Affiliation:
1. Michigan Department of Health and Human Services, Lansing, MI; and
2. Centers for Disease Control and Prevention, Atlanta, GA.
Abstract
Introduction:
People living with HIV (PLWH) have higher prevalence of adverse COVID-19 outcomes, and many reside in socially vulnerable communities. Our aim was to evaluate how engagement in HIV care may increase vaccination likelihood.
Methods:
Michigan HIV surveillance data were extracted from the Enhanced HIV/AIDS Reporting System and matched at the person-level to COVID-19 vaccination records from the Michigan Care Improvement Registry (through December 31, 2021 [n = 15,537]). Based on residential census tract, we classified PLWH into quartiles (<25th percentile [least vulnerable], 25th to <50th, 50th to <75th, ≥75th [most vulnerable]) of the 2018 CDC Social Vulnerability Index. Using log binomial regression, we estimated the relative prevalence of COVID-19 vaccine series initiation among PLWH by quartile of social vulnerability and Ryan White participation; models were adjusted for covariates.
Results:
By December 31, 2021, 67% of PLWH in Michigan had initiated a COVID-19 vaccine series; 47% resided in an area deemed most vulnerable and 54% had participated in Ryan White services. Compared with PLWH in the most vulnerable quartile, those who resided in least vulnerable quartiles had higher prevalence of vaccine initiation (Prevalence Ratio [95% Confidence Interval]: 1.67 [1.50 to 1.86]). Participants in Ryan White had greater prevalence of initiation (1.52 [1.42 to 1.62]) compared with those who were not participants; initiation remained higher when adjusted for covariates including social vulnerability quartile.
Conclusions:
Ryan White participation was associated with increased COVID-19 vaccine initiation regardless of community-level vulnerability. Wraparound services may be key in vaccine promotion interventions in this vulnerable population.
Funder
Centers for Disease Control and Prevention
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Pharmacology (medical),Infectious Diseases
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