Vaccine Attitudes and COVID-19 Vaccine Intentions and Prevention Behaviors among Young People At-Risk for and Living with HIV in Los Angeles and New Orleans.

Dallas Swendeman,Stephanie Sumstine,Maria Isabel Fernandez,Karin Nielsen-Saines,Mary Jane Rotheram-Borus,Peter Norwood,Manuel A Ocasio,Nicholas Santabarbara,Warren Scott Comulada,Elizabeth M Arnold,Wilson Ramos,Katherine Lewis,Sergio Jimenez,Jessica Saleska

doi:10.3390/vaccines10030413

Abstract

Sexual and gender minority (SGM) and racial or ethnic minority youth at-risk for or living with HIV may have higher risk of SARS-CoV-2 infection. However, there are few data on vaccine hesitancy/acceptance and COVID-19 self-protective behaviors among this population. Youth aged 15–24 years (n = 440), predominantly African American and Latine (73%, n = 320) SGM, from Los Angeles and New Orleans reported their vaccine attitudes and COVID-19 and HIV preventive behaviors in October 2020. Latent class analyses categorized individuals into groups based on their vaccine attitudes and preventive behaviors. Relationships between these groups and other factors were analyzed using Fisher’s exact tests, ANOVA, and logistic regression. Most youth had accepting vaccine attitudes (70.2%, n = 309), with 20.7% hesitant (n = 91), and 9.1% resistant (n = 40). SGM and African Americans were significantly less accepting than their cis-gender and heterosexual peers. About two-thirds (63.2%, n = 278) of the respondents reported consistent COVID-19 self-protective behaviors. Youth with pro-vaccine attitudes were most consistently self-protective; however, only 54.4% (n= 168/309) intended to take a COVID-19 vaccine. Homelessness history, race, and sexual orientation were associated with vaccine attitudes. Accepting vaccine attitudes and consistent COVID-19 self-protective behaviors were closely related. COVID-19 attitudes/behaviors were not associated with HIV risk and only loosely associated with SARS-CoV-2 vaccine intentions.

Highlights

Sexual and gender minority (SGM) and racial or ethnic minority young people, such as Black and Latine, gay, bisexual, transgender, and non-binary people, are at increased risk of acquiring and dying from COVID-19 [1], in addition to HIV [2]
About two-thirds of the sample was recruited in Los Angeles (n = 303) and one-third in New Orleans (n = 137)
About 61% (n = 272) of the youth reported unprotected anal sex in the last year, 79.1% (n = 348) of youth reported not using condoms all the time and did not consistently use condoms, and only 14% (n = 62) were using Pre-Exposure Prophylaxis (PrEP) to protect themselves from HIV

Summary

Introduction

Sexual and gender minority (SGM) and racial or ethnic minority young people, such as Black and Latine, gay, bisexual, transgender, and non-binary people, are at increased risk of acquiring and dying from COVID-19 [1], in addition to HIV [2]. SGM youth experience various stressors and forms of stigma and discrimination, which may impact health outcomes [5]. SGM youth experience high rates of family rejection based on their sexual orientation or gender identity, which, coupled with other risk factors, result in a high risk of several related factors, such as homelessness, mental health disorders, suicidal ideations and attempts, hospitalizations, and alcohol and drug abuse [6–8]. For COVID-19 vaccines, in Black, Indigenous, and People of Color (BIPOC) communities, hesitancy may be a form of protection given historical experiences with racism and research that have led to a lack of trust [15]

Results

Discussion

Conclusion