A Cross-Sectional Study of COVID-19 Vaccine Hesitancy and Behaviours among People Living with HIV in British Columbia

ObjectiveAlthough COVID-19 vaccination is important for People Living with HIV given their elevated infection and comorbidity risks, some PLHIV are hesitant to accept vaccination. Hence, we conducted a cross-sectional study in British Columbia, Canada, aimed to identify socio-economic and health-related factors predicting COVID-19 vaccine uptake and contributing to hesitancy among PLHIV. MethodsA 34-item anonymous self-administered survey was disseminated to PLHIV accessing services through HIV and AIDS-related organisations e-newsletters between November 2022 and January 2023 in British Columbia. The survey included sociodemographic information, COVID-19 factors, HIV indicators, and the Vaccine Hesitancy Scale. Descriptive and inferential statistics were conducted to detect significant associations between the sociodemographic characteristics, health-related factors and COVID-19 vaccine uptake using IBM(R) SPSS(R) 28 and significance level at p<0.05. ResultsFrom the 276 respondents (mean age 29.93{+/-}7.55), 54.7% were men, 31.6% identified as sexual minorities, and 46.7% were of indigenous origin. Approximately 40% of the respondents received at least three vaccine doses, while 82.2% received at least one dose. Vaccine hesitancy was associated with lower education, age <44, and low income. Predictors of COVID-19 vaccine uptake included age [OR=1.06, 95% CI=1.01-1.12], bachelors degree [OR=0.22, 95% CI=0.07-0.72], family/friends infected with COVID-19 [OR 3.68 95% CI=1.56 - 8.67], HIV viral load >500 copies [OR=0.20, 95% CI=0.06-0.61], belief in vaccine importance [OR= 0.51, CI=0.28-0.95], trust in Health Canadas information [OR 0.49 CI=0.29-0.83], and concerns about vaccine adverse effects [OR=0.35, CI=0.22-0.56]. Concerns about vaccine adverse effects reduced the likelihood of receiving three COVID-19 vaccine doses by 65%. ConclusionsConsiderations must be taken around specific factors that may have an impact on COVID-19 vaccination rates among PLHIV, including information about vaccine adverse effects, HIV viral load, age, and education level. This insight should guide the development of policies and interventions aimed at encouraging individuals to maintain an up-to-date vaccination status.