Background <p>The tolerance of inactivated SARS-CoV-2 vaccines in people living with HIV (PLWH) remains unclear. We aimed to evaluate the tolerance of inactivated SARS-CoV-2 vaccines in PLWH.</p> Methods <p>This retrospective cohort study recruited 3327 PLWH for questionnaires and laboratory testing. Subjects were screened to ensure they were receiving antiretroviral therapy for PLWH without SARS-CoV-2 infection. Poisson regression analyses were conducted to assess the association between vaccination and HIV viral rebound, estimating absolute risk difference and relative risk (RR).</p> Results <p>A total of 724 PLWH without SARS-CoV-2 infection participated in this study. No significant increase in HIV viral rebound risk was observed after vaccination in the 1/2-dose, 3-dose, and 4-dose groups compared to the 0-dose group. The RRs for the 1/2-dose, 3-dose, and 4-dose groups were 1.22 (95% confidence interval [CI]: 0.55, 2.72), 0.90 (95% CI: 0.48, 1.69), and 1.01 (95% CI: 0.35, 2.89), respectively. Similar results were observed across subgroups. Post-vaccination adverse reactions were minimal, occurring in 2.16% of cases, mostly fatigue and muscle soreness.</p> Conclusion <p>Our study suggests that inactivated SARS-CoV-2 vaccines do not adversely affect the risk of HIV viral rebound and were well-tolerated in PLWH.</p>