions and systemic reactions including fatigue, fever, myalgia and headache.…”

“…6,7 Despite the vaccine effectiveness, the rates of COVID-19 vaccine hesitancy among PLHIV ranges from 16%-91% depending on the study settings and the points of time when the studies were conducted. [8][9][10][11][12][13] The main reasons for vaccine hesitation were concerns about safety, 8-13 efficacy [8][9][10][11][12][13] and the impact of the vaccines on antiretroviral therapy (ART) efficacy. 11 In addition, hesitation was found to be associated with medical mistrust, feelings of vaccines being experimental, obtaining information from social media, political conservativeness, and lower education level.…”