Experience of maternal immunization among women living with HIV in Belgium: A mixed-methods study.

Objective: Maternal immunization during pregnancy has benefits for both women living with HIV (WLWH) and their HIV-exposed uninfected newborns. Vaccine hesitancy may hamper vaccine acceptability during pregnancy. We aimed to assess the experience of WLWH with a history of pregnancy with maternal immunization. Methods: In-person quantitative survey with embedded collection of qualitative data was performed among WLWH with a history of pregnancy Results: Between October and November 2021, a total of 20 WLWH followed at Saint-Pierre University Hospital Center HIV reference center in Brussels (Belgium) were included. The majority originated from Sub-Saharan Africa and had education level below or equivalent to secondary school. Most of the participants agreed that vaccination during pregnancy is necessary, highlighting the benefits for the health of the mother and the newborn. Reluctant participants expressed concerns about safety or lack of information. Most of the participants mentioned health-care providers (HCP) (mainly HIV physician) as the main person of trust for vaccine information in general. Social media were also mentioned as an important source of information on vaccination. Conclusions: The benefits for the mother and the newborn were associated with favorable opinion on maternal immunization while doubt about safety or lack of information appeared to be hurdles to acceptance. Proactive communication on the benefit of maternal immunization for both the mother and newborn by HIV physician and HCP involved in prenatal care is needed to increase acceptability of maternal immunization among WLWH.