COVID‐19 vaccine acceptance among people living with HIV: A systematic review and meta‐analysis

Abstract

AbstractObjectiveTo assess coronavirus disease 2019 (COVID‐19) vaccine acceptance among people living with HIV (PLHIV) worldwide.MethodsWe searched MEDLINE, PSYINFO, CINHAL, Scopus and EMBASE databases and other sources including free Google search and subject‐specific journals from January 2020 to September 2021. The study population included adults (aged 18+ years) living with HIV and evaluated for COVID‐19 vaccine acceptance. A random effect meta‐analysis model was used to estimate the pooled COVID‐19 vaccine acceptance rate. Subgroup analyses were performed, and factors associated with COVID‐19 vaccine hesitancy underwent narrative analysis. Of 558 initial records, 14 studies were eligible for review.ResultsThe overall pooled COVID‐19 vaccine acceptance rate among adult PLHIV was 62% (95% confidence interval [CI], 56%–69%). In subgroup analysis, the estimated pooled COVID‐19 vaccine acceptance rate was higher in high‐income countries: 63% (95% CI, 55%–70%) versus 62% (95% CI, 54%–71%) in low‐ and middle‐income countries, and in studies conducted in 2022 (66% [95% CI, 58%–75%]) than in studies conducted in 2021 (57% [95% CI, 47%–68%]). Reasons for lower COVID‐19 vaccine acceptance included higher monthly income, being non‐homosexual, history of chronic disease, COVID‐19‐related medical mistrust, not knowing anyone who died of COVID‐19, believing oneself to be immune to COVID‐19, general vaccine refusal, negative attitude to the vaccine, concerns about efficacy, safety and side effects, distrust in common sources of vaccine‐related information and using social media as a source of information on COVID‐19.ConclusionAmong PLHIV, acceptance of COVID‐19 vaccine is generally low. A greater emphasis on collaborative efforts between all concerned bodies is needed to boost vaccine acceptance in this population.