Prevalence and correlates of SARS-CoV-2 seropositivity among people who inject drugs in the San Diego-Tijuana border region.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2021
2021
Historique:
received:
05
08
2021
accepted:
05
11
2021
entrez:
22
11
2021
pubmed:
23
11
2021
medline:
15
12
2021
Statut:
epublish
Résumé
People who inject drugs may be at elevated SARS-CoV-2 risk due to their living conditions and/or exposures when seeking or using drugs. No study to date has reported upon risk factors for SARS-CoV-2 infection among people who inject drugs. Between October, 2020 and June, 2021, participants aged ≥18 years from San Diego, California, USA and Tijuana, Baja California, Mexico who injected drugs within the last month underwent interviews and testing for SARS-CoV-2 RNA and antibodies. Binomial regressions identified correlates of SARS-CoV-2 seropositivity. Of 386 participants, SARS-CoV-2 seroprevalence was 36.3% (95% CI: 31.5%-41.1%); 92.1% had detectable IgM antibodies. Only 37.5% had previously been tested. Seroprevalence did not differ by country of residence. None tested RNA-positive. Most (89.5%) reported engaging in ≥1 protective behavior [e.g., facemasks (73.5%), social distancing (46.5%), or increasing handwashing/sanitizers (22.8%)]. In a multivariate model controlling for sex, older age, and Hispanic/Latinx/Mexican ethnicity were independently associated with SARS-CoV-2 seropositivity, as was engaging in sex work (AdjRR: 1.63; 95% CI: 1.18-2.27) and having been incarcerated in the past six months (AdjRR: 1.49; 95% CI: 0.97-2.27). Comorbidities and substance using behaviors were not associated with SARS-CoV-2 seropositivity. In this community-based study of people who inject drugs in the San Diego-Tijuana border region, over one third were SARS-CoV-2 seropositive, exceeding estimates from the general population in either city. We found no evidence that substance use behaviors were associated with an elevated risk of SARS-CoV-2 infection, but observed that circumstances in the risk environment, notably sex work and incarceration, were independently associated with higher SARS-CoV-2 seroprevalence. Our findings suggest that a binational policy response to COVID-19 mitigation is warranted beyond the closure of the U.S.-Mexico border. Furthermore, decriminalizing sex work and drug use could reduce the burden of COVID-19 among people who inject drugs.
Sections du résumé
BACKGROUND
People who inject drugs may be at elevated SARS-CoV-2 risk due to their living conditions and/or exposures when seeking or using drugs. No study to date has reported upon risk factors for SARS-CoV-2 infection among people who inject drugs.
METHODS AND FINDINGS
Between October, 2020 and June, 2021, participants aged ≥18 years from San Diego, California, USA and Tijuana, Baja California, Mexico who injected drugs within the last month underwent interviews and testing for SARS-CoV-2 RNA and antibodies. Binomial regressions identified correlates of SARS-CoV-2 seropositivity.
RESULTS
Of 386 participants, SARS-CoV-2 seroprevalence was 36.3% (95% CI: 31.5%-41.1%); 92.1% had detectable IgM antibodies. Only 37.5% had previously been tested. Seroprevalence did not differ by country of residence. None tested RNA-positive. Most (89.5%) reported engaging in ≥1 protective behavior [e.g., facemasks (73.5%), social distancing (46.5%), or increasing handwashing/sanitizers (22.8%)]. In a multivariate model controlling for sex, older age, and Hispanic/Latinx/Mexican ethnicity were independently associated with SARS-CoV-2 seropositivity, as was engaging in sex work (AdjRR: 1.63; 95% CI: 1.18-2.27) and having been incarcerated in the past six months (AdjRR: 1.49; 95% CI: 0.97-2.27). Comorbidities and substance using behaviors were not associated with SARS-CoV-2 seropositivity.
CONCLUSIONS
In this community-based study of people who inject drugs in the San Diego-Tijuana border region, over one third were SARS-CoV-2 seropositive, exceeding estimates from the general population in either city. We found no evidence that substance use behaviors were associated with an elevated risk of SARS-CoV-2 infection, but observed that circumstances in the risk environment, notably sex work and incarceration, were independently associated with higher SARS-CoV-2 seroprevalence. Our findings suggest that a binational policy response to COVID-19 mitigation is warranted beyond the closure of the U.S.-Mexico border. Furthermore, decriminalizing sex work and drug use could reduce the burden of COVID-19 among people who inject drugs.
Identifiants
pubmed: 34807963
doi: 10.1371/journal.pone.0260286
pii: PONE-D-21-25385
pmc: PMC8608290
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0260286Subventions
Organisme : NIDA NIH HHS
ID : R01 DA049644
Pays : United States
Organisme : NIDA NIH HHS
ID : R01 DA055491
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI036214
Pays : United States
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
J Stud Alcohol Drugs. 2020 Sep;81(5):556-560
pubmed: 33028465
JAMA Netw Open. 2021 Jun 1;4(6):e2113787
pubmed: 34137826
Harm Reduct J. 2021 May 10;18(1):52
pubmed: 33971892
Nat Med. 2020 Aug;26(8):1200-1204
pubmed: 32555424
JMIR Public Health Surveill. 2021 Nov 9;7(11):e29319
pubmed: 34591780
Int J Womens Health. 2021 Jun 01;13:509-523
pubmed: 34113178
Int J Epidemiol. 2021 Mar 3;50(1):31-40
pubmed: 33682886
PLoS One. 2011 Apr 25;6(4):e19048
pubmed: 21541349
World Psychiatry. 2021 Oct 5;:
pubmed: 34612005
Lancet. 2020 Jul 4;396(10243):9-11
pubmed: 32422122
MMWR Morb Mortal Wkly Rep. 2020 May 01;69(17):521-522
pubmed: 32352957
J Infect Dis. 2020 Oct 13;222(10):1592-1595
pubmed: 32729903
Front Psychiatry. 2021 Aug 06;12:646206
pubmed: 34421664
Ann Intern Med. 2021 Jan;174(1):42-49
pubmed: 32931328
Health Aff (Millwood). 2021 Jun;40(6):870-878
pubmed: 33979192
Open Forum Infect Dis. 2020 Aug 07;7(8):ofaa325
pubmed: 32875005
PLoS One. 2021 Apr 28;16(4):e0249938
pubmed: 33909632
Public Health. 2021 Mar;192:8-11
pubmed: 33601307
J Infect Public Health. 2021 Jul;14(7):845-851
pubmed: 34118734
Mol Psychiatry. 2021 Jan;26(1):30-39
pubmed: 32929211
Int J Drug Policy. 2021 Jun;92:103127
pubmed: 33549464
Harm Reduct J. 2014 Feb 12;11:4
pubmed: 24520885
Drug Alcohol Depend. 2021 Apr 1;221:108584
pubmed: 33607497
J Gen Intern Med. 2021 Oct;36(10):3096-3102
pubmed: 34291377
Psychiatr Serv. 2020 Dec 1;71(12):1308
pubmed: 33019859
Ann Intern Med. 2020 Jul 7;173(1):61-62
pubmed: 32240293
Clin Infect Dis. 2021 Nov 2;73(9):e2978-e2984
pubmed: 32898272
Public Health Rep. 2010 Jul-Aug;125 Suppl 4:101-9
pubmed: 20626197
N Engl J Med. 2020 Sep 10;383(11):1085-1087
pubmed: 32706954
JAMA. 2020 Jun 23;323(24):2466-2467
pubmed: 32391864