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. 2025 May;29(5):1516-1524.
doi: 10.1007/s10461-025-04622-0. Epub 2025 Mar 10.

Mapping Vaccination Mindsets among UK Residents of Black Ethnicities with HIV: Lessons from COVID-19

Zoe Moon #  1 , Lucy Campbell #  2   3 , Zoe Ottaway  2   3 , Julie Fox  3   4 , Fiona Burns  5   6 , Lisa Hamzah  7 , Andrew Ustianowski  8 , Amanda Clarke  9   10 , Sarah Schoeman  11 , Deirdre Sally  12 , Shema Tariq  13 , Frank A Post #  2   3 , Rob Horne #  14
Affiliations

Mapping Vaccination Mindsets among UK Residents of Black Ethnicities with HIV: Lessons from COVID-19

Zoe Moon et al. AIDS Behav. 2025 May.

Abstract

Vaccine hesitancy is a leading threat to public health, but little is known about the beliefs and mindsets that drive vaccine hesitancy, especially among people of Black ethnicities. This study aimed to understand vaccine related beliefs and their relationship with SARS-CoV-2 vaccine uptake in UK residents of Black ethnicities living with HIV. Adults of self-reported Black ethnicities with HIV were recruited at 12 clinics in England. Participants completed questionnaires in clinic, including an adapted version of the Beliefs about Medicines Questionnaire (BMQ) to assess Necessity and Concerns beliefs about the SARS-CoV-2 vaccine. SARS-CoV-2 vaccination status was ascertained through self-report and shared care records. A total of 863 participants were enrolled between June 2021 and October 2022, most of whom (92%) had received at least one dose of the SARS CoV-2 vaccine. After adjusting for age and region of birth, higher perceived need for the vaccine (OR = 2.39, 95% CI = 1.51-3.81), fewer concerns about the vaccine (OR = 0.16, 95% CI = 0.08-0.30), and weaker endorsement of COVID-19 Conspiracy Beliefs (OR = 0.31, 95% CI = 0.19-0.50) were associated with vaccination uptake. Being born outside sub-Saharan Africa was associated with reduced odds of being vaccinated. This study shows the importance of specific beliefs driving vaccine hesitancy and uptake. Further studies should explore the role of these beliefs and mindsets in influencing uptake of other vaccinations, and to work with key stakeholders to explore how to address vaccine hesitancy and improve vaccine uptake in these and other populations.

Keywords: Attitudes; Beliefs; Black ethnicities; COVID-19; SARS-CoV-2; Vaccine hesitancy.

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Conflict of interest statement

Declarations. Competing Interests: ZM reports paid work for UCL Business Company Spoonful of Sugar. JF reports grants GlaxoSmithKline. FB reports grants and personal fees from Gilead Sciences. AU reports personal fees from Generate, Gilead Sciences, ViiV Healthcare/GlaxoSmithKline, Merck/MSD, Moderna and Pfizer. AC reports grants and personal fees from Gilead Sciences, grants and personal fees from ViiV Healthcare/GlaxoSmithKline, and grants and personal fees from MSD. SS reports personal fees from ViiV Healthcare and grants from Gilead Sciences, ViiV Healthcare/GlaxoSmithKline, and MSD. FAP reports personal fees from Gilead Sciences, ViiV Healthcare/GlaxoSmithKline and MSD, and grants from Gilead Sciences, ViiV Healthcare/GlaxoSmithKline and MSD. RH reports grants/research support from AstraZeneca; National Institute for Health Research (NIHR), Collaboration for Leadership in Applied Health Research and Care (CLAHRC), North Thames at Bart’s Health NHS Trust and Asthma UK (AUKCAR); Honoraria/consultation fees: AbbVie, Amgen, Astellas, AstraZeneca, Biogen, Erasmus, Idec, Gilead Sciences, GlaxoSmithKline, Janssen, Merck Sharp Dohme, Novartis, Pfizer, Roche, Shire Pharmaceuticals, TEVA. Founder and shareholder of a UCLBusiness company (Spoonful of Sugar Ltd) providing consultancy on supporting patients with medicines and treatment related behaviours to healthcare policy makers, providers and industry. All other authors declare no conflicts of interest. Ethics Approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by a National Health Service Research Ethics Committee (21/ES/0047) and the Health Research Authority (IRAS 294887). Consent to Participate: Informed Consent was obtained from all individual participants included in the study.

Figures

Fig. 1
Fig. 1
Proportion of participants agreeing, expressing uncertainty, or disagreeing with COVID-19 conspiracy, misconception and racial inequality statements
Fig. 2
Fig. 2
Proposed conceptual model
See this image and copyright information in PMC

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