A Brief Peer-Led Intervention to Increase COVID-19 Vaccine Uptake Among People Who Inject Drugs in San Diego County: Results From a Pilot Randomized Controlled Trial

Steffanie A Strathdee; Daniela Abramovitz; Alicia Y Harvey-Vera; Tara Stamos-Buesig; Carlos F Vera; Irina Artamonova; Jenna Logan; Thomas L Patterson; Argentina E Servin; Angela R Bazzi

doi:10.1093/ofid/ofad392

A Brief Peer-Led Intervention to Increase COVID-19 Vaccine Uptake Among People Who Inject Drugs in San Diego County: Results From a Pilot Randomized Controlled Trial

Open Forum Infect Dis. 2023 Jul 21;10(8):ofad392. doi: 10.1093/ofid/ofad392. eCollection 2023 Aug.

Authors

Affiliations

¹ School of Medicine, University of California San Diego, La Jolla, California, USA.
² Facultad de Medicina, Universidad Xochicalco, Tijuana, Mexico.
³ United States-Mexico Border Health Commission, Tijuana, Mexico.
⁴ OnPoint, Harm Reduction Coalition of San Diego, San Diego, California, USA.
⁵ Department of Psychiatry, University of California San Diego, La Jolla, California, USA.
⁶ Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, California, USA.
⁷ Department of Community Health Sciences, School of Public Health, Boston University, Boston, Massachusetts, USA.

Abstract

Background: We evaluated the impact of a brief peer-led intervention on COVID-19 vaccination among people who inject drugs (PWID) presenting at syringe services program (SSP) locations in San Diego County, California.

Methods: Between March and July 2022, PWID aged ≥18 years without recent voluntary COVID-19 testing who were not up to date on COVID-19 vaccinations received a single-session motivational interviewing intervention (LinkUP) or an attention-matched didactic control condition from trained peer counselors at SSP sites randomized by week. Following either 30-minute session, counselors offered referrals to local vaccination services. Multivariable log binomial regression via generalized estimating equations assessed LinkUP effects on (1) acceptance of COVID-19 vaccination referrals immediately postintervention and (2) COVID-19 vaccine uptake at 6-month follow-up.

Results: COVID-19 vaccination outcomes were obtained on 135 (90.6%) of 149 participants. In multivariable analysis, participants receiving LinkUP had greater acceptance of COVID-19 vaccination referrals than controls (adjusted relative risk, 3.50; 95% CI, 1.01-12.2) and were marginally more likely to report receiving a new COVID-19 vaccine dose (adjusted relative risk, 1.57; 95% CI, .99-2.48). After 6 months, 20% reported receiving a new vaccine dose; however, if COVID-19 vaccine had been available at SSPs, this proportion could have been as high as 34.3% (45.3% LinkUP vs 24.3% control; P = .01).

Conclusions: A brief peer-led SSP-based intervention significantly improved COVID-19 vaccination among PWID. Further improvements could likely be obtained by supporting SSPs to offer COVID-19 vaccination on-site instead of relying on referrals.

Clinical trials registration: ClinicalTrials.gov NCT05181657.

Keywords: COVID-19; harm reduction; motivational interviewing; substance use; vulnerable populations.

Associated data

ClinicalTrials.gov/NCT05181657