An Audit of Adult Vaccination in HIV-Positive Patients Attending a Tertiary Centre HIV Clinic

Abstract

Background: People living with HIV (PLWH) have a greater risk of acquiring vaccine preventable diseases (VPDs) and of developing severe disease due to impaired immune responses. The risk of acquiring VPDs among PLWH is greater in adults aged 15-49 years as a result of common infections found in occupational, social and travel settings. At the same time, studies have demonstrated low vaccination coverage among this population. For this reason, international and local guidelines for the vaccination of HIV-infected adults have been drawn up to address challenges in immunization in the HIV setting. However, there is little evidence on the compliance to these guidelines and on the knowledge and attitudes of PLWH to vaccination for VPDs. Aim: The aim of the study was to investigate vaccination uptake, knowledge, and acceptance of vaccination among PLWH. Methodology: In-depth interviews and retrospective file reviews among PLWH attending the Charlotte Maxeke Johannesburg Academic Hospital HIV Clinic over a 1-month period. Results: Among the 107 PLWH who were recruited and interviewed, it was found that 24.3% had received at least one vaccine following their HIV diagnosis. The majority of participants (76.6%) had a history of tuberculosis (TB), which was the most common vaccine-preventable disease among the sample. Influenza vaccination had the highest uptake rate at 76.9%. Overall, 65% of participants believed that vaccines could prevent diseases, while 41.1% thought vaccines were harmful. Interestingly, 56% did not believe that vaccines worsened their HIV condition. Furthermore, 67.2% of participants expressed their willingness to accept a vaccine if it was recommended by their healthcare provider. The most significant factors associated with vaccine uptake were awareness of the influenza vaccine and the willingness to accept a vaccine after a recommendation. Conclusion: Our study revealed poor adherence to the vaccination guidelines for PLWH in South Africa. Only four vaccines against influenza, hepatitis B, shingles and pneumococcal diseases had been taken and commonly known among this population.