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
[http://dx.doi.org/10.23750/abm.v91i1.9397] [PMID: 32191675]
[http://dx.doi.org/10.1016/j.jve.2020.100019] [PMID: 33083001]
[http://dx.doi.org/10.1016/S2352-3018(20)30305-2] [PMID: 33316211]
[http://dx.doi.org/10.1186/s12981-021-00335-1] [PMID: 33952300]
[http://dx.doi.org/10.1089/aid.2020.0284] [PMID: 33599163]
[http://dx.doi.org/10.1097/QAD.0000000000002666] [PMID: 32796217]
[http://dx.doi.org/10.1093/cid/ciaa1946] [PMID: 33395474]
[http://dx.doi.org/10.1007/s10461-020-02983-2] [PMID: 32734438]
[http://dx.doi.org/10.1080/14656566.2021.1887140] [PMID: 33634724]
[http://dx.doi.org/10.1111/1751-7915.13818] [PMID: 33960659]
[http://dx.doi.org/10.3892/ijmm.2020.4596] [PMID: 32377694]
[http://dx.doi.org/10.1016/j.jmii.2020.09.005] [PMID: 33046418]
[http://dx.doi.org/10.1016/S0140-6736(20)31604-4] [PMID: 32702298]
[http://dx.doi.org/10.1080/17441692.2021.1916056] [PMID: 33870859]
[http://dx.doi.org/10.1093/cid/cit816] [PMID: 24421306]
[http://dx.doi.org/10.1002/jmv.26321] [PMID: 32692406]
[http://dx.doi.org/10.3390/vaccines9010016] [PMID: 33396832]
[http://dx.doi.org/10.3390/vaccines9040302] [PMID: 33804808]
[http://dx.doi.org/10.11648/j.cajph.20210702.12]
[http://dx.doi.org/10.11604/pamj.2021.38.230.27325] [PMID: 34046135]
[http://dx.doi.org/10.7717/peerj.11153] [PMID: 33828927]
[http://dx.doi.org/10.1080/17441692.2013.859720] [PMID: 24294986]
[http://dx.doi.org/10.1177/1558689809349691]
[http://dx.doi.org/10.2188/jea.JE20080026] [PMID: 19265273]
[http://dx.doi.org/10.1371/journal.pone.0245176] [PMID: 33444360]
[http://dx.doi.org/10.3390/vaccines9020119] [PMID: 33546165]
[http://dx.doi.org/10.1093/cid/ciab054] [PMID: 33491049]
[http://dx.doi.org/10.1017/S0033291720005188] [PMID: 33305716]
[http://dx.doi.org/10.5395/rde.2017.42.2.152] [PMID: 28503482]
[http://dx.doi.org/10.1017/CBO9780511974175]
[http://dx.doi.org/10.1002/9781118548387]
[http://dx.doi.org/10.1136/bmj.320.7227.114] [PMID: 10625273]
[http://dx.doi.org/10.1177/1049732305285708] [PMID: 16449687]
[http://dx.doi.org/10.1093/ofid/ofab154] [PMID: 34621912]
[http://dx.doi.org/10.9734/jammr/2021/v33i830881]
[http://dx.doi.org/10.1016/j.vaccine.2020.12.083] [PMID: 33461834]
[http://dx.doi.org/10.1136/bmj.327.7410.380-c] [PMID: 12907514]