Understanding COVID-19 Vaccine Uptake and Hesitancy among People with HIV in Freetown, Sierra Leone: A Cross-Sectional Study.

Publication date: Nov 02, 2023

People with HIV (PWH) incur a higher risk of COVID-19-related morbidity and mortality rates, yet less is known about COVID-19 vaccine uptake and hesitancy in this group. We conducted a cross-sectional study in Freetown, Sierra Leone, from April to June 2022, using the VAX scale, a validated instrument, to assess attitudes towards COVID-19 vaccination and calculate the hesitancy (VAX) scores. We used generalized linear models to identify the factors associated with vaccine hesitancy. Overall, 490 PWH were enrolled (71. 4% female, median age: 38 years, median CD4 count: 412 cells/mm). About 17. 3% received ≥1 dose of a COVID-19 vaccine. The mean VAX score was 43. 14 +/- 7. 05, corresponding to 59. 9% participants being vaccine-hesitant. A preference for natural immunity (65. 8%) and concerns about profiteering (64. 4%) were the commonest reasons for hesitancy, followed by a mistrust of vaccine benefits (61. 4%) and worries about future effects (48. 0%). In the adjusted regression analysis, being a Muslim (β = 2. 563, p < 0. 001) and having an urban residence (β = 1. 709, p = 0. 010) were associated with greater vaccine hesitancy, while testing for COVID-19 was associated with reduced vaccine hesitancy (β = -3. 417, p = 0. 027). These findings underscore the importance of addressing vaccine hesitancy as a critical element boosting COVID-19 vaccine uptake among PWH.

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Concepts Keywords
April COVID-19
Muslim Sierra Leone
Profiteering vaccination


Type Source Name
disease VO COVID-19 vaccine
disease MESH COVID-19
disease MESH morbidity
disease VO vaccination
disease VO vaccine
disease VO dose
drug DRUGBANK Coenzyme M
disease VO USA
disease MESH Infectious Diseases
disease VO population
disease IDO susceptibility
disease MESH cardiovascular diseases
disease MESH obesity
disease MESH HIV infection
pathway REACTOME HIV Infection

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