Journal Article

A cross-sectional study of factors associated with COVID-19 testing among people who inject drugs: missed opportunities for reaching those most at risk

Vera, Carlos F., Harvey-Vera, Alicia Yolanda, Patterson, Thomas Leroy, Bazzi, Angela Robertson, Abramovitz, Daniela, Strathdee, Steffanie Ann, Yeager, Samantha, Brugman, Emma L., Rangel, Gudelia, Algarin, Angel Blake, Artamonova, Irina, Smith, Laramie Rae

2022

Overview

Background People who inject drugs (PWID) are vulnerable to SARS-CoV-2 infection. We examined correlates of COVID-19 testing among PWID in the U.S.-Mexico border region and described encounters with services representing potential opportunities (i.e., ‘touchpoints’) where COVID-19 testing could have been offered. Methods Between October, 2020 and September, 2021, participants aged ≥18 years from San Diego, California, USA and Tijuana, Baja California, Mexico who injected drugs within the last month completed surveys and SARS-CoV-2, HIV, and HCV serologic testing. Logistic regression identified factors associated with COVID-19 testing including potential touchpoints, comorbidities and COVID-19 related misinformation and disinformation. Results Of 583 PWID, 30.5% previously had a COVID-19 test. Of 172 PWID who tested SARS-CoV-2 seropositive (30.1%), 50.3% encountered at least one touchpoint where COVID-19 testing could have been offered within the prior six months. Factors independently associated with at least two fold higher odds of COVID-19 testing were living in San Diego, recent incarceration, receiving substance use treatment, and experiencing ≥1 chronic health condition. Homelessness, having received ≥1 dose of COVID-19 vaccine, and having a HIV or HCV test since the COVID-19 epidemic began were also independently associated with having had a prior COVID-19 test. Conclusion We identified several factors independently associated with COVID-19 testing and multiple touchpoints where COVID-19 testing could be scaled up for PWID, such as SUD treatment programs and syringe service programs. Integrated health services are needed to improve access to rapid, free COVID-19 testing in this vulnerable population.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Acquired immune deficiency syndrome / Adolescent / Adult / AIDS / At risk populations / Biostatistics / Care and treatment / Chronic illnesses / Conspiracy / Coronaviruses / COVID-19 / COVID-19 - diagnosis / COVID-19 - epidemiology / COVID-19 diagnostic tests / COVID-19 Testing / COVID-19 Vaccines / Cross-Sectional Studies / Disease transmission / Drug Users / Drugs / Emergency medical care / Environmental Health / Epidemics / Epidemiology / False information / Fentanyl / Food / Health insurance / Health services / Hepatitis C / Hepatitis C - complications / Heroin / HIV / HIV Infections - epidemiology / Homeless people / Homelessness / Human immunodeficiency virus / Humans / Imprisonment / Integrative medicine / Laboratories / Marginalized groups / Medical treatment / Medicine / Medicine & Public Health / Methamphetamine / Methods / Mexico - epidemiology / Misinformation / Needle exchange programs / Pharmaceutical industry / Polymerase chain reaction / Prevalence / Public Health / SARS-CoV-2 / Serology / Severe acute respiratory syndrome / Severe acute respiratory syndrome coronavirus 2 / Social distancing / Substance abuse / Substance abuse treatment / Substance Abuse, Intravenous - complications / Substance Abuse, Intravenous - epidemiology / Substance use / Testing / Testing, substance use treatment / Tests / Treatment programs / Vaccine / Variables / Viral diseases / Vulnerability