Socio-demographic determinants of COVID-19 vaccination status among people living with HIV; A cross-sectional study in selected regions in Tanzania
Authors: Stephen Kunda John , Mshiu Johnson , Christopher Felix , Wiketye Victor , Kimbute Omary , Martin Anelisa , Makasi Charles , Range Nyangosya , Majaha Melkizedeck , Mgina Erick , Shemdoe Aloisia , Maokola Werner , Rwebembera Anath , Ngowi Bernard , Kilale Andrew 
Published: March 2024

Abstract
Background
Public Health and Social Measures are among the commonly used methods to prevent the spread of COVID-19. Vaccination has also been an integral component of infectious disease prevention and control and it has been used widely to protect humans against some of the very serious diseases such as COVID-19. People living with HIV (PLHIV) are known to be more vulnerable to the severest form of COVID-19 than the general population. Other groups of people likely to get the severe form of COVID-19 include the elderly and those with co-morbidities such as cancers, cardiovascular diseases, diabetes, etc.
Objectives
The main objective of the study was to establish socio-demographic factors that determine COVID-19 vaccination status among PLHIV in selected regions in mainland Tanzania and to provide insight into ways to enhance COVID-19 vaccine coverage in Tanzania.
Methods
A facility-based cross-sectional study was conducted in March-April 2022 among PLHIV in selected regions of Tanzania namely Kagera, Tabora, Geita, and Dar es Salaam. A total of 25 Care and Treatment Centres (CTCs) were randomly selected with a probability proportion of size in each region. In each CTC, 11 PLHIV eligible for vaccination were systematically selected to participate in the study. Face-to-face interviews were conducted using a structured questionnaire and Open Data Kit (ODK) software was used to record and transfer data to a designated server. Data cleaning and analysis were done using Stata version 14.0. A chi-square test was used to assess the association between socio-demographic characteristics and COVID-19 vaccination status. A generalized linear mixed-effects model was fitted to determine factors associated with COVID-19 vaccination status.
Results
Out of 1,100 PLHIV interviewed, 696 (63.3%) were found to be vaccinated against COVID-19. Level of education, age, occupation, employment status, location, and level of health facilities were found to be significant determinants of COVID-19 vaccination status among PLHIV in the study areas. PLHIV who had college and university education, elderly, farmers, and those employed and living in a rural setting were found to be more likely to be vaccinated than other comparison groups in the categories analyzed.
Conclusion
The study established that the COVID-19 vaccination status among PLHIV attending health facilities in the study area was higher than in the general population, this could be attributed to the effort by the public and private sectors to encourage PLHIV to vaccinate. To be able to attain the target of vaccination coverage of 60% as suggested by the WHO, the study emphasizes different interventions including an increase in the number of vaccination centers, support to those willing to vaccinate but unable to access vaccination services, emphasis on not only elderly people but also members of the community who are middle-aged and younger to take COVID-19 vaccine and more effort and engagement of higher levels of health service provision including health centers and hospitals.