HIV/AIDS患者23价肺炎疫苗接种意愿及影响因素

Willingness and influencing factors of 23-valent pneumococcal polysaccharide vaccine(PPV23)vaccination among HIV/AIDS patients

目的了解HIV/AIDS患者在传染病定点医院门诊接种23价肺炎球菌多糖疫苗(PPV23)意愿现状及影响因素。方法以2023年3月8日至4月30日在杭州市西溪医院接受ART的HIV/AIDS患者作为研究对象。并通过《中国疾病预防控制信息系统》的子系统——传染病报告信息管理系统,收集最近一次CD4细胞计数和血浆HIV RNA,采用二元Logistic回归分析探讨PPV23疫苗接种意愿的相关因素。结果有效调查的967名HIV/AIDS患者中,既往知晓PPV23疫苗124例(12.8%);认为自己需要接种PPV23疫苗320例(33.1%);近3年接种过PPV23疫苗者9例(0.9%);本次愿意接种PPV23疫苗651例(67.3%)。多因素非条件Logistic回归分析结果显示,文化程度为高中及以上(OR=1.776,95%CI:1.063~2.969)、吸烟(OR=1.828,95%CI:1.294~2.582)、交通便利(OR=2.809,95%CI:2.059~3.834)、COVID-19疫苗接种两针次以上(OR接种两针次=2.081,95%CI:1.134~3.820、OR_(接种三针次)=2.766,95%CI:1.594~4.799、OR_(接种四针次)=3.963,95%CI:1.445~10.871)是HIV/AIDS患者接种PPV23疫苗意愿的保护因素,未感染新冠(OR=0.607,95%CI:0.381~0.967)或不清楚新冠感染(OR=0.567,95%CI:0.387~0.831)、最关注PPV23疫苗来源地(国产或进口)(OR=0.307,95%CI:0.137~0.688)是HIV/AIDS患者接种PPV23疫苗意愿的危险因素。结论HIV/AIDS患者在定点医院门诊接种PPV23意愿率较高,文化程度高、吸烟、交通便利、新冠疫苗接种两针次及以上及既往感染新冠是PPV23疫苗接种的主要人群。

Objective To understand the willingness of HIV/AIDS patients to receive the 23-valent pneumococcal polysaccharide vaccine(PPV23)in outpatient settings of infectious disease designated hospitals and to identify influencing factors.Methods HIV/AIDS patients receiving antiretroviral therapy(ART)at the Affiliated Hangzhou Xixi Hospital from March 8 to April 30,2023,were included in the study.Data on the most recent CD4 cell count and plasma HIV RNA were collected through the China Disease Prevention and Control Information System's subsystem,Infectious Disease Report Information Management System.Binary logistic regression analysis was adopted to explore factors related to the willingness to receive the PPV23 vaccine.Results Among 967 HIV/AIDS patients surveyed,124(12.8%)had prior knowledge of PPV23 vaccine,320(33.1%)believed they needed PPV23 vaccination,9(0.9%)had received PPV23 vaccination in the past three years,and 651(67.3%)were willing to receive PPV23 vaccination.Multivariate unconditional logistic regression analysis revealed that having a high school education or above(OR=1.776,95%CI:1.063-2.969),smoking(OR=1.828,95%CI:1.294-2.582),convenient transportation(OR=2.809,95%CI:2.059-3.834),receiving two or more doses of COVID-19 vaccine(OR for two doses=2.081,95%CI:1.134-3.820;OR for three doses=2.766,95%CI:1.594-4.799;OR for four doses=3.963,95%CI:1.445-10.871)were protective factors for the willingness to receive PPV23 vaccine.Factors associated with a lower willingness included no COVID-19 infection(OR=0.607,95%CI:0.381-0.967)or unclear COVID-19 infection status(OR=0.567,95%CI:0.387-0.831)and being most concerned about the source(domestic or imported)of the PPV23 vaccine(OR=0.307,95%CI:0.137-0.688).Conclusions HIV/AIDS patients'willingness to receive PPV23 vaccination in outpatient settings of designated hospitals remained high Individuals with higher education,smokers,those with convenient transportation,those who received two or more doses of the COVID-19 vaccine,and those previously infected with COVID-19 were more likely to be willing to receive the PPV23 vaccination.