Exploring the predictors of COVID-19 vaccination uptake among people living with HIV/AIDS in Tennessee

Document Type

Article

Publication Date

2025

Abstract

Background: Tennessee is ranked 47th among the 50 states in the US in COVID-19 vaccine uptake, with only 63.8% of the state’s eligible population being vaccinated with at least one dose of COVID-19 vaccine. In addition, Tennessee has 20,466 people living with HIV/AIDS (PLWHA), a population that can be more susceptible to opportunistic infections than the general population. With relatively high COVID-19 infection rate, lower COVID-19 vaccine uptake rate, and increasing burden of HIV in Tennessee, it is important to study COVID-19 vaccine uptake and associated factors among people living with HIV/AIDS (PLWHA) in Tennessee. Methods: The Tennessee Department of Health HIV surveillance and COVID-19 immunization dataset is a combination of enhanced HIV/AIDS Reporting System (eHARS) database and COVID-19 immunization dashboard. A secondary data analysis was completed to determine the predictors of uptake of COVID-19 vaccine uptake and the number of vaccine doses received by PLWHA in the state using logistic regression and negative binomial regression analyses respectively. Results: There was a significant association between age group (p < 0.0001), gender (p < 0.0001), and region (p < 0.0001) with uptake of COVID-19 vaccination. In the multivariable model, individuals less than 25 years of age and residents of West Tennessee were significantly less likely to get COVID-19 vaccination. Furthermore, those with male same-sex partners were predicted to receive 1.6 times (IRR 1.68; 95% CI = 1.56–1.81 where IRR = Incidence Rate Ratio) more doses while people who inject drug (PWID) were 23.5% less likely (IRR 0.77; 95% CI = 0.69–0.85) to take more doses of COVID-19 vaccines than heterosexuals who do not inject drugs. Key findings: It is imperative to concentrate efforts and strategies to improve the COVID-19 vaccine behavior among individuals younger than 25 years and people who inject drugs correcting negative perceptions of vaccines using knowledge, attitude and practice frameworks. © 2025 Elsevier B.V., All rights reserved.

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