Prevalence and correlates of SARS-CoV-2 seropositivity among people who inject drugs in the San Diego-Tijuana border region.
<h4>Background</h4>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.<h4>Methods and findings...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2021-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0260286 |
| _version_ | 1797867562101374976 |
|---|---|
| author | Steffanie A Strathdee Daniela Abramovitz Alicia Harvey-Vera Carlos F Vera Gudelia Rangel Irina Artamonova Antoine Chaillon Caroline Ignacio Alheli Calderon Natasha K Martin Thomas L Patterson |
| author_facet | Steffanie A Strathdee Daniela Abramovitz Alicia Harvey-Vera Carlos F Vera Gudelia Rangel Irina Artamonova Antoine Chaillon Caroline Ignacio Alheli Calderon Natasha K Martin Thomas L Patterson |
| author_sort | Steffanie A Strathdee |
| collection | DOAJ |
| description | <h4>Background</h4>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.<h4>Methods and findings</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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. |
| first_indexed | 2024-04-09T23:42:07Z |
| format | Article |
| id | doaj.art-ea6f0b1c70034888aa021f988d57c973 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-09T23:42:07Z |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-ea6f0b1c70034888aa021f988d57c9732023-03-18T05:32:35ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-011611e026028610.1371/journal.pone.0260286Prevalence and correlates of SARS-CoV-2 seropositivity among people who inject drugs in the San Diego-Tijuana border region.Steffanie A StrathdeeDaniela AbramovitzAlicia Harvey-VeraCarlos F VeraGudelia RangelIrina ArtamonovaAntoine ChaillonCaroline IgnacioAlheli CalderonNatasha K MartinThomas L Patterson<h4>Background</h4>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.<h4>Methods and findings</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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.https://doi.org/10.1371/journal.pone.0260286 |
| spellingShingle | Steffanie A Strathdee Daniela Abramovitz Alicia Harvey-Vera Carlos F Vera Gudelia Rangel Irina Artamonova Antoine Chaillon Caroline Ignacio Alheli Calderon Natasha K Martin Thomas L Patterson Prevalence and correlates of SARS-CoV-2 seropositivity among people who inject drugs in the San Diego-Tijuana border region. PLoS ONE |
| title | Prevalence and correlates of SARS-CoV-2 seropositivity among people who inject drugs in the San Diego-Tijuana border region. |
| title_full | Prevalence and correlates of SARS-CoV-2 seropositivity among people who inject drugs in the San Diego-Tijuana border region. |
| title_fullStr | Prevalence and correlates of SARS-CoV-2 seropositivity among people who inject drugs in the San Diego-Tijuana border region. |
| title_full_unstemmed | Prevalence and correlates of SARS-CoV-2 seropositivity among people who inject drugs in the San Diego-Tijuana border region. |
| title_short | Prevalence and correlates of SARS-CoV-2 seropositivity among people who inject drugs in the San Diego-Tijuana border region. |
| title_sort | prevalence and correlates of sars cov 2 seropositivity among people who inject drugs in the san diego tijuana border region |
| url | https://doi.org/10.1371/journal.pone.0260286 |
| work_keys_str_mv | AT steffanieastrathdee prevalenceandcorrelatesofsarscov2seropositivityamongpeoplewhoinjectdrugsinthesandiegotijuanaborderregion AT danielaabramovitz prevalenceandcorrelatesofsarscov2seropositivityamongpeoplewhoinjectdrugsinthesandiegotijuanaborderregion AT aliciaharveyvera prevalenceandcorrelatesofsarscov2seropositivityamongpeoplewhoinjectdrugsinthesandiegotijuanaborderregion AT carlosfvera prevalenceandcorrelatesofsarscov2seropositivityamongpeoplewhoinjectdrugsinthesandiegotijuanaborderregion AT gudeliarangel prevalenceandcorrelatesofsarscov2seropositivityamongpeoplewhoinjectdrugsinthesandiegotijuanaborderregion AT irinaartamonova prevalenceandcorrelatesofsarscov2seropositivityamongpeoplewhoinjectdrugsinthesandiegotijuanaborderregion AT antoinechaillon prevalenceandcorrelatesofsarscov2seropositivityamongpeoplewhoinjectdrugsinthesandiegotijuanaborderregion AT carolineignacio prevalenceandcorrelatesofsarscov2seropositivityamongpeoplewhoinjectdrugsinthesandiegotijuanaborderregion AT alhelicalderon prevalenceandcorrelatesofsarscov2seropositivityamongpeoplewhoinjectdrugsinthesandiegotijuanaborderregion AT natashakmartin prevalenceandcorrelatesofsarscov2seropositivityamongpeoplewhoinjectdrugsinthesandiegotijuanaborderregion AT thomaslpatterson prevalenceandcorrelatesofsarscov2seropositivityamongpeoplewhoinjectdrugsinthesandiegotijuanaborderregion |