Duncan Dustin T, Park Su Hyun, Chen Yen-Tyng, Dolotina Brett, Worrall Wilder R, Hanson Hillary, Durrell Mainza, Franco Gustavo Arruda, Morse Stephen S, Schneider John A
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA.
Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore.
Vaccines (Basel). 2023 Apr 3;11(4):787. doi: 10.3390/vaccines11040787.
Although there is limited literature on medication adherence (including HIV care engagement) and COVID-19 vaccine hesitancy in general populations (i.e., non-sexual or gender minority populations), even less is known about whether HIV care engagement correlates with COVID-19 vaccine hesitancy among sexual and gender minorities, especially those from intersectional backgrounds. The objective of the current study was to examine if an association exists between HIV status neutral care (i.e., current pre-exposure prophylaxis [PrEP] or antiretroviral therapy [ART] use) and COVID-19 vaccination hesitancy among Black cisgender sexual minority men and transgender women at the initial peak of the pandemic.
We conducted the N2 COVID Study in Chicago from 20 April 2020 to 31 July 2020 (analytic = 222), including Black cisgender sexual minority men and transgender women who were vulnerable to HIV as well as those who were living with HIV. The survey included questions regarding HIV care engagement, COVID-19 vaccination hesitancy and COVID-19 related socio-economic hardships. Multivariable associations estimated adjusted risk ratios (ARRs) using modified Poisson regressions for COVID vaccine hesitancy adjusting for baseline socio-demographic characteristics and survey assessment time period.
Approximately 45% of participants reported COVID-19 vaccine hesitancy. PrEP and ART use were not associated with COVID-19 vaccine hesitancy when examined separately or combined ( > 0.05). There were no significant multiplicative effects of COVID-19 related socio-economic hardships and HIV care engagement on COVID-19 vaccine hesitancy.
Findings suggest no association between HIV care engagement and COVID-19 vaccine hesitancy among Black cisgender sexual minority men and transgender women at the initial peak of the pandemic. It is therefore essential that COVID-19 vaccine promotion interventions focus on all Black sexual and gender minorities regardless of HIV care engagement and COVID-19 vaccine uptake is likely related to factors other than engagement in HIV status neutral care.
尽管关于普通人群（即非性少数或性别少数群体）的药物依从性（包括艾滋病毒护理参与情况）和新冠病毒疫苗犹豫情况的文献有限，但对于性少数和性别少数群体，尤其是具有交叉背景的群体中，艾滋病毒护理参与情况与新冠病毒疫苗犹豫之间的关系，了解得更少。本研究的目的是调查在疫情初期高峰时，黑人顺性别性少数男性和跨性别女性中，艾滋病毒状态中性护理（即当前使用暴露前预防[PrEP]或抗逆转录病毒疗法[ART]）与新冠病毒疫苗犹豫之间是否存在关联。
我们于2020年4月20日至2020年7月31日在芝加哥开展了N2新冠研究（分析样本量 = 222），纳入了易感染艾滋病毒的黑人顺性别性少数男性和跨性别女性以及艾滋病毒感染者。该调查包括有关艾滋病毒护理参与情况、新冠病毒疫苗犹豫以及与新冠病毒相关的社会经济困难的问题。多变量关联分析使用修正泊松回归估计调整风险比（ARR），以分析新冠病毒疫苗犹豫情况，并对基线社会人口统计学特征和调查评估时间段进行调整。
约45%的参与者表示对新冠病毒疫苗存在犹豫。单独或综合考虑时，PrEP和ART的使用与新冠病毒疫苗犹豫均无关联（P > 0.05）。与新冠病毒相关的社会经济困难和艾滋病毒护理参与情况对新冠病毒疫苗犹豫没有显著的相乘效应。
研究结果表明，在疫情初期高峰时，黑人顺性别性少数男性和跨性别女性中，艾滋病毒护理参与情况与新冠病毒疫苗犹豫之间无关联。因此，至关重要的是，新冠病毒疫苗推广干预措施应针对所有黑人性少数和性别少数群体，无论其艾滋病毒护理参与情况如何，且新冠病毒疫苗接种情况可能与参与艾滋病毒状态中性护理以外 的因素有关。
