title: Rates and correlates of influenza vaccination among HIV-infected adults in the HIV Outpatient Study (HOPS), USA, 1999-2008.
abstract: BACKGROUND
  We sought to describe rates of vaccination among HIV-infected adults in care and identify factors associated with vaccination.
  
  
  METHODS
  Using data abstracted from medical records of participants in the HIV Outpatient Study (HOPS) during 8 influenza seasons (1999-2008) and negative binomial models with generalized estimating equation methods, we examined factors associated with increased prevalence of annual influenza vaccination.
  
  
  RESULTS
  Among active patients, 25.8% to 43.3% were vaccinated for influenza each year (annual mean=35%, test for trend p=0.71). Vaccination rates peaked in October and November of each season and decreased sharply thereafter. In multivariable analysis, patients who were male (67.2%), non-Hispanic white (70%) or Hispanic (66%), had lower HIV viral loads (73.5%), were prescribed antiretroviral treatment (72.7%), or had a greater number of clinical encounters per year (86.7%) were more likely to receive influenza vaccination.
  
  
  CONCLUSIONS
  The decreased likelihood of vaccination among women and non-Hispanic black patients suggests the need for focused efforts to reduce disparities. Increasing patient and clinician education on the importance of universal vaccination, and ensuring that vaccination activities continue in HIV clinics during the later months of the influenza season may improve influenza vaccine coverage.
authors.affiliation: Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, USA. mvd8@cdc.gov
authors.forename: Marcus D
authors.initials: MD
authors.lastname: Durham
authors.forename: Kate
authors.initials: K
authors.lastname: Buchacz
authors.forename: Carl
authors.initials: C
authors.lastname: Armon
authors.forename: Pragna
authors.initials: P
authors.lastname: Patel
authors.forename: Kathy
authors.initials: K
authors.lastname: Wood
authors.forename: John T
authors.initials: JT
authors.lastname: Brooks
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology*; D054625:Healthcare Disparities; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D017678:Sex Distribution; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D044966:Anti-Retroviral Agents; D007252:Influenza Vaccines