Trends in COVID-19 Vaccine Hesitancy and Uptake among Persons Living with HIV in Washington, DC

Document Type

Journal Article

Publication Date



Journal of acquired immune deficiency syndromes (1999)




OBJECTIVES: The COVID-19 pandemic has disproportionately impacted older people, people with underlying health conditions, racial and ethnic minorities, socioeconomically disadvantaged, and people living with HIV (PWH). We sought to describe vaccine hesitancy and associated factors, reasons for vaccine hesitancy, and vaccine uptake over time in PWH in Washington, DC. METHODS: We conducted a cross-sectional survey between October 2020 and December 2021 among PWH enrolled in a prospective longitudinal cohort in DC. Survey data were linked to electronic health record data and descriptively analyzed. Multivariable logistic regression was performed to identify factors associated with vaccine hesitancy. The most common reasons for vaccine hesitancy and uptake were assessed. RESULTS: Among 1,029 participants (66% men, 74% Black, median age 54), 13% were vaccine hesitant and 9% refused. Females were 2.6 to 3.5 times, non-Hispanic Blacks were 2.2 times, Hispanics, and those of other race/ethnicities were 3.5 to 8.8 times and younger PWH were significantly more likely to express hesitancy or refusal than males, non-Hispanic Whites and older PWH, respectively. The most reported reasons for vaccine hesitancy were side effect concerns (76%), plans to use other precautions/masks (73%), and speed of vaccine development (70%). Vaccine hesitancy and refusal declined over time (33% in October 2020 vs. 4% in December 2021, p<0.0001). CONCLUSIONS: This study is one of the largest analyses of vaccine hesitancy among PWH in a US urban area highly impacted by HIV and COVID-19. Multi-level culturally appropriate approaches are needed to effectively address COVID-19 vaccine concerns raised among PWH.