Louisiana State University Health Sciences Center, School of Public Health, New Orleans, LA.
Louisiana State University Pennington Biomedical Research Center, Baton Rouge, LA.
J Prev Med Hyg. 2022 Apr 26;63(1):E115-E124. doi: 10.15167/2421-4248/jpmh2022.63.1.2258. eCollection 2022 Mar.
Despite the burden of disease and increased risk of influenza-associated morbidity and mortality among PLWHA, influenza vaccination has been understudied in this population.
We built an 11-year cohort of HIV-infected adults from medical records of PLWHA seeking care within the Louisiana State University medical system from June 2002-June 2013. Influenza vaccination uptake among PLWHA was calculated overall and for each medical facility for each influenza season. Linear regression was used to assess influenza vaccination uptake over time, both overall and by facility. Data were restricted to the final influenza season (2012-13) to assess predictors of PLWHA vaccination. Individuals were nested within medical facilities in order to assess the amount of variability in influenza vaccination rates across medical facilities.
Influenza vaccination uptake among PLWHA increased over the study period (p < 0.01). The overall proportion of PLWHA vaccinated during the 2012-13 influenza season was 33.7%. 37.9% of the variability in the model occurred at the facility-level.
Although there was an increase in influenza vaccination within the PLWHA cohort over the course of the study, vaccination rates remained low overall. Special efforts must be made to increase vaccination uptake among PLWHA, with particular focus on those within the population who are likely to be at highest risk. The substantial variability at the facility-level indicates that there are unmeasured facility-level factors that contribute significantly to PLWHA vaccination.
尽管艾滋病毒感染者（PLWHA）面临疾病负担和流感相关发病率和死亡率增加的风险，但在该人群中，流感疫苗接种的研究相对较少。
我们从 2002 年 6 月至 2013 年 6 月期间在路易斯安那州立大学医疗系统寻求医疗护理的 PLWHA 的医疗记录中建立了一个由 11 年 HIV 感染成年人组成的队列。我们计算了每个流感季节中 PLWHA 的总体流感疫苗接种率以及每个医疗设施的接种率。线性回归用于评估总体和按设施划分的流感疫苗接种率随时间的变化。数据仅限于最后一个流感季节（2012-13 年），以评估 PLWHA 接种的预测因素。个体被嵌套在医疗设施内，以评估各医疗设施之间流感疫苗接种率的差异。
在研究期间，PLWHA 的流感疫苗接种率有所增加（p < 0.01）。在 2012-13 流感季节，PLWHA 接种疫苗的总体比例为 33.7%。模型中 37.9%的变异性发生在设施层面。
尽管在研究过程中，PLWHA 队列中的流感疫苗接种率有所增加，但总体接种率仍然较低。必须特别努力提高 PLWHA 的疫苗接种率，特别是针对那些可能面临最高风险的人群。设施层面的显著变异性表明，存在未被测量的设施层面因素，这些因素对 PLWHA 的疫苗接种有重大影响。
