3C model indicators and HPV vaccination (in)completeness among people living with HIV in an area of Northeastern Brazil.

This study aimed to describe indicators of vaccine hesitancy and analyze HPV vaccination (in)completeness among people living with HIV. The study was conducted at a specialized service and the Reference Center for Special Immunobiologicals in Alagoas, Brazil. Data were collected using an instrument based on the 3C model: Confidence, Complacency, and Convenience. Vaccination status was obtained from the Brazilian Immunization Program Information System. Descriptive and bivariate analyses were followed by logistic regression. 26.4% of participants had completed the vaccination schedule, 47.2% had received no doses, and 56.0% were unaware of their entitlement to vaccination through the public health system. Awareness of this entitlement was associated with higher odds of receiving at least one dose (OR=2.34; 95% CI: 1.13-4.82). High Confidence and Convenience and low Complacency were observed. After adjustment for age, race/color, and viral load, Black/Brown participants had lower odds of completing the vaccination schedule (aOR=0.29; 95% CI: 0.11-0.82), whereas participants with an undetectable viral load had higher odds of completing it (aOR=13.18; 95% CI: 1.66-104.37). Improving HPV vaccination coverage requires strategies beyond individual factors, including active recommendations by healthcare professionals, educational campaigns, assessment of vaccination status in HIV care, and actions to reduce inequities in access.