Socio-demographic determinants of COVID-19 vaccination status among people living with HIV; a cross-sectional study in selected regions in Tanzania.

Background: Public Health and Social Measures (PHSM) are among the commonly used methods to prevent the spread of Corona Virus Disease of 2029 (COVID-19). Vaccination has also been an integral component of infectious disease prevention and control and it has been used widely to protect humans against some of the very serious diseases such as COVID-19. People living with HIV (PLHIV) are known to be more vulnerable to the severest form of COVID-19 than the general population. Other groups of people likely to get the severe form of COVID-19 include the elderly and those with co-morbidities such as cancers, cardiovascular diseases, diabetes, etc. OBJECTIVES: The main objective of the study was to establish socio-demographic factors that could determine COVID-19 vaccination status among PLHIV in selected regions in mainland Tanzania and to provide insight into ways to increase COVID-19 vaccine coverage in Tanzania.

Methods: A facility-based cross-sectional study was conducted between March and April 2022 among PLHIV in four conveniently sampled regions of Tanzania namely Kagera, Tabora, Geita, and Dar es Salaam. A total of 25 Care and Treatment Centres (CTCs) were randomly selected with a probability proportion by size in each region. In each CTC, 11 PLHIV eligible for vaccination were systematically selected to participate in the study. Face-to-face interviews were conducted using a structured questionnaire and Open Data Kit (ODK) software was used to record and transfer data to a designated server. Data cleaning and analysis were done using Stata version 14.0. A chi-square test was used to assess the association between socio-demographic characteristics and COVID-19 vaccination status. A generalized linear mixed-effects model was fitted to determine factors associated with COVID-19 vaccination status.

Results: Out of 1,100 PLHIV interviewed, 696 (63.3%) were found to be vaccinated against COVID-19. Level of education, age, occupation, employment status, location, and level of health facilities were found to be significantly associated with of COVID-19 vaccination status among PLHIV in the study areas. PLHIV who had college and university education, elderly, farmers, and those employed and living in a rural setting were found to be more likely to be vaccinated than other comparison groups in the categories analyzed.

Conclusion: This facility-based cross-sectional study showed a higher COVID-19 vaccination rate (63.3%) among PLHIV compared to the general population. This could be explained by efforts by both public and private sectors to promote COVID-19 vaccination among PLHIV have had a positive impact on vaccination uptake. However, to meet the World Health Organization (WHO) target of 60% vaccination coverage, additional tailored interventions are required. These should include specific strategies that could be effective in urban areas, expanding vaccination access by increasing the number of vaccinations centers, supporting those who face barriers to vaccination, and actively engaging not only elderly individuals but also middle-aged and younger members of the community and PLHIV networks. Moreover, greater involvement from higher levels of health service provision, such as health centers and hospitals, will be likely increase vaccination coverage and address the unmet needs of this population.