4.7 Article

Predictors of reported influenza vaccination in HIV-infected women in the United States, 2006-2007 and 2007-2008 seasons

Journal

PREVENTIVE MEDICINE
Volume 50, Issue 5-6, Pages 223-229

Publisher

ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.ypmed.2010.03.007

Keywords

HIV/AIDS; Highly active antiretroviral therapy; Influenza vaccine; Vaccine coverage; Multi-center study; Cohort study; United States; Adult; Female

Funding

  1. National Institute of Allergy and Infectious Diseases [UO1-AI-35004, UO1-AI-31834, UO1-AI-34994, UO1-AI-34989, UO1-AI-34993, UO1-AI-42590]
  2. National Institute of Child Health and Human Development [UO1-HD-32632]
  3. National Cancer Institute
  4. National Institute on Drug Abuse
  5. National Institute on Deafness and Other Communication Disorders
  6. National Center for Research Resources [UCSF-CTSI] [UL1 RR024131]
  7. Johns Hopkins Training Program in Sexually Transmitted Infections [T32-AI050056]

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Objective. To estimate the cumulative incidence of self-reported influenza vaccination (vaccination coverage) and investigate predictors in HIV-infected women. Methods. In an ongoing cohort study of HIV-infected women in five US cities, data from two influenza seasons (2006-2007 n = 1209 and 2007-2008 n = 1161) were used to estimate crude and adjusted prevalence ratios (aPR) and 95% confidence intervals ([.]) from Poisson regression with robust variance models using generalized estimating equations (GEE). Results. In our study, 55% and 57% of HIV-infected women reported vaccination during the 2006-2007 and 2007-2008 seasons, respectively. Using data from both seasons, older age, non-smoking status, CD4 T-lymphocyte (CD4) count >= 200 cells/mm(3), and reporting at least one recent healthcare visit was associated with increased vaccination coverage. In the 2007-2008 season, a belief in the protection of the vaccine (aPR = 1.38 [1.18, 1.61]) and influenza vaccination in the previous season (aPR = 1.66 [1.44, 1.91]) most strongly predicted vaccination status. Conclusion. Interventions to reach unvaccinated HIV-infected women should focus on changing beliefs about the effectiveness of influenza vaccination and target younger women, current smokers, those without recent healthcare visits, or a CD4 count <200 cells/mm(3). (C) 2010 Elsevier Inc. All rights reserved.

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