Sociodemographic, HIV-Related Characteristics, and Health Care Factors as Predictors of Self-Reported Vaccination Coverage in a Nationwide Sample of People Aging with HIV in Germany.

Jochen Drewes,Phil C. Langer,Dieter Kleiber,Jennifer Ebert,Burkhard Gusy

doi:10.3390/ijerph18094901

Abstract

Preventing infectious diseases through vaccination becomes more significant among the growing population of people aging with HIV. Coverage rates for vaccinations and factors associated with vaccination utilization among this population in Germany are unknown. We assessed the coverage of eight recommended vaccinations in a certain time frame in our convenience sample of 903 people living with HIV aged 50 years and older. We analysed coverage rates and used bivariate and multiple linear regression analyses to identify factors associated with number of reported vaccinations. Coverage rates in our sample ranged between 51.0% for meningococcus disease and 84.6% for the triple vaccination against tetanus, diphtheria, and pertussis. All rates were higher compared to the German general population. Seven factors were related to the number of vaccinations in multiple regression analysis: sexual orientation, education, relationship status, CD4 count, time since last visit to HIV specialist, type of HIV specialist, and distance to HIV specialist. Vaccination coverage among people aging with HIV in Germany is high, but not optimal. To improve vaccination uptake, strengthened efforts need to be focused on female and heterosexual male patients, socioeconomically disadvantaged patients, and patients with barriers to access regular HIV care.

Highlights

In the growing population of people aging with HIV (PAWH), the prevention and management of comorbidities become more and more significant
Rates range between 51.0% for meningococcus disease and 84.6% for the triple vaccination against tetanus, diphtheria, and pertussis
We found several factors associated with vaccination utilization, with the strongest association for CD4 count, sexual orientation, distance to HIV provider, and socioeconomic status (SES)

Summary

Introduction

In the growing population of people aging with HIV (PAWH), the prevention and management of comorbidities become more and more significant. PAWH have a higher overall comorbidity burden [1] and a higher risk for more severe courses of comorbid diseases [2,3]—some of these being preventable by vaccination. Vaccines are in general considered safe and effective in people living with HIV (PLWH); exceptions refer to attenuated vaccines [2,4]. To acknowledge this situation and to increase vaccination coverage among PLWH, national guidelines regarding vaccinations in this population were issued in several countries [2], including Germany [5]. Recommended, vaccinations against human papillomavirus and herpes zoster were not available or recommended at the time of our study

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