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Willingness to Receive COVID-19 Vaccination Among People Living With HIV and AIDS in China: Nationwide Cross-sectional Online Survey.
JMIR Public Health Surveill. 2021 10 21; 7(10):e31125.JP

Abstract

BACKGROUND

HIV infection is a significant independent risk factor for both severe COVID-19 presentation at hospital admission and in-hospital mortality. Available information has suggested that people living with HIV and AIDS (PLWHA) could benefit from COVID-19 vaccination. However, there is a dearth of evidence on willingness to receive COVID-19 vaccination among PLWHA.

OBJECTIVE

The aim of this study was to investigate willingness to receive COVID-19 vaccination among a national sample of PLWHA in China.

METHODS

This cross-sectional online survey investigated factors associated with willingness to receive COVID-19 vaccination among PLWHA aged 18 to 65 years living in eight conveniently selected Chinese metropolitan cities between January and February 2021. Eight community-based organizations (CBOs) providing services to PLWHA facilitated the recruitment. Eligible PLWHA completed an online survey developed using a widely used encrypted web-based survey platform in China. We fitted a single logistic regression model to obtain adjusted odds ratios (aORs), which involved one of the independent variables of interest and all significant background variables. Path analysis was also used in the data analysis.

RESULTS

Out of 10,845 PLWHA approached by the CBOs, 2740 completed the survey, and 170 had received at least one dose of the COVID-19 vaccine. This analysis was performed among 2570 participants who had never received COVID-19 vaccination. Over half of the participants reported willingness to receive COVID-19 vaccination (1470/2570, 57.2%). Perceptions related to COVID-19 vaccination were significantly associated with willingness to receive COVID-19 vaccination, including positive attitudes (aOR 1.11, 95% CI 1.09-1.12; P<.001), negative attitudes (aOR 0.96, 95% CI 0.94-0.97; P<.001), perceived support from significant others (perceived subjective norm; aOR 1.53, 95% CI 1.46-1.61; P<.001), and perceived behavioral control (aOR 1.13, 95% CI 1.11-1.14; P<.001). At the interpersonal level, receiving advice supportive of COVID-19 vaccination from doctors (aOR 1.99, 95% CI 1.65-2.40; P<.001), CBO staff (aOR 1.89, 95% CI 1.51-2.36; P<.001), friends and/or family members (aOR 3.22, 95% CI 1.93-5.35; P<.001), and PLWHA peers (aOR 2.38, 95% CI 1.85-3.08; P<.001) was associated with higher willingness to receive COVID-19 vaccination. The overall opinion supporting COVID-19 vaccination for PLWHA on the internet or social media was also positively associated with willingness to receive COVID-19 vaccination (aOR 1.59, 95% CI 1.31-1.94; P<.001). Path analysis indicated that interpersonal-level variables were indirectly associated with willingness to receive COVID-19 vaccination through perceptions (β=.43, 95% CI .37-.51; P<.001).

CONCLUSIONS

As compared to PLWHA in other countries and the general population in most parts of the world, PLWHA in China reported a relatively low willingness to receive COVID-19 vaccination. The internet and social media as well as interpersonal communications may be major sources of influence on PLWHA's perceptions and willingness to receive COVID-19 vaccination.

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Authors+Show Affiliations

Huang X
Infectious Disease Department, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Yu M
Tianjin Center for Disease Control and Prevention, Tianjin, China.
Fu G
Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
Lan G
Guangxi Center for Disease Control and Prevention, Nanning, China.
Li L
Infectious Disease Department, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
Yang J
Department of Preventive Medicine, Changzhi Medical College, Changzhi, China.
Qiao Y
Infectious Disease Department, The Second Hospital of Huhhot, Huhhot, China.
Zhao J
Shenzhen Center for Disease Control and Prevention, Shenzhen, China.
Qian HZ
SJTU-Yale Joint Center for Biostatistics and Data Sciences, Shanghai Jiao Tong University, Shanghai, China.
Zhang X
Department of Public Health, University of Tennessee, Knoxville, TN, United States.
Liu X
Infectious Disease Department, Peking Union Medical College Hospital, Beijing, China.
Jin X
AIDS Healthcare Foundation China, Beijing, China.
Chen G
Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
Jiang H
Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Tang W
STD Prevention and Control Department, University of North Carolina Project-China, Guangzhou, China.
Wang Z
Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Xu J
Clinical Research Academy, Peking University Shenzhen Hospital, Peking University, Shenzhen, China.

MeSH

COVID-19COVID-19 VaccinesChinaCross-Sectional StudiesHIV InfectionsHumansSARS-CoV-2Vaccination

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

34543223

Citation

Huang, Xiaojie, et al. "Willingness to Receive COVID-19 Vaccination Among People Living With HIV and AIDS in China: Nationwide Cross-sectional Online Survey." JMIR Public Health and Surveillance, vol. 7, no. 10, 2021, pp. e31125.
Huang X, Yu M, Fu G, et al. Willingness to Receive COVID-19 Vaccination Among People Living With HIV and AIDS in China: Nationwide Cross-sectional Online Survey. JMIR Public Health Surveill. 2021;7(10):e31125.
Huang, X., Yu, M., Fu, G., Lan, G., Li, L., Yang, J., Qiao, Y., Zhao, J., Qian, H. Z., Zhang, X., Liu, X., Jin, X., Chen, G., Jiang, H., Tang, W., Wang, Z., & Xu, J. (2021). Willingness to Receive COVID-19 Vaccination Among People Living With HIV and AIDS in China: Nationwide Cross-sectional Online Survey. JMIR Public Health and Surveillance, 7(10), e31125. https://doi.org/10.2196/31125
Huang X, et al. Willingness to Receive COVID-19 Vaccination Among People Living With HIV and AIDS in China: Nationwide Cross-sectional Online Survey. JMIR Public Health Surveill. 2021 10 21;7(10):e31125. PubMed PMID: 34543223.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Willingness to Receive COVID-19 Vaccination Among People Living With HIV and AIDS in China: Nationwide Cross-sectional Online Survey. AU - Huang,Xiaojie, AU - Yu,Maohe, AU - Fu,Gengfeng, AU - Lan,Guanghua, AU - Li,Linghua, AU - Yang,Jianzhou, AU - Qiao,Ying, AU - Zhao,Jin, AU - Qian,Han-Zhu, AU - Zhang,Xiangjun, AU - Liu,Xinchao, AU - Jin,Xia, AU - Chen,Guohong, AU - Jiang,Hui, AU - Tang,Weiming, AU - Wang,Zixin, AU - Xu,Junjie, Y1 - 2021/10/21/ PY - 2021/06/10/received PY - 2021/09/02/accepted PY - 2021/08/25/revised PY - 2021/9/21/pubmed PY - 2021/10/30/medline PY - 2021/9/20/entrez KW - COVID-19 vaccination KW - internet and social media influences KW - interpersonal communication KW - people living with HIV and AIDS KW - perceptions KW - willingness SP - e31125 EP - e31125 JF - JMIR public health and surveillance JO - JMIR Public Health Surveill VL - 7 IS - 10 N2 - BACKGROUND: HIV infection is a significant independent risk factor for both severe COVID-19 presentation at hospital admission and in-hospital mortality. Available information has suggested that people living with HIV and AIDS (PLWHA) could benefit from COVID-19 vaccination. However, there is a dearth of evidence on willingness to receive COVID-19 vaccination among PLWHA. OBJECTIVE: The aim of this study was to investigate willingness to receive COVID-19 vaccination among a national sample of PLWHA in China. METHODS: This cross-sectional online survey investigated factors associated with willingness to receive COVID-19 vaccination among PLWHA aged 18 to 65 years living in eight conveniently selected Chinese metropolitan cities between January and February 2021. Eight community-based organizations (CBOs) providing services to PLWHA facilitated the recruitment. Eligible PLWHA completed an online survey developed using a widely used encrypted web-based survey platform in China. We fitted a single logistic regression model to obtain adjusted odds ratios (aORs), which involved one of the independent variables of interest and all significant background variables. Path analysis was also used in the data analysis. RESULTS: Out of 10,845 PLWHA approached by the CBOs, 2740 completed the survey, and 170 had received at least one dose of the COVID-19 vaccine. This analysis was performed among 2570 participants who had never received COVID-19 vaccination. Over half of the participants reported willingness to receive COVID-19 vaccination (1470/2570, 57.2%). Perceptions related to COVID-19 vaccination were significantly associated with willingness to receive COVID-19 vaccination, including positive attitudes (aOR 1.11, 95% CI 1.09-1.12; P<.001), negative attitudes (aOR 0.96, 95% CI 0.94-0.97; P<.001), perceived support from significant others (perceived subjective norm; aOR 1.53, 95% CI 1.46-1.61; P<.001), and perceived behavioral control (aOR 1.13, 95% CI 1.11-1.14; P<.001). At the interpersonal level, receiving advice supportive of COVID-19 vaccination from doctors (aOR 1.99, 95% CI 1.65-2.40; P<.001), CBO staff (aOR 1.89, 95% CI 1.51-2.36; P<.001), friends and/or family members (aOR 3.22, 95% CI 1.93-5.35; P<.001), and PLWHA peers (aOR 2.38, 95% CI 1.85-3.08; P<.001) was associated with higher willingness to receive COVID-19 vaccination. The overall opinion supporting COVID-19 vaccination for PLWHA on the internet or social media was also positively associated with willingness to receive COVID-19 vaccination (aOR 1.59, 95% CI 1.31-1.94; P<.001). Path analysis indicated that interpersonal-level variables were indirectly associated with willingness to receive COVID-19 vaccination through perceptions (β=.43, 95% CI .37-.51; P<.001). CONCLUSIONS: As compared to PLWHA in other countries and the general population in most parts of the world, PLWHA in China reported a relatively low willingness to receive COVID-19 vaccination. The internet and social media as well as interpersonal communications may be major sources of influence on PLWHA's perceptions and willingness to receive COVID-19 vaccination. SN - 2369-2960 UR - https://www.unboundmedicine.com/medline/citation/34543223/Willingness_to_Receive_COVID_19_Vaccination_Among_People_Living_With_HIV_and_AIDS_in_China:_Nationwide_Cross_sectional_Online_Survey_ DB - PRIME DP - Unbound Medicine ER -