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Willingness to Receive COVID-19 Vaccination Among People Living With HIV and AIDS in China: A Nationwide Online Survey

37 Pages Posted: 8 May 2021

See all articles by Xiaojie Huang

Xiaojie Huang

Capital Medical University - Center for Infectious Diseases

Maohe Yu

Tianjin Centers for Disease Control and Prevention

Gengfeng Fu

Jiangsu Provincial Center for Disease Control and Prevention - Institute for STI and HIV Control and Prevention

Guanghua Lan

Guangxi Center for Disease Prevention and Control

Linghua Li

Guangzhou Medical University - Guangzhou Eighth People's Hospital

Jianzhou Yang

Changzhi Medical College - Department of Preventive Medicine

Ying Qiao

The Second Hospital of Huhhot

Jin Zhao

Shenzhen Center for Disease Control and Prevention

Han-Zhu Qian

Shanghai Jiao Tong University (SJTU) - SJTU-Yale Joint Center for Biostatistics and Data Sciences

Xiangjun Zhang

University of Tennessee, Knoxville - Department of Public Health

Xinchao Liu

Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC) - Peking Union Medical College Hospital

Xia Jin

AIDS Healthcare Foundation (AHF) China

Guohong Chen

Jiangsu Provincial Center for Disease Control and Prevention

Hui Jiang

The Chinese University of Hong Kong (CUHK) - JC School of Public Health and Primary Care

Weiming Tang

University of North Carolina Project-China; Dermatology Hospital of Southern Medical University

Zixin Wang

The Chinese University of Hong Kong (CUHK) - Centre for Health Behaviours Research

Junjie Xu

Changzhi Medical College - Department of Preventive Medicine

More...

Abstract

Background: People living with HIV and AIDS (PLWHA) could benefit from COVID-19 vaccination. There is a dearth of evidence on willingness to receive COVID-19 vaccination (WTR) among PLWHA.

Methods: The study is a multicenter cross-sectional online survey conducted in eight conveniently selected Chinese metropolitan cities between January and February 2021. Participants were PLWHA aged 18-65 years and living in the study cities. Eight community-based organizations (CBO) providing services to PLWHA, one in each city, facilitated the recruitment through their networks. Eligible PLWHA completed an online survey developed using Golden Data, a widely used encrypted web-based survey platform in China. Logistic regression models and path analysis were used in data analysis.

Findings: Out of 10,845 PLWHA approached by the CBO, 2740 completed the survey. This analysis was performed among 2570 participants who had never received COVID-19 vaccination. Over half of the participants reported WTR (57·2%, 1470/2570). After adjusting for potential confounders, all four constructs of the Theory of Planned Behavior (TPB) were significantly associated with WTR, including positive attitudes (adjusted odds ratio, aOR: 1·11, 95%CI: 1·09, 1·12), negative attitudes (aOR: 0·96, 95%CI: 0·94, 0.97), perceived support from significant others (perceived subjective norm) (aOR: 1·53, 95%CI: 1·46, 1·61), and perceived higher behavioral control (aOR: 1·13, 95%CI: 1·11, 1·14). At the interpersonal level, receiving advice supportive of COVID-19 vaccination from doctors (aOR: 1·99, 95%CI: 1·65, 2·40), CBO staff (aOR: 1·89, 95%CI: 1·51, 2·36), friends and/or family members (aOR: 3·22, 95%CI: 1·93, 5·35), and PLWHA peers (aOR: 2.38, 95%CI: 1·85, 3·08) were associated with higher WTR. Overall opinion supporting COVID-19 vaccination for PLWHA on Internet or social media was also positively associated with WTR (aOR: 1·59, 95%CI: 1·31, 1·94). Path analysis indicated that interpersonal-level variables was indirectly associated with WTR through TPB-related perceptions (β=0·43, 95% CI=0·37, 0·51).

Interpretation: PLWHA in China reported a relatively low WTR. Interpersonal communication and Internet/social media may be the major sources to convey information and promote COVID-19 vaccination in the population.

Funding Statement: This work was supported by the Academic technology leader project of Changzhi Medical College (Grant No. XSQ201902), he Beijing Excellent Talent Plan (2018000021223ZK04) and the National Institute of Mental Health of the National Institutes of Health under Award Numbers R34MH119963.

Declaration of Interests: The authors have no conflicts of interest to disclose.

Ethics Approval Statement: The Institutional Review Boards of Changzhi Medical College (RT2021003) approved this study.

Keywords: People living with HIV and AIDS; COVID-19; vaccination; willingness; socioecological model

Suggested Citation

Huang, Xiaojie and Yu, Maohe and Fu, Gengfeng and Lan, Guanghua and Li, Linghua and Yang, Jianzhou and Qiao, Ying and Zhao, Jin and Qian, Han-Zhu and Zhang, Xiangjun and Liu, Xinchao and Jin, Xia and Chen, Guohong and Jiang, Hui and Tang, Weiming and Wang, Zixin and Xu, Junjie, Willingness to Receive COVID-19 Vaccination Among People Living With HIV and AIDS in China: A Nationwide Online Survey. Available at SSRN: https://ssrn.com/abstract=3836494 or http://dx.doi.org/10.2139/ssrn.3836494

Xiaojie Huang

Capital Medical University - Center for Infectious Diseases

Beijing, 100069
China

Maohe Yu

Tianjin Centers for Disease Control and Prevention ( email )

Gengfeng Fu

Jiangsu Provincial Center for Disease Control and Prevention - Institute for STI and HIV Control and Prevention ( email )

China

Guanghua Lan

Guangxi Center for Disease Prevention and Control

Guangxi, 530028
China

Linghua Li

Guangzhou Medical University - Guangzhou Eighth People's Hospital ( email )

Guangzhou, 510080
China

Jianzhou Yang

Changzhi Medical College - Department of Preventive Medicine

Changzhi
China

Ying Qiao

The Second Hospital of Huhhot ( email )

Jin Zhao

Shenzhen Center for Disease Control and Prevention

Shenzhen, 518055
China

Han-Zhu Qian

Shanghai Jiao Tong University (SJTU) - SJTU-Yale Joint Center for Biostatistics and Data Sciences

KoGuan Law School
Shanghai 200030, Shanghai 200052
China

Xiangjun Zhang

University of Tennessee, Knoxville - Department of Public Health

The Boyd Center for Business and Economic Research
Knoxville, TN 37996
United States

Xinchao Liu

Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC) - Peking Union Medical College Hospital ( email )

Beijing, 100730
China

Xia Jin

AIDS Healthcare Foundation (AHF) China

Guohong Chen

Jiangsu Provincial Center for Disease Control and Prevention ( email )

China

Hui Jiang

The Chinese University of Hong Kong (CUHK) - JC School of Public Health and Primary Care

China

Weiming Tang

University of North Carolina Project-China ( email )

Guangzhou, 510095
China

Dermatology Hospital of Southern Medical University

Guangzhou
China

Zixin Wang (Contact Author)

The Chinese University of Hong Kong (CUHK) - Centre for Health Behaviours Research ( email )

Junjie Xu

Changzhi Medical College - Department of Preventive Medicine ( email )

Changzhi, Shanxi
China