A Postpandemic Assessment of COVID-19 Prevention Disparities Among People Living With HIV: A Multisite International Study

ABSTRACT: The COVID-19 pandemic highlighted global health care disparities, significantly affecting people living with HIV. Widespread access to testing and vaccines is crucial to safeguard this susceptible group. This multisite, cross-sectional study examined determinants of COVID-19 prevention among 1,397 people living with HIV across eight countries. Participants were from Botswana, China (Hong Kong), Colombia, Kenya, Nigeria, South Africa, Thailand, and the United States. Key outcomes included adherence to restrictions, vaccination, and testing. Results showed that South Africa had the lowest adherence to COVID-19 restrictions, Nigeria had the lowest vaccination rates, and testing access was limited in Colombia, Kenya, and Nigeria. Influential factors included country, housing stability, sexual activity, age, race, information sources, and local prevention policies. These findings reveal how social, structural, geospatial, and informational factors drive COVID-19 prevention disparities among people living with HIV. Context-tailored interventions are critical to reduce inequities and boost future pandemic preparedness among people living with HIV.