PREVALENCE AND CORRELATES OF SARS-COV-2 VACCINE UPTAKE AND HESITANCY AMONG PEOPLE WITH HIV ACROSS THE U.S.

Abstract

People with HIV (PWH) have higher risk of COVID-19 mortality. SARS-CoV-2 vaccination is highly effective among PWH, although vaccine hesitancy could limit the population-level impact. From 2/2021-4/2022, PWH from 8 sites in the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) completed a vaccine hesitancy instrument as part of routine care. Participants were defined as vaccine hesitant if they had not received the SARS-CoV-2 vaccine and would probably/definitely not receive it. We assessed factors associated with SARS-CoV-2 vaccine hesitancy using logistic regression adjusted for demographics, unsuppressed viral load (VL>200 copies/mL), month, and time on ART; using inverse probability weighting for survey non-response. Overall, 3,288 PWH with a median age of 55 were included; 18% were female and 94% were virally suppressed. At the time of survey, 27% reported they had not received the SARS-CoV-2 vaccine, and 9% (n=279) reported vaccine hesitancy. Factors associated with vaccine hesitancy included female sex (Adjusted Odds Ratio [AOR]=2.3; 95% Confidence Interval (CI)=1.6-3.2), Black vs. White race (AOR 1.7; 95% CI=1.2-2.4), younger age (AOR 1.4; 95% CI=1.2-1.5), and unsuppressed VL (AOR 1.9; 95% CI=1.3-3.0). Overall, over one-quarter of PWH in this multisite cohort were unvaccinated for SARS-CoV-2 when interviewed 2/21-4/22. Vaccine hesitancy was reported by approximately 9% of PWH, and was higher among women, Black PWH, younger PWH, PWH with unsuppressed VL, and those in the South/Midwest. Renewed efforts are needed to address concerns of PWH about vaccinations against COVID-19 as the pandemic evolves, and vaccines in general, given the potential for future pandemics.