JMIR Publications

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 among PLWHA.

Objective:

This study investigated willingness to receive COVID-19 vaccination among a national sample of PLWHA.

Methods:

This cross-sectional online survey investigated factors associated with willingness to receive COVID-19 vaccination among PLWHA aged 18-65 years living in eight conveniently selected Chinese metropolitan cities between January and February 2021. Eight community-based organizations (CBO) 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. Logistic regression models and path analysis were used in data analysis.

Results:

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 willingness to receive COVID-19 vaccination (57.2%, 1470/2570). After adjusting for potential confounders, all four constructs of the Theory of Planned Behavior (TPB) were significantly associated with willingness to receive COVID-19 vaccination, including positive attitudes (adjusted odds ratio, aOR: 1.11, 95%CI: 1.09, 1.12, P<.001), 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 willingness to receive COVID-19 vaccination. Overall opinion supporting COVID-19 vaccination for PLWHA on Internet or social media was also positively associated with willingness to receive COVID-19 vaccination (aOR: 1.59, 95%CI: 1.31, 1.94). Path analysis indicated that interpersonal-level variables was indirectly associated with willingness to receive COVID-19 vaccination through TPB-related perceptions (β=0.43, 95% CI=0.37, 0.51, P<.001).

Conclusions:

PLWHA in China reported a relatively low willingness to receive COVID-19 vaccination. Internet/social media and interpersonal communications may be a major source of influence on PLWHA’s perceptions and willingness to receive COVID-19 vaccination.