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Master of Public Health

Predictors of COVID-19 vaccine acceptability among patients living with HIV in northern Nigeria: A mixed methods study

AUTHORS

Iliyasu Z , Kwaku AA , Umar AA , Tsiga-Ahmed F , Nass NS , Abdullahi HM , Amole TG , Salihu HM , Aliyu MH , . Current HIV research. 2021 12 16; ().

ABSTRACT

BACKGROUND: People living with HIV (PLHIV) are at increased risk of COVID-19 acquisition, severe disease, and poor outcomes. Yet, little is known about COVID-19 vaccine hesitancy among PLHIV in high HIV burden countries such as Nigeria.

OBJECTIVE: This study aims to assess the acceptability of the COVID-19 vaccine and identify predictors and reasons for vaccine hesitancy among patients living with HIV and attending a tertiary hospital in Kano, northern Nigeria.

METHODS: Using a mixed-methods design, structured questionnaires were administered to a clinic-based sample of patients living with HIV (n=344), followed by 20 in-depth interviews with a sub-sample. Logistic regression and the framework approach were used to analyze the data.

RESULTS: Less than half (46.2%, n=159) of the respondents were willing to take the COVID-19 vaccine. Vaccine acceptance was higher among non-Muslim PLHIV (Adjusted Odds Ratio (aOR)=1.26, 95% Confidence Interval (95%CI): 1.10-4.00), persons with high-risk perception (aOR=2.43, 95%CI:1.18-5.00), those who were not worried about infertility-related rumors (aOR=13.54, 95%CI:7.07-25.94) and persons who perceived antiretroviral drugs are protective against COVID-19 (aOR = 2.76, 95%CI: 1.48-5.14). In contrast, vaccine acceptance was lower among persons who were not more concerned about the potential effects of COVID-19-HIV co-infection (aOR=0.20, 95%CI:0.10-0.39). The most common reasons for vaccine hesitancy included doubts about the existence of COVID-19, low-risk perception, anxiety about antiretroviral treatment-vaccine interactions, safety concerns, and infertility-related rumors.

CONCLUSION: Covid-19 vaccine acceptance was low among PLHIV. COVID-19 vaccine acceptance was associated with respondents’ faith, risk perception, perception of the protective effects of antiretroviral treatment, concerns about COVID-19-HIV co-infection, and infertility-related rumors. Vaccination counseling should be integrated into HIV treatment services to improve COVID-19 vaccine uptake among PLHIV in Kano and similar settings.

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