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Time-to-completion of COVID-19 vaccination primary series varies by HIV viral load status among people who inject drugs in Baltimore, Maryland

People who inject drugs (PWID) may have diminished access to essential preventive services like COVID-19 vaccination given structural and substance use barriers. We aimed to assess the role of HIV on COVID-19 vaccination uptake among adult PWID participating in the ALIVE cohort study in Baltimore, M...

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Autores principales: Baker, Pieter, Cepeda, Javier A, Schluth, Catherine, Astemborski, Jacquie, Feder, Kenneth A., Rudolph, Jacqueline, Sun, Jing, Kirk, Gregory D., Mehta, Shruti H., Genberg, Becky L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10570701/
https://www.ncbi.nlm.nih.gov/pubmed/37840593
http://dx.doi.org/10.1016/j.pmedr.2023.102448
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author Baker, Pieter
Cepeda, Javier A
Schluth, Catherine
Astemborski, Jacquie
Feder, Kenneth A.
Rudolph, Jacqueline
Sun, Jing
Kirk, Gregory D.
Mehta, Shruti H.
Genberg, Becky L.
author_facet Baker, Pieter
Cepeda, Javier A
Schluth, Catherine
Astemborski, Jacquie
Feder, Kenneth A.
Rudolph, Jacqueline
Sun, Jing
Kirk, Gregory D.
Mehta, Shruti H.
Genberg, Becky L.
author_sort Baker, Pieter
collection PubMed
description People who inject drugs (PWID) may have diminished access to essential preventive services like COVID-19 vaccination given structural and substance use barriers. We aimed to assess the role of HIV on COVID-19 vaccination uptake among adult PWID participating in the ALIVE cohort study in Baltimore, Maryland who were alive as of April 2021. We abstracted COVID-19 vaccination data from electronic medical records via the regional health information exchange. We used Kaplan-Meier method to estimate time from universal vaccine eligibility (April 6, 2021) to completion of the COVID-19 vaccination primary series (1 dose J&J or 2 doses mRNA) by HIV viral load status (uninfected, PWH [HIV-RNA < 400 copies/mL], PWH [HIV-RNA ≥ 400 copies/mL]) and Cox Proportional Hazards regression to adjust for potential confounders. Our sample (N = 960) was primarily black (77%) and male (65%) with 31% reporting recent injection drug use. Among 265 (27%) people living with HIV (PWH) in our sample, 84% were virally suppressed. As of February 22, 2022, 539 (56%) completed the primary series, 131 (14%) received a single dose of mRNA vaccine and 290 (30%) remained unvaccinated. Compared to PWID without HIV, virally suppressed PWH were more likely to complete the primary series (Adjusted Hazard Ratio [aHR]:1.23,95% Confidence Interval [95 %CI]:1.07,1.50), while PWH who were not virally suppressed were less likely (aHR:0.72,95 %CI:0.45,1.16), although this was not statistically significant. We conclude that among PWID, HIV infection and viral suppression is associated with quicker vaccination uptake, likely due to HIV care engagement. Targeted improvements along the HIV care continuum may bolster vaccine uptake.
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spelling pubmed-105707012023-10-14 Time-to-completion of COVID-19 vaccination primary series varies by HIV viral load status among people who inject drugs in Baltimore, Maryland Baker, Pieter Cepeda, Javier A Schluth, Catherine Astemborski, Jacquie Feder, Kenneth A. Rudolph, Jacqueline Sun, Jing Kirk, Gregory D. Mehta, Shruti H. Genberg, Becky L. Prev Med Rep Regular Article People who inject drugs (PWID) may have diminished access to essential preventive services like COVID-19 vaccination given structural and substance use barriers. We aimed to assess the role of HIV on COVID-19 vaccination uptake among adult PWID participating in the ALIVE cohort study in Baltimore, Maryland who were alive as of April 2021. We abstracted COVID-19 vaccination data from electronic medical records via the regional health information exchange. We used Kaplan-Meier method to estimate time from universal vaccine eligibility (April 6, 2021) to completion of the COVID-19 vaccination primary series (1 dose J&J or 2 doses mRNA) by HIV viral load status (uninfected, PWH [HIV-RNA < 400 copies/mL], PWH [HIV-RNA ≥ 400 copies/mL]) and Cox Proportional Hazards regression to adjust for potential confounders. Our sample (N = 960) was primarily black (77%) and male (65%) with 31% reporting recent injection drug use. Among 265 (27%) people living with HIV (PWH) in our sample, 84% were virally suppressed. As of February 22, 2022, 539 (56%) completed the primary series, 131 (14%) received a single dose of mRNA vaccine and 290 (30%) remained unvaccinated. Compared to PWID without HIV, virally suppressed PWH were more likely to complete the primary series (Adjusted Hazard Ratio [aHR]:1.23,95% Confidence Interval [95 %CI]:1.07,1.50), while PWH who were not virally suppressed were less likely (aHR:0.72,95 %CI:0.45,1.16), although this was not statistically significant. We conclude that among PWID, HIV infection and viral suppression is associated with quicker vaccination uptake, likely due to HIV care engagement. Targeted improvements along the HIV care continuum may bolster vaccine uptake. 2023-09-28 /pmc/articles/PMC10570701/ /pubmed/37840593 http://dx.doi.org/10.1016/j.pmedr.2023.102448 Text en © 2023 The Authors. Published by Elsevier Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Regular Article
Baker, Pieter
Cepeda, Javier A
Schluth, Catherine
Astemborski, Jacquie
Feder, Kenneth A.
Rudolph, Jacqueline
Sun, Jing
Kirk, Gregory D.
Mehta, Shruti H.
Genberg, Becky L.
Time-to-completion of COVID-19 vaccination primary series varies by HIV viral load status among people who inject drugs in Baltimore, Maryland
title Time-to-completion of COVID-19 vaccination primary series varies by HIV viral load status among people who inject drugs in Baltimore, Maryland
title_full Time-to-completion of COVID-19 vaccination primary series varies by HIV viral load status among people who inject drugs in Baltimore, Maryland
title_fullStr Time-to-completion of COVID-19 vaccination primary series varies by HIV viral load status among people who inject drugs in Baltimore, Maryland
title_full_unstemmed Time-to-completion of COVID-19 vaccination primary series varies by HIV viral load status among people who inject drugs in Baltimore, Maryland
title_short Time-to-completion of COVID-19 vaccination primary series varies by HIV viral load status among people who inject drugs in Baltimore, Maryland
title_sort time-to-completion of covid-19 vaccination primary series varies by hiv viral load status among people who inject drugs in baltimore, maryland
topic Regular Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10570701/
https://www.ncbi.nlm.nih.gov/pubmed/37840593
http://dx.doi.org/10.1016/j.pmedr.2023.102448
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