Abstract Objective Although COVID-19 vaccination is important for People Living with HIV (PLHIV) given their elevated infection and comorbidity risks, some PLHIV remain hesitant to accept vaccination. Hence, we conducted a cross-sectional study in British Columbia, Canada, aimed to identify socio-economic and health-related factors predicting COVID-19 vaccine uptake and contributing to hesitancy among PLHIV. Methods A 34-item anonymous self-administered survey was disseminated to PLHIV accessing services through HIV and AIDS-related organisations between November 2022 and January 2023 in British Columbia. The survey included sociodemographic information, COVID-19 factors, HIV indicators, and the Vaccine Hesitancy Scale (VHS). Descriptive and inferential statistics were conducted to detect significant associations between the sociodemographic characteristics, health-related factors and COVID-19 vaccine uptake using IBM ® SPSS ® 28 and significance level at p < 0.05. Results From the 276 respondents (mean age 29.93 ± 7.55), 54.7% were men, 31.6% identified as sexual minorities, and 46.7% were of indigenous origin. At the time of the study, approximately 37.6% of the respondents received at least three vaccine doses, while 82.2% received at least one dose. Vaccine hesitancy was associated with lower education, age < 25, and low income. Predictors of COVID-19 vaccine uptake included age OR = 1.06, 95% CI = 1.01–1.12, trade school or higher OR = 0.22, 95% CI = 0.07–0.72, family/friends infected with COVID-19 OR 3.68, 95% CI = 1.56–8.67, viral loads more than 200 copies/mL OR = 0.20, 95% CI 0.01–0.81, and on specific items form the VHS: belief in vaccine importance OR = 0.51, 95% CI = 0.28–0.95, trust in Health Canada’s information OR = 0.49, 95% CI = 0.29–0.83, and concerns about vaccine adverse effects OR = 0.35, 95% CI = 0.22–0.56. Concerns about vaccine adverse effects reduced the likelihood of receiving three COVID-19 vaccine doses by 65% overall. Conclusions Considerations must be taken around specific factors that may have an impact on COVID-19 vaccination rates among PLHIV, including information about vaccine adverse effects, HIV viral load, age, and education level. This insight should guide the development of policies and interventions aimed at encouraging individuals to maintain an up-to-date vaccination status.
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