Acceptance of COVID-19 Vaccination and its Related Factors Among HIV/AIDS Patients in Guangxi, China: A Cross-Sectional Survey.

Background Vaccination is the most effective approach against the coronavirus disease 2019 (COVID-2019) pandemic. This study aimed to investigate acceptance and the predominant influential factors of COVID-19 vaccination among people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). Methods A cross-sectional survey was carried out in five cities in Guangxi from 7 May to 1 June 2021. Questionnaires on the acceptance of COVID-19 vaccination and the influential factors were conducted among HIV/AIDS patients recruited by random cluster sampling. We performed univariate and multivariate logistic regression analysis to identify factors associated with acceptance of COVID-19 vaccination among HIV/AIDS patients. Results Of all the participants (n = 903), 72.9% (n = 658) were willing to accept the COVID-19 vaccine and there was no statistically significant difference between CD4+T cell count and willingness to vaccinate using stratified analysis (P > 0.05). The main reason for willingness to accept the COVID-19 vaccine was fear of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (76.0%), whereas patients who were reluctant to receive the vaccine were mainly concerned about the safety of the vaccine (54.7%) and whether it would impact anti-retroviral therapy(ART) efficacy (50.6%). The most significant factors influencing vaccination were concerns that the vaccine was unsafe in HIV patients (OR=0.082, 95%CI = 0.024–0.282) and that it would be less effective in preventing SARS-CoV-2 infection in HIV patients (OR = 0.093, 95%CI = 0.030–0.287). Other factors associated with acceptance of the COVID-19 vaccine included Zhuang ethnicity (OR=1.653, 95%CI=1.109–2.465), the highest education level of middle school and high school or above (OR=1.747, 95%CI=1.170–2.608; OR=2.492, 95%CI=1.326–4.682), unknown vaccination type (OR=0.487, 95%CI=0.305–0.776) and little vaccine influence on ART efficacy (OR=2.889, 95%CI=1.378-6.059). Conclusions Acceptance of the COVID-19 vaccination is high among HIV/AIDS patients, although some patients refused vaccination because of vaccine safety and influence on ART efficacy. More research is needed to investigate the impact of the COVID-19 vaccine on the efficacy of ART and to evaluate its effectiveness in preventing SARS-CoV-2 infection in HIV patients so that concerns about COVID-19 vaccination issues can be addressed in HIV patients.