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

BMC Public Health. 2022 Apr 27;22(1):842. doi: 10.1186/s12889-022-13273-y.

Abstract

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.

Keywords: COVID-19; SARS-CoV-2; Substance use; Testing, substance use treatment.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • COVID-19 Testing
  • COVID-19 Vaccines
  • COVID-19* / diagnosis
  • COVID-19* / epidemiology
  • Cross-Sectional Studies
  • Drug Users*
  • HIV Infections* / epidemiology
  • Hepatitis C* / complications
  • Humans
  • Mexico / epidemiology
  • Prevalence
  • SARS-CoV-2
  • Substance Abuse, Intravenous* / complications
  • Substance Abuse, Intravenous* / epidemiology

Substances

  • COVID-19 Vaccines