A Comparison of COVID-19 Vaccine and PrEP Hesitancy Among Individuals Living in Mississippi: A Qualitative Study

Mississippi (MS) trails behind other states in both pre-exposure prophylaxis (PrEP) and COVID-19 vaccine uptake. This study investigated similarities in willingness to receive the COVID-19 vaccine and use PrEP. Semi-structured interviews were conducted between April 2021 and January 2022 with 15 clinical staff and 49 PrEP-eligible patients living in MS. Reflexive thematic analysis was conducted. Overall, 51% of patients were on PrEP, and 67% received the COVID-19 vaccine. Among PrEP users, 64% had received the vaccine. Participants reported similar hesitations (efficacy, side effects, and no perceived risk) and reasons for use (health autonomy and protecting themselves and others) regarding PrEP and the COVID-19 vaccine. Taking PrEP did not increase the likelihood of getting the COVID-19 vaccine, thus engaging in one prevention behavior does not lead to engaging in other prevention behaviors. However, results indicated commonalities in hesitancy and motivators to utilize both preventive measures. Future prevention and implementation efforts can be informed by these commonalities.