Higher COVID-19 Vaccine Uptake Seen Among Subpopulations With HIV

COVID-19 vaccine uptake among people living with HIV was associated with older age, more years living with HIV, higher education level, and higher perceived COVID-19 vulnerability.

COVID-19 vaccine uptake and intent are high among people living with HIV, especially sexual and gender minority (SGM) cisgender men and transgender people, as well as those more likely to report an undetectable HIV viral load.

These findings were published in AIDS Patient Care and STDs.

Vaccine uptake was associated with older age, more years living with HIV, higher education level attained, and higher perceived COVID-19 vulnerability. Additionally, those who were unvaccinated had greater intentions of being vaccinated, particularly if they were of an older age or lived more years with HIV, and SGM participants had greater intentions of getting vaccinated than non-SGM participants. Vaccination and intent of vaccination were both associated with lower vaccine hesitancy.

“Patterns of vaccination are consistent with the health behavior literature in so much as those with higher levels of perceived heath vulnerability due to age as well as higher levels of proactivity about their HIV health are more likely to be vaccinated or intend to be vaccinated,” the study authors said.

The cross-sectional study was conducted by Rutgers School of Public Health, where researchers collected data on 496 people living with HIV between March 2021 and May 2021, after COVID-19 vaccines became widely available in the United States.

Participants were surveyed on their vaccine uptake, intent, and hesitancy, as well as perceived COVID-19 vulnerability. The survey also asked about HIV health indicators, such as years since HIV diagnosis and viral loads, and general demographic questions about age, race and ethnicity, gender and sexuality, education, and employment.

The median (SD) age was 50.08 (0.61) years (range, 19-78 years). Gay cisgender men (45.6%) and heterosexual cisgender women (20.4%) made up the largest proportion of participants. A majority were White non-Hispanic (47.8%), Black/African American non-Hispanic (26.4%), and Latinx/Hispanic (14.7%); were employed full or part time (37.9% and 17.9%, respectively); and from the Northeast (35.5%) or South (28.4%).

During the study period, 319 (64.3%) of the 496 participants had received at least 1 dose of a vaccine, and 110 (66.3%) of those not yet vaccinated said they intended to receive the vaccine when it became available to them.

“We found that participants who did not intend to receive a COVID-19 vaccine reported higher levels of vaccine hesitancy (mean, 2.99 [0.69]) compared with the uncertain (mean, 2.46 [0.46]) and intended (mean, 1.93 [0.65) groups,” the authors said. “Also, those who intended to receive the COVID-19 vaccine had a higher average number of years since their diagnosis of HIV than the maybe and no groups.”

Additionally, participants with at least bachelor’s degree were 1.79 times more likely to get vaccinated compared with participants with a high school degree, GED, trade school degree, or less education.

Of all participants, 310 (62.5%) reported that a friend or family member had received a COVID-19 diagnosis, while 158 (31.9%) knew a friend or family member who died due to COVID-19.

The authors also noted that Black participants with HIV in the study were least likely to be vaccinated and that racial disparities occur in both HIV and COVID-19 management and treatment trials.

“These findings should be considered in light of studies that have demonstrated the relation between race and residential segregation for individuals infected with HIV and COVID-19 in the United States, with people of color tending to live in less economically advantaged neighborhood,” they said. “These patterns, in turn, affect outcomes, where higher rates of mortality due to HIV and COVID-19 infections are linked to poverty.”

Although its short time span, small population size, and English-only surveys were noted as limitations in the study, the authors said the data emphasize the need for COVID-19 vaccine outreach efforts and HIV care access.

“Ongoing vigilance is required to vaccinate the US population, particularly those with underlying conditions such as HIV, as is the need to tailor health messaging to the highly diverse population of [people living with HIV], with particular emphasis on the intersection of HIV and SGM status,” the authors wrote.


Jaiswal J, Krause KD, Martino RJ, et al. SARS-CoV-2 vaccination hesitancy and behaviors in a national sample of people living with HIV. AIDS Patient Care and STDs. 2022;36(1):34-44. doi:10.1089/apc.2021.0144

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