COVID-19 vaccine utilisation among people living with HIV on antiretroviral therapy in Zimbabwe.

Background: Several studies have now highlighted COVID-19 vaccination hesitancy in the public. However, not much is known about COVID-19 vaccination amoung people living with HIV (PLHIV). Aim: This study aimed to examine the predisposition of PLHIV on antiretroviral therapy to utilise the COVID-19 vaccine. Setting: The study was done in urban and rural communities of Zimbabwe. Methods: The study utilised a concurrent triangulation design of which only one data collection phase was used. The quantitative data were collected from 2157 PLHIV on antiretroviral viral therapy through a structured interviewer-administered questionnaire. On the other hand, qualitative data were collected through in-depth interviews. Results: The study found a higher proportion of COVID-19 vaccine utilisation among adults in comparison to adolescents and young people. Fear of side effects contributed to the most common reason for not getting vaccinated. Adolescents aged 15-19 years were significantly less likely to receive the COVID-19 vaccine (adjusted odds ratios [aOR] = 0.58; 95% CI: 0.41-0.83). Being a previous contact of a COVID-19 case was significantly associated with higher odds of COVID-19 vaccination (aOR = 3.43; 95% CI: 1.92-6.10). Additionally, living in a rural area was associated with higher odds of COVID-19 vaccination among PLHIV (aOR = 1.38; 95% CI: 1.05-1.83). Conclusion: There is need to broaden to speak to the role of families, communities and healthcare workers ensuring adolescent and youth-friendly information and support for vaccinations. Contribution: The COVID-19 vaccination rates were lower among adolescents and young people compared to adults living with HIV. Adolescents and young people face challenges in accessing adolescent-friendly health services.