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Multicenter Study
. 2023 Apr 6;41(15):2476-2484.
doi: 10.1016/j.vaccine.2023.02.056. Epub 2023 Feb 23.

COVID-19 vaccine hesitancy among people living with HIV in a low-resource setting: A multi-center study of prevalence, correlates and reasons

Sahabi Kabir Sulaiman  1 , Muhammad Sale Musa  2 , Fatimah Isma'il Tsiga-Ahmed  3 , Farouq Muhammad Dayyab  4 , Abdulwahab Kabir Sulaiman  5 , Bashir Dabo  6 , Saidu Idris Ahmad  7 , Salisu Abubakar Haruna  8 , Abdullahi Abdurrahman Zubair  9 , Aminu Hussein  10 , Sadiya Usman  11 , Jummai Usman Wada  12 , Ayoola Yekeen Ayodele  13 , Muhammed Wulgo Ali  13 , Bello Tijjani Makama  14 , Abdulaziz Tijjani Bako  15 ; SQuAD-HIV collaborators
Collaborators, Affiliations
Multicenter Study

COVID-19 vaccine hesitancy among people living with HIV in a low-resource setting: A multi-center study of prevalence, correlates and reasons

Sahabi Kabir Sulaiman et al. Vaccine. .

Abstract

Background: Hesitancy to COVID-19 vaccine may worsen the burden of COVID-19 among people living with HIV (PLHIV), who are at a higher risk of COVID-19-related hospitalization and death, compared to HIV non-infected individuals. Therefore, we evaluate the predictors and reasons for COVID-19 vaccine hesitancy among unvaccinated PLHIV in six antiretroviral therapy (ART) clinics across northern Nigeria.

Methodology: In this cross-sectional study, conducted between October 2021 and February 2022 in six hospitals across two geopolitical regions of Nigeria, we utilized interviewer-administered questionnaires to assess COVID-19 vaccine hesitancy among a convenience sample of 790 eligible adult PLHIV. Hesitancy was defined as answering 'no' or 'maybe' to a question asking participants their willingness to accept the COVID-19 vaccine. A multivariate logistic regression model was used to estimate the adjusted odds ratio (aOR) and 95% confidence interval (CI) of the factors associated with COVID-19 vaccine hesitancy among PLHIV.

Results: Of the total 660 unvaccinated participants included in the analysis (61.82% female, mean age [SD] of 39.76 [10.75]), 381 (57.72%) were hesitant to COVID-19 vaccine. Being 50 years and older (aOR: 0.43; 95% CI: 0.21-0.89), being unemployed (aOR: 0.57; 95% CI: 0.34-0.95), experiencing the adverse effects of ART (aOR: 0.36; 95% CI: 0.15-0.86), and perception of being at high risk of contracting COVID-19 (aOR: 0.22; 95% CI: 0.13-0.37) were associated with significantly lower odds of hesitancy. Conversely, being female (aOR: 1.64; 95% CI: 1.02-2.61) and attending ART clinics at state administrative capital cities (IIDH Kano [aOR: 2.40; 95% CI: 1.10-5.25], MMSH Kano [aOR: 5.59; 95% CI: 1.97-10.66], YSSH Damaturu [aOR: 9.88; 95% CI: 4.02-24.29] vs. GH Gashua) were associated with significantly higher odds of hesitancy. The most common reasons for hesitancy include fear of potential adverse effects, skepticism about vaccine efficacy, the rapid development of the COVID-19 vaccine, and the perceived lack of effort to develop a cure or vaccine for HIV/AIDS.

Conclusion: Interventions aimed at combating misperceptions and misinformation regarding the COVID-19 vaccination program may reduce the prevalence of COVID-19 vaccine hesitancy among unvaccinated PLHIV.

Keywords: Acceptance/Hesitancy; COVID-19 vaccine; HIV; Nigeria; Uptake/Vaccination.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Proportion of COVID-19 vaccine uptake, non-uptake, and missing data among the participants.
Fig. 2
Fig. 2
Multivariable logistic regression model for factors independently associated with hesitancy to COVID-19 vaccine. AUC = 0.785, Hosmer–Lemeshow chi squared (8) = 8.00, p-value = 0.433. Keys: *= p-value < 0.05, **= p-value < 0.01, ***= p-value < 0.001.
Fig. 3
Fig. 3
Reasons for hesitancy towards accepting COVID-19 vaccine among the study participants.
See this image and copyright information in PMC

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