CTN 328-1: Vaccine Confidence in HIV

About The Study

CTN 328-1 aimed to document factors that affect COVID-19 vaccine confidence and uptake in people living with HIV. The study also aimed to determine the level of knowledge that people living with HIV in Canada have about COVID-19 and COVID-19 vaccines. This survey-based investigation was a sub-study of CTN 328, a cross-Canada study to assess the immune response of people living with HIV to COVID-19 vaccination.

About the Problem

Vaccination is an effective method to prevent the spread of COVID-19 and to limit the severity of illness in people who become infected. Some people are hesitant to be vaccinated against COVID-19 and other diseases for a variety of reasons. In certain cases, people living with HIV are hesitant to receive the COVID-19 vaccine, even though they may be at higher risk of more severe disease if they get infected.

Vaccine confidence is affected by many different factors, like political leanings, age, education, ethnicity, income, gender, and religious beliefs. Vaccine uptake can also be affected by social norms (behaviours that are seen as “normal”) and by health literacy (a person’s ability to access, understand, appraise, and apply health information). In people living with HIV, vaccine confidence may be affected by how confident a person is that the vaccine will protect them, their perceived risk of COVID-19–related illness, and experiences of stigma and mistrust of the medical system. Overall, the factors that contribute to COVID-19 vaccine confidence in people living with HIV in Canada are not well understood.

Study Approach

This study aimed to enroll a minimum of 250 participants (both vaccinated and unvaccinated) through social media and community-based organizations. The study team recruited people from a number of key groups, including injection drug users, women, and people from African, Caribbean, and Black communities.

Participants in this study completed an online questionnaire, which covered things like a person’s perceptions of vaccine safety, COVID-19–related risk, and the vaccination process, as well as related knowledge, attitudes, and trust. All participants accessed the informed consent form online as part of the survey process. Researchers used this information to understand the factors that are related to vaccine confidence or hesitancy. Ultimately, this information can be used to inform new approaches to improve vaccine uptake in people living with HIV in Canada.

Results

The CTN 328-1 questionnaire gathered data from 259 people living with HIV in Canada to understand why they received the vaccine and possible links between vaccine beliefs and behaviour. Almost 90 per cent of respondents received at least one dose of COVID-19 vaccine, and over 80 per cent believed that vaccination was important for the health of themselves and others. Factors associated with an increased likelihood of receiving a COVID-19 vaccine include being of an older age.

Additional analyses showed that females were more likely to lack confidence in COVID-19 vaccines than males. More specifically, females were less likely to believe the vaccines were important for their or other peoples’ health or a good way to protect themselves from infection. Furthermore, females were less trustworthy of the vaccine-related information provided by health care providers and public health officials.

Conclusion

While many people living with HIV received the COVID-19 vaccine and considered it important for their health and the health of others, there remains some vaccine hesitancy, particularly among younger people and females. Additional work is needed to understand the different attitudes towards vaccines and to develop and share educational initiatives to understand and improve vaccine confidence.