COVID-19 Vaccination Uptake Among People Living with HIV in Chongwe District of Zambia from 2021 to 2023

<i>Background: </i>COVID-19 vaccination is especially important for people living with HIV because it significantly reduces their risk of severe illness and death due to their potentially weakened immune systems. Despite, PLWHIV being a priority population for the COVID-19 vaccination there has been low uptake of COVID-19 vaccines among PLWHIV in Zambia. Therefore, the aim of the research was to investigate determinants of COVID-19 vaccinations uptake among people living with HIV in Chongwe district of Zambia. <i>Methods: </i>This was an analytical cross-sectional study conducted among 537 PLWHIV, aged 12 years and above in Chongwe district between 2021 and 2023. Data was collected through a data extraction form from SmartCare an electronic database used to manage HIV data and an interviewer administered questionnaire. Binary logistic regression models were used to investigate determinants of COVID-19 vaccine uptake among PLWHIV through bivariate and multivariate analysis. <i>Results: </i>Results indicated that participants with a monthly income exceeding 1000 had significantly higher odds of influencing COVID-19 vaccination uptake among PLWHIV (aOR 4.061; 95% CI 1.751-9.421; p = 0.001). Additionally, variables such as not missing clinical visits (aOR 1.258; 95% CI 1.036-3.389; p = 0.006) and not missing pharmacy pick-ups (OR 2.752; 95% CI 1.527-3.660; p = 0.00), Clients without comorbidities (aOR 1.347; 95% CI 0.174-1.692; p = 0.003), participants who understood COVID-19 vaccination (aOR 1.125; 95% CI 1.052-2.299; p = 0.000), clients who were aware of COVID-19 vaccinations (aOR 2.021; 95% CI 1.001-3.652; p = 0.02), participants who reported receiving IEC (aOR 4.366; 95% CI 1.869-5.297; p = 0.006) and unsatisfied clients with services (aOR 2.444; 95% CI 1.390-4.298; p = 0.002) had higher odds of influencing COVID-19 vaccines uptake among PLWHIV in Chongwe. <i>Conclusion and Recommendations: </i>The determinants of COVID-19 vaccination uptake are a combination of various factors. Therefore, there is need for tailored interventions to enhance eeducation and Awareness: enhance giving IEC, Improve Service delivery, Strengthen Support Systems, integration of vaccination into other ART services, Address financial barriers, target outreach awareness programs, tailor interventions for those with Comorbidities, Partnerships and Collaboration with key institutions.