Assessing SARS-CoV-2 vaccine hesitancy among the people living with and without HIV from May to September 2022 in Blantyre, Malawi

Vaccine hesitancy is a significant obstacle to the prevention and control of coronavirus disease 2019, especially among people with human immunodeficiency virus (HIV) in developing countries like Malawi, where HIV prevalence rate is high and limited data is available on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine hesitancy among people living with HIV (PLHIV). This study was conducted among people aged ≥18 years at Mpemba health center, Blantyre. All PLHIV were interviewed using a structured questionnaire. All non-PLHIVs who were willing and were conveniently available were investigated. Multivariate logistic regression model and generalized linear model were used to assess the factors associated with SARS-CoV-2 vaccine hesitancy and knowledge, attitude, and trust. Totally 682 subjects were recruited with 341 PLHIV and 341 non-PLHIV. SARS-CoV-2 vaccine hesitancy rates were similar between PLHIV and non-PLHIV (56.0% vs. 57.2%, p = .757). In PLHIV, SARS-CoV-2 vaccine hesitancy was associated with education, occupation, and religion (all p < .05). In non-PLHIV, vaccine hesitancy was associated with sex, education, occupation, income, marital status, and residence (all p < .05). Higher knowledge, attitude, and trust scores were associated with a lower vaccine hesitancy rate in PLHIV (knowledge: OR = 0.79, 95% CI 0.65–0.97, p = .022; attitude: OR = 0.45, 95% CI 0.37–0.55, p < .001; trust: OR = 0.84, 95% CI 0.71–0.99, p = .038). SARS-CoV-2 vaccine hesitancy was high among PLHIV in Blantyre city, Malawi, which was a similar situation to non-PLHIV. Targeted efforts are needed to address these concerns and increase knowledge, trust, and positive attitudes toward the vaccine to reduce vaccine hesitancy against SARS-CoV-2 in PLHIV.