Govere-Hwenje Sabina, Jarolimova Jana, Yan Joyce, Khumalo Anele, Zondi Gugulami, Ngcobo Marcia, Wara Nafisa J, Zionts Dani, Bogart Laura M, Parker Robert A, Bassett Ingrid V
AIDS Healthcare Foundation.
Massachusetts General Hospital Infectious Diseases Division.
Res Sq. 2022 Apr 12:rs.3.rs-824083. doi: 10.21203/rs.3.rs-824083/v1.
People living with HIV (PLWH) may have a poorer prognosis with COVID-19 infection and are an important population for COVID-19 vaccination. We assessed the willingness and reasons for COVID-19 vaccine acceptance or hesitancy among PLWH in South Africa. We conducted a cross-sectional study consisting of telephone interviews with a randomly selected subset of participants enrolled in a prospective observational cohort study evaluating a decentralized antiretroviral therapy (ART) delivery program in South Africa. Questions assessed willingness to accept a future COVID-19 vaccine, concerns regarding COVID-19 vaccination, and overall vaccine confidence. Interviews were conducted between September 2020 and January 2021. We evaluated participant demographics, sources of COVID-19 information, stigma and medical mistrust, uptake of non-pharmaceutical interventions, and socioeconomic impacts of the COVID-19 pandemic as potential covariates of willingness to accept vaccination. We completed interviews with 213 participants; 153 (72%) were female, median age 35y, and 100 (47%) had completed secondary school. Among the participants, 121 (57%) were willing to accept future vaccination, 46 (22%) were unsure, and 45 (21%) stated they did not intend to be vaccinated. Fear of side effects, reported by 42 (20%), was the most common concern about COVID-19 vaccination. Older age was associated with willingness to accept vaccination (aOR 1.75 for every 10-year increase in age, 95% CI 1.10-2.78, p=0.02), while higher medical mistrust related to COVID-19 (aOR 0.21, 95% CI 0.093-0.45, p<0.001) and use of social media for COVID-19 information (aOR 0.30, 95% CI 0.11-0.84, p=0.02) were associated with lower willingness to accept vaccination. In this cohort of PLWH in South Africa, over half were willing to accept COVID-19 vaccination, although a substantial proportion remained unsure or were not willing to be vaccinated. Public health messaging should emphasize the safety and efficacy of COVID-19 vaccination and address misinformation and medical mistrust among PLWH. Ongoing efforts to ensure access to COVID-19 vaccines for vulnerable populations are crucial.
感染新冠病毒的艾滋病毒感染者（PLWH）预后可能较差，是新冠病毒疫苗接种的重要人群。我们评估了南非艾滋病毒感染者接受或犹豫接种新冠病毒疫苗的意愿及原因。我们开展了一项横断面研究，对参与一项前瞻性观察队列研究的部分随机抽取的参与者进行电话访谈，该队列研究评估了南非的一项去中心化抗逆转录病毒疗法（ART）提供项目。问题涉及接受未来新冠病毒疫苗的意愿、对新冠病毒疫苗接种的担忧以及总体疫苗信心。访谈于2020年9月至2021年1月进行。我们评估了参与者的人口统计学特征、新冠病毒信息来源、耻辱感和医疗不信任感、非药物干预措施的采用情况以及新冠疫情的社会经济影响，将其作为接受疫苗接种意愿的潜在协变量。我们完成了对213名参与者的访谈；153名（72%）为女性，年龄中位数为35岁，100名（47%）完成了中学教育。在参与者中，121名（57%）愿意接受未来的疫苗接种，46名（22%）不确定，45名（21%）表示他们不打算接种疫苗。42名（20%）报告的对副作用的恐惧是对新冠病毒疫苗接种最常见的担忧。年龄较大与接受疫苗接种的意愿相关（年龄每增加10岁，调整后比值比为1.75，95%置信区间为1.10 - 2.78，p = 0.02），而与新冠病毒相关的较高医疗不信任感（调整后比值比为0.21，95%置信区间为0.093 - 0.45，p < 0.001）以及使用社交媒体获取新冠病毒信息（调整后比值比为0.30，95%置信区间为0.11 - 0.84，p = 0.02）与接受疫苗接种的意愿较低相关。在南非的这一艾滋病毒感染者队列中，超过一半的人愿意接受新冠病毒疫苗接种，尽管有相当一部分人仍不确定或不愿意接种。公共卫生宣传应强调新冠病毒疫苗接种的安全性和有效性，并解决艾滋病毒感染者中的错误信息和医疗不信任问题。持续努力确保弱势群体能够获得新冠病毒疫苗至关重要。
