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Current HIV Research

Editor-in-Chief

ISSN (Print): 1570-162X
ISSN (Online): 1873-4251

Research Article

Predictors of COVID-19 Vaccine Acceptability among Patients Living with HIV in Northern Nigeria: A Mixed Methods Study

Author(s): Zubairu Iliyasu*, Aminatu A. Kwaku, Amina A. Umar, Fatimah Tsiga-Ahmed, Nafisa S. Nass, Hadiza M. Abdullahi, Taiwo G. Amole, Hamisu M. Salihu and Muktar H. Aliyu

Volume 20, Issue 1, 2022

Published on: 19 January, 2022

Page: [82 - 90] Pages: 9

DOI: 10.2174/1570162X19666211217093223

Price: $65

Abstract

Background: People living with HIV (PLHIV) are at increased risk of COVID-19 acquisition, severe disease, and poor outcomes. Yet, little is known about COVID-19 vaccine hesitancy among PLHIV in high HIV burden countries, such as Nigeria.

Objective: This study aims to assess the acceptability of the COVID-19 vaccine and identify predictors and reasons for vaccine hesitancy among patients living with HIV and attending a tertiary hospital in Kano, northern Nigeria.

Methods: Using a mixed-methods design, structured questionnaires were administered to a clinic- based sample of patients living with HIV (n = 344), followed by 20 in-depth interviews with a sub-sample. Logistic regression and the framework approach were used to analyze the data.

Results: Less than half (46.2 %, n = 159) of the respondents were willing to take the COVID-19 vaccine. Vaccine acceptance was higher among non-Muslim PLHIV (Adjusted Odds Ratio (aOR) = 1.26, 95 % Confidence Interval (95 % CI): 1.10-4.00), persons with high-risk perception (aOR = 2.43, 95 % CI:1.18-5.00), those who were not worried about infertility-related rumors (aOR = 13.54, 95 % CI:7.07-25.94) and persons who perceived antiretroviral drugs are protective against COVID-19 (aOR = 2.76, 95 % CI: 1.48-5.14). In contrast, vaccine acceptance was lower among persons who were not concerned about the potential effects of COVID-19-HIV co-infection (aOR = 0.20, 95 % CI:0.10-0.39). The most common reasons for vaccine hesitancy included doubts about the existence of COVID-19, low-risk perception, anxiety about antiretroviral treatmentvaccine interactions, safety concerns, and infertility-related rumors.

Conclusion: Covid-19 vaccine acceptance was low among PLHIV. COVID-19 vaccine acceptance was associated with respondents’ faith, risk perception, perception of the protective effects of antiretroviral treatment, concerns about COVID-19-HIV co-infection, and infertility-related rumors. Vaccination counseling should be integrated into HIV treatment services to improve COVID-19 vaccine uptake among PLHIV in Kano, Nigeria and similar settings.

Keywords: SARS-Co-V-2, COVID-19, HIV, COVID vaccine acceptability, vaccine hesitancy, co-morbidities.

Graphical Abstract

[1]
Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed 2020; 91(1): 157-60.
[http://dx.doi.org/10.23750/abm.v91i1.9397] [PMID: 32191675]
[2]
World Health Organization (WHO). Available from: https://covid19.who.int.
[3]
Prabhu S, Poongulali S, Kumarasamy N. Impact of COVID-19 on people living with HIV: A review. J Virus Erad 2020; 6(4): 100019.
[http://dx.doi.org/10.1016/j.jve.2020.100019] [PMID: 33083001]
[4]
Bhaskaran K, Rentsch CT, MacKenna B, et al. HIV infection and COVID-19 death: A population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform. Lancet HIV 2021; 8(1): e24-32.
[http://dx.doi.org/10.1016/S2352-3018(20)30305-2] [PMID: 33316211]
[5]
Gatechompol S, Avihingsanon A, Putcharoen O, Ruxrungtham K, Kuritzkes DR. COVID-19 and HIV infection co-pandemics and their impact: A review of the literature. AIDS Res Ther 2021; 18(1): 28.
[http://dx.doi.org/10.1186/s12981-021-00335-1] [PMID: 33952300]
[6]
Patel RH, Acharya A, Chand HS, Mohan M, Byrareddy SN. Human immunodeficiency virus and severe acute respiratory syndrome coronavirus 2 coinfection: A systematic review of the literature and challenges. AIDS Res Hum Retroviruses 2021; 37(4): 266-82.
[http://dx.doi.org/10.1089/aid.2020.0284] [PMID: 33599163]
[7]
Hadi YB, Naqvi SFZ, Kupec JT, Sarwari AR. Characteristics and outcomes of COVID-19 in patients with HIV: A multicentre research network study. AIDS 2020; 34(13): F3-8.
[http://dx.doi.org/10.1097/QAD.0000000000002666] [PMID: 32796217]
[8]
Triant VA, Gandhi RT. When epidemics collide: Why people with human immunodeficiency virus may have worse COVID-19 outcomes and implications for vaccination. Clin Infect Dis 2021; 72(12): e1030-34.
[http://dx.doi.org/10.1093/cid/ciaa1946] [PMID: 33395474]
[9]
Mirzaei H, McFarland W, Karamouzian M, Sharifi H. COVID-19 Among people living with HIV: A systematic review. AIDS Behav 2021; 25(1): 85-92.
[http://dx.doi.org/10.1007/s10461-020-02983-2] [PMID: 32734438]
[10]
Gutierrez MDM, Mur I, Mateo MG, Vidal F, Domingo P. Pharmacological considerations for the treatment of COVID-19 in people living with HIV (PLWH). Expert Opin Pharmacother 2021; 22(9): 1127-41.
[http://dx.doi.org/10.1080/14656566.2021.1887140] [PMID: 33634724]
[11]
Brüssow H. COVID-19: Vaccine’s progress. Microb Biotechnol 2021; 14(4): 1246-57.
[http://dx.doi.org/10.1111/1751-7915.13818] [PMID: 33960659]
[12]
Calina D, Docea AO, Petrakis D, et al. Towards effective COVID 19 vaccines: Updates, perspectives and challenges (Review). Int J Mol Med 2020; 46(1): 3-16.
[http://dx.doi.org/10.3892/ijmm.2020.4596] [PMID: 32377694]
[13]
Yamamoto S, Saito M, Nagai E, et al. Antibody response to SARS-CoV-2 in people living with HIV. J Microbiol Immunol Infect 2021; 54(1): 144-6.
[http://dx.doi.org/10.1016/j.jmii.2020.09.005] [PMID: 33046418]
[14]
Folegatti PM, Ewer KJ, Aley PK, et al. Safety and immunogenicity of the ChAdOx1 nCoV-19 vaccine against SARS-CoV-2: A preliminary report of a phase 1/2, single-blind, randomised controlled trial. Lancet 2020; 396(10249): 467-78.
[http://dx.doi.org/10.1016/S0140-6736(20)31604-4] [PMID: 32702298]
[15]
Šehović AB, Govender K. Addressing COVID-19 vulnerabilities: How do we achieve global health security in an inequitable world. Glob Public Health 2021; 16(8-9): 1198-208.
[http://dx.doi.org/10.1080/17441692.2021.1916056] [PMID: 33870859]
[16]
Rubin LG, Levin MJ, Ljungman P, et al. 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis 2014; 58(3): 309-18.
[http://dx.doi.org/10.1093/cid/cit816] [PMID: 24421306]
[17]
Kanwugu ON, Adadi P. HIV/SARS-CoV-2 coinfection: A global perspective. J Med Virol 2021; 93(2): 726-32.
[http://dx.doi.org/10.1002/jmv.26321] [PMID: 32692406]
[18]
Lin C, Tu P, Beitsch LM. Confidence and receptivity for COVID-19 vaccines: A rapid systematic review. Vaccines (Basel) 2020; 9(1): 16.
[http://dx.doi.org/10.3390/vaccines9010016] [PMID: 33396832]
[19]
Vallée A, Fourn E, Majerholc C, Touche P, Zucman D. COVID-19 vaccine hesitancy among french people living with HIV. Vaccines (Basel) 2021; 9(4): 302.
[http://dx.doi.org/10.3390/vaccines9040302] [PMID: 33804808]
[20]
Federal Ministry of Health. Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS) 2018: Technical Report. Abuja, Nigeria 2019. Available from: www.ciheb.org/PHIA Last accessed May 12, 2021.
[21]
Nigeria Centre for Disease Control (NCDC). Available from: https://covid19.ncdc.gov.ngLast accessed May 12, 2021.
[22]
Tobin EA, Okonofua M, Azeke A, Ajekweneh V, Akpede G. Willingness to accept a covid-19 vaccine in Nigeria: A population-based cross-sectional study. Cent Afr J Public Health 2021; 7(2): 53-60.
[http://dx.doi.org/10.11648/j.cajph.20210702.12]
[23]
Adebisi YA, Alaran AJ, Bolarinwa OA, Akande-Sholabi W, Lucero-Prisno DE. When it is available, will we take it? Social media users’ perception of hypothetical COVID-19 vaccine in Nigeria. Pan Afr Med J 2021; 38(230): 230.
[http://dx.doi.org/10.11604/pamj.2021.38.230.27325] [PMID: 34046135]
[24]
Ilesanmi O, Afolabi A, Uchendu O. The prospective COVID-19 vaccine: Willingness to pay and perception of community members in Ibadan, Nigeria. PeerJ 2021; 9: e11153.
[http://dx.doi.org/10.7717/peerj.11153] [PMID: 33828927]
[25]
Ghinai I, Willott C, Dadari I, Larson HJ. Listening to the rumours: What the Northern Nigeria polio vaccine boycott can tell us ten years on. Glob Public Health 2013; 8(10): 1138-50.
[http://dx.doi.org/10.1080/17441692.2013.859720] [PMID: 24294986]
[26]
Feilzer MY. Doing mixed methods research pragmatically: Implications for the rediscovery of pragmatism as a research paradigm. J Mixed Methods Res 2010; 4(1): 6-16.
[http://dx.doi.org/10.1177/1558689809349691]
[27]
Creswell JW, Plano Clark VL. Designing and conducting mixed methods research. 2nd ed. Thousand Oaks: Sage 2011; pp. 43-51.
[28]
Iliyasu Z, Babashani M. Prevalence and predictors of tuberculosis coinfection among HIV-seropositive patients attending the Aminu Kano teaching hospital, Northern Nigeria. J Epidemiol 2009; 19(2): 81-7.
[http://dx.doi.org/10.2188/jea.JE20080026] [PMID: 19265273]
[29]
Lwanga SK, Lemeshow S. Sample size determination in health studies: A practical manual. World Health Organization 1991; pp. 29-32.
[30]
Habib MA, Dayyab FM, Iliyasu G, Habib AG. Knowledge, attitude and practice survey of COVID-19 pandemic in Northern Nigeria. PLoS One 2021; 16(1): e0245176.
[http://dx.doi.org/10.1371/journal.pone.0245176] [PMID: 33444360]
[31]
Moore DS, McCabe GP. Introduction to the Practice of Statistics. New York: W.H. Freeman 1999; p. 443.
[32]
Shekhar R, Sheikh AB, Upadhyay S, et al. COVID-19 vaccine acceptance among health care workers in the United States. Vaccines (Basel) 2021; 9(2): 119.
[http://dx.doi.org/10.3390/vaccines9020119] [PMID: 33546165]
[33]
Shaw J, Stewart T, Anderson KB, et al. Assessment of U.S. health care personnel (HCP) attitudes towards COVID-19 vaccination in a large university health care system. Clin Infect Dis 2021; 25: ciab054054.
[http://dx.doi.org/10.1093/cid/ciab054] [PMID: 33491049]
[34]
Freeman D, Loe BS, Chadwick A, et al. COVID-19 vaccine hesitancy in the UK: The Oxford coronavirus explanations, attitudes, and narratives survey (Oceans) II. Psychol Med 2020; 1-15. Online ahead of print.
[http://dx.doi.org/10.1017/S0033291720005188] [PMID: 33305716]
[35]
Kim HY. Statistical notes for clinical researchers: Chi-squared test and Fisher’s exact test. Restor Dent Endod 2017; 42(2): 152-5.
[http://dx.doi.org/10.5395/rde.2017.42.2.152] [PMID: 28503482]
[36]
Katz MH. Multivariable analysis-A practical guide for clinicians and public health researchers. Cambridge, U.K.: Cambridge University Press 2011.
[http://dx.doi.org/10.1017/CBO9780511974175]
[37]
Hosmer DW, Lemeshow S. Applied Logistic Regression. New York: Wiley 2013.
[http://dx.doi.org/10.1002/9781118548387]
[38]
Pope C, Ziebland S, Mays N. Qualitative research in health care. Analysing qualitative data. BMJ 2000; 320(7227): 114-6.
[http://dx.doi.org/10.1136/bmj.320.7227.114] [PMID: 10625273]
[39]
Farmer T, Robinson K, Elliott SJ, Eyles J. Developing and implementing a triangulation protocol for qualitative health research. Qual Health Res 2006; 16(3): 377-94.
[http://dx.doi.org/10.1177/1049732305285708] [PMID: 16449687]
[41]
Jones DL, Salazar AS, Rodriguez VJ, et al. SARS-CoV-2: Vaccine hesitancy among underrepresented racial and ethnic groups with HIV in Miami, Florida Open Forum Infect Dis 2021; 8(6): ofab154.
[http://dx.doi.org/10.1093/ofid/ofab154] [PMID: 34621912]
[42]
Eniade OD, Olarinmoye A, Otovwe A, Akintunde FE, Okedare OO, Aniyeloye AO. Willingness to accept COVID-19 vaccine and its determinants among Nigeria Citizens: A web-based cross-sectional study. J Adv Med Med Res 2021; 33(8): 13-22.
[http://dx.doi.org/10.9734/jammr/2021/v33i830881]
[43]
Wong MCS, Wong ELY, Huang J, et al. Acceptance of the COVID-19 vaccine based on the health belief model: A population-based survey in Hong Kong. Vaccine 2021; 39(7): 1148-56.
[http://dx.doi.org/10.1016/j.vaccine.2020.12.083] [PMID: 33461834]
[44]
Raufu A. Polio vaccine plans may run into problems in Nigeria. BMJ 2003; 327(7410): 380.
[http://dx.doi.org/10.1136/bmj.327.7410.380-c] [PMID: 12907514]

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