Hepatitis B Virus Knowledge, Preventive Practices, and Vaccination Status Among People Living with HIV at the Nigerian Institute of Medical Research, Lagos: A Cross-Sectional Study

Abstract

Hepatitis B Virus (HBV) co-infection substantially increases liver-related morbidity and mortality among people living with HIV (PLHIV). Although vaccination remains the most effective strategy for prevention HBV infection, its uptake is conventionally assumed to depend on adequate knowledge and positive attitudes towards vaccination. This study assessed knowledge, attitudes, and practices regarding HBV vaccination among HIV-positive patients and examined whether knowledge significantly predicts vaccination uptake. A cross-sectional institutional survey was conducted among 374 HIV-positive patients receiving care at the Nigerian Institute of Medical Research (NIMR), Yaba, Lagos State. Participants were selected using purposive sampling. and data were collected using a structured questionnaire. Data were analysed using SPSS version 26.0, through descriptive statistics, chi-square tests, and logistic regression with statistical significance set at p<0.05. The majority of respondents were female (70.2%), married (62.9%), and had tertiary-educated (40.7%). Overall, 82% of participants demonstrated low levels of knowledge regarding HBV infection and vaccination (Mean=1.20±0.443), while 58% exhibited negative attitudes toward HBV vaccination (Mean=2.73±0.580). Despite these findings, self-reported HBV vaccination uptake was relatively high (79.6%, Mean = 1.4\11±0.423). Healthcare facilities were identified as the primary source of HBV related information. Education level were significantly associated with vaccination status (p=0.025), while gender was significantly associated with knowledge level (p = 0.010). Occupation was not significantly associated with attitude (p = 0.466). Logistic regression analysis indicated that knowledge was not a significant predictor of vaccination uptake (χ² = 4.49, p = 0.106, R² = 0.018). The findings demonstrate a notable disconnect between knowledge and predominantly negative attitudes. This challenge the conventional assumption that knowledge necessarily drives vaccination behavior and suggest that health-system factors, including routine vaccine provision and health-care provider recommendations, may play a more important role in vaccination uptake among PLHIV. Interventions should therefore combine improved vaccine accessibility and provider-led vaccination strategies with targeted education, particularly through the integration of HBV vaccination into routine HIV care.