Division of HIV, ID, and Global Medicine, University of California, San Francisco, CA.
Division of Prevention Science, University of California, San Francisco, CA.
J Acquir Immune Defic Syndr. 2024 Sep 1;97(1):13-18. doi: 10.1097/QAI.0000000000003466.
People with HIV (PWH) have higher risk of COVID-19 mortality. SARS-CoV-2 vaccination is highly effective among PWH, although vaccine hesitancy could limit the population-level impact.
From February 2021 to April 2022, PWH from 8 sites in the Centers for AIDS Research Network of Integrated Clinical Systems completed a vaccine hesitancy instrument as part of routine care.
Participants were defined as vaccine hesitant if they had not received the SARS-CoV-2 vaccine and would probably/definitely not receive it. We assessed factors associated with SARS-CoV-2 vaccine hesitancy using logistic regression adjusted for demographics, unsuppressed viral load (VL > 200 copies/mL), month, and time on ART; using inverse probability weighting for survey nonresponse.
Overall, 3288 PWH with a median age of 55 were included; 18% were female and 94% were virally suppressed. At the time of survey, 27% reported they had not received the SARS-CoV-2 vaccine, and 9% (n = 279) reported vaccine hesitancy. Factors associated with vaccine hesitancy included female sex (adjusted odds ratio [AOR] = 2.3; 95% confidence interval (CI): 1.6-3.2), Black vs. White race (AOR 1.7; 95% CI: 1.2 to 2.4), younger age (AOR 1.4; 95% CI: 1.2 to 1.5), and unsuppressed VL (AOR 1.9; 95% CI: 1.3 to 3.0).
Overall, over one-quarter of PWH in this multisite cohort were unvaccinated for SARS-CoV-2 when interviewed February 21-April 22. Vaccine hesitancy was reported by approximately 9% of PWH and was higher among women, Black PWH, younger PWH, PWH with unsuppressed VL, and those in the South/Midwest. Renewed efforts are needed to address concerns of PWH about vaccinations against COVID-19 as the pandemic evolves, and vaccines in general, given the potential for future pandemics.
HIV 感染者（PWH）患 COVID-19 后死亡的风险更高。SARS-CoV-2 疫苗在 PWH 中的有效性很高，尽管疫苗犹豫可能会限制其对人群的影响。
从 2021 年 2 月到 2022 年 4 月，来自艾滋病研究中心网络综合临床系统的 8 个地点的 PWH 在常规护理中完成了疫苗犹豫量表。
如果 PWH 尚未接种 SARS-CoV-2 疫苗且可能/肯定不会接种疫苗，则将其定义为疫苗犹豫者。我们使用调整了人口统计学、未抑制的病毒载量（VL>200 拷贝/mL）、月份和 ART 时间的逻辑回归评估了与 SARS-CoV-2 疫苗犹豫相关的因素；使用调查无反应的逆概率加权。
总体而言，纳入了 3288 名中位年龄为 55 岁的 PWH；18%为女性，94%的病毒载量得到抑制。在调查时，27%的人报告尚未接种 SARS-CoV-2 疫苗，9%（n=279）报告疫苗犹豫。与疫苗犹豫相关的因素包括女性（调整后的优势比[OR] = 2.3；95%置信区间[CI]：1.6-3.2）、黑人和白人种族（OR 1.7；95%CI：1.2-2.4）、年龄较小（OR 1.4；95%CI：1.2-1.5）和未抑制的 VL（OR 1.9；95%CI：1.3-3.0）。
总体而言，在接受采访的 2 月 21 日至 4 月 22 日，该多地点队列中超过四分之一的 PWH 未接种 SARS-CoV-2 疫苗。大约 9%的 PWH 报告了疫苗犹豫，女性、黑人 PWH、年轻 PWH、未抑制 VL 的 PWH 和南方/中西部地区的 PWH 中报告疫苗犹豫的比例更高。随着大流行的发展，以及一般疫苗的发展，需要重新努力解决 PWH 对 COVID-19 疫苗接种的担忧，因为未来可能会出现大流行。
