Reasons for COVID-19 Vaccine Hesitancy Among Chinese People Living With HIV/AIDS: Structural Equation Modeling Analysis

Abstract

Background Many countries and organizations recommended people living with HIV/AIDS (PLWHA) receive the COVID-19 vaccine. However, vaccine hesitancy still exists and becomes a barrier for promoting COVID-19 vaccination among PLWHA. Objective This study aims to investigate factors that contributed to COVID-19 vaccine hesitancy among PLWHA. Methods The study used a multicenter cross-sectional design and an online survey mode. We recruited PLWHA aged 18-65 years from 5 metropolitan cities in China between January 2021 and February 2021. Participants completed an online survey through Golden Data, a widely used encrypted web-based survey platform. Multiple linear regression models were used to assess the background characteristics in relation to COVID-19 vaccine hesitancy, and structural equation modeling was performed to assess the relationships among perceived benefits, perceived risks, self-efficacy, subjective norms, and COVID-19 vaccine hesitancy. Results Among 1735 participants, 41.61% (722/1735) reported COVID-19 vaccine hesitancy. Older age, no other vaccinations in the past 3 years, and having chronic disease history were positively associated with COVID-19 vaccine hesitancy. Structural equation modeling revealed a direct relationship of perceived benefits, perceived risks, and subjective norms with self-efficacy and vaccine hesitancy and an indirect relationship of perceived benefits, perceived risks, and subjective norms with vaccine hesitancy. Moreover, self-efficacy toward COVID-19 vaccination was low. PLWHA had concerns of HIV disclosure during COVID-19 vaccination. Family member support could have an impact on COVID-19 vaccination decision-making. Conclusions COVID-19 vaccine hesitancy was high among PLWHA in China. To reduce COVID-19 vaccine hesitancy, programs and strategies should be adopted to eliminate the concerns for COVID-19 vaccination, disseminate accurate information on the safety and efficacy of the COVID-19 vaccine, encourage family member support for COVID-19 vaccination, and improve PLWHA’s trust of medical professionals.

The safety and immunogenicity of a two-dose schedule of CoronaVac, and the immune persistence of vaccination for six months, in people living with HIV: A multicenter prospective cohort study

“…Since PLWH have an increased risk of breakthrough infections compared to the general population, a booster dose to PLWH would be an alternative method to sustain sufficient protection. Though China is promoting a prime-boost schedule, a high proportion of PLWH failed to receive a booster dose due to vaccine hesitancy ( 35 ). Considering that the Chinese government has recently published novel guidance regarding a shorter interval of prime-boost schedule (3 months) among elderly than younger adults (6 months), this finding will provide strong evidence to formulate specific vaccination guidance in PLWH ( 36 ).…”

“…CoronaVac is the most widely utilized COVID-19 vaccine in China and has been introduced globally in more than 20 low-income and middle-income countries, such as Brazil, Chile, and Turkey (5)(6)(7). Studies showed that a two-dose CoronaVac regimen was effective in terms of an overall 67.7% (95% Confidence interval (CI), 35.9% to 83.7%) efficacy for the prevention of symptomatic COVID-19 and a 92% positivity of neutralizing antibodies (nAbs) among healthy adults (7)(8)(9)(10)(11).…”

Perception of and Vaccine Readiness towards Mpox among Men Who Have Sex with Men Living with HIV in China: A Cross-Sectional Study

“…When vaccine resources are limited, MSM living with HIV may need to be considered as a priority group. In addition, previous studies have shown that despite specific guidelines, people living with HIV remain skeptical about the safety and effectiveness of vaccination because of their immunosuppressed status [ 23 , 24 ]. It is necessary to assess the perception of and vaccine readiness towards Mpox among this population who are at very high risk for Mpox transmission.…”

Disparities in COVID-19 vaccination coverage in rural Romania

“…[4] Older age and having a chronic disease history were reported to be positively associated with COVID-19 vaccine hesitancy in Chinese people living with HIV/ AIDS (Yao et al, 2022).…”

“…Same structural discriminatory attitudes, together with transport and language barriers are highlighted in Butler et al, 2022. A better focus on speci c disadvantaged groups has been emphasized -for instance, in relation to patients with mental illness (Payberah et al, 2022), people living with HIV/AIDS (Yao et al, 2022) or robust disaggregated data on vaccine hesitancy among ethnic minorities (Hussain et al, 2022).…”