On the fence: Factors associated with COVID-19 vaccine hesitancy among sexually Minoritized men who use substances in the United States
Objective: Substance use during the COVID-19 (SARS-CoV-2) pandemic has exponentially increased among sexually minoritized men (SMM), who are more vulnerable to COVID-19 transmission, morbidity, and mortality than their heterosexual counterparts. Understanding the factors that mediate and are associa...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-02-01
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| Series: | Preventive Medicine Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211335525000257 |
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| Summary: | Objective: Substance use during the COVID-19 (SARS-CoV-2) pandemic has exponentially increased among sexually minoritized men (SMM), who are more vulnerable to COVID-19 transmission, morbidity, and mortality than their heterosexual counterparts. Understanding the factors that mediate and are associated with COVID-19 vaccine uptake in a national sample of SMM that use substances may inform targeted interventions to maximize public acceptance. Methods: A cross-sectional analysis was performed using data from a national sample of 2753 SMM in the United States between May 2021–July 2022. We performed a mediation analysis using the Karlson-Holm-Breen method, and factors associated with the likelihood of vaccine uptake were modeled using logistic regression, adjusting for time and age. Results: The median age of the overall sample was 38.9 years old and mainly comprised of White (n = 511; 57 %), HIV-negative (n = 407; 52 %) SMM who used stimulants (n = 724; 92 %). Compared to their counterparts who abstained from drugs in the past three months, SMM who used methamphetamine (aOR: 0.32, CI: 0.24–0.43) or opioids (aOR: 0.52 CI: 0.40–0.67) had significantly lower odds of receiving a COVID-19 vaccine. Those who used cocaine in the past 3 months (aOR: 1.44 CI: 1.20–1.73) had significantly greater odds of receiving a COVID-19 vaccine than those who did not. Vaccine hesitancy partially meditated the direct effects of methamphetamine use on vaccine uptake (OR = 0.40; CI: 0.26–0.61]). Conclusion: The lower vaccination rates among those with a negative HIV status and those who use methamphetamine and opioids warrant attention to inform future vaccination efforts. |
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| ISSN: | 2211-3355 |