ABSTRACT
Background: COVID-19 has hindered HCV and HIV screening, particularly in marginalised groups, who have some of the highest rates of these conditions and lowest rates of COVID-19 vaccination. We assessed the acceptability of combining HCV testing with COVID-19 vaccination in a centre for addiction services (CAS) in Barcelona and a mobile testing unit (MTU) in Madrid, Spain. Methods: From 28/09/2021-30/06/2022, 187 adults from marginalised populations were offered HCV antibody (Ab) testing along with COVID-19 vaccination. If HCV Ab+, they were tested for HCV-RNA. MTU participants were screened for HIV, per the standard of care. HCV-RNA+ and HIV+ participants not on ART were offered treatment. Results: Findings show how of the 86 CAS participants: 93% had been previously vaccinated for COVID-19, of whom 90% had the full first round schedule; none had a COVID-19 vaccine booster and all received a COVID-19 vaccine; 62.8% were tested for HCV Ab, of whom 31.5% were positive, of whom all were tested for HCV-RNA and none were positive. Of the 101 MTU participants: none had been vaccinated for COVID-19 and all received a COVID-19 vaccine; all were tested for HCV Ab and HIV and 14.9% and 8.9% were positive, respectively; of those HCV Ab+, nine (60%) were HCV-RNA+, of whom eight (88.9%) have started treatment; five (55.6%) of those HIV+ had abandoned ART, of whom three (60%) have re-started it. Conclusions: The intervention had an acceptability rate of 62.8% at the CAS and 100% at the MTU and can be used in marginalised communities.
Subject(s)
COVID-19 , HIV Infections , Hepatitis CABSTRACT
This one-year follow-up study investigated COVID-19 vaccine acceptance in 23 countries. In June 2021, 75.2% of respondents reported to accept the vaccine, of which 49% had received at least one vaccine dose and 51% were willing to get it once available to them. Factors associated with COVID-19 vaccine acceptance include perceived safety and trust in science, as measured by a novel COVID-VAC score, and personal experience with COVID-19. Males, healthcare workers, well-to-do people, those with university degrees, and those whose physician recommended vaccination were more likely to accept it. Trust in governmental ability to address COVID-19 was weakly associated with vaccine acceptance. Respondents strongly supported vaccination to travel internationally, but weakly supported vaccinating children for school attendance. Hesitancy rates remain high in LMICs. Health policymakers should aggressively communicate vaccination need and inform accurately about efficacy and safety compared to disease risk, and healthcare workers need a greater vaccine communications role.
Subject(s)
COVID-19ABSTRACT
Background: The simplicity and low cost of rapid point-of-care tests greatly facilitate large-scale population testing, which can contribute to controlling the spread of the COVID-19 virus.Methods: Between April and May 2020, the applicability of a self-testing strategy for SARS-CoV2 detection was evaluated in a population-based, cross-sectional study in Cantabria, Spain. For the self-testing strategy, participants received the necessary material for blood self-collection and performance of a rapid antibodies test using lateral flow immunoassay at home without the supervision of healthcare personnel.Findings: A total of 1,022 participants were enrolled. The vast majority of participants correctly performed the COVID-19 self-test the first time (91.3% [95% IC 89.4-92.9]). Only a minority of participants (0.7%) needed the help of healthcare personnel, and 6.9% required a second kit delivery, for a total valid test result in 96.9% of the participants. Incorrect use of the self-test did not depend on the educational level, age over 65 years, or housing area. Prevalence of IgG antibodies against SARS-CoV2 for subjects with a valid rapid test result was 3.1% (95% IC 2.2-4.4), similar to the seroprevalence result obtained using a conventional approach carried out by healthcare professionals.Interpretation: A strategy of COVID-19 self-testing could be applied as a screening tool in surveillance programs.Funding Statement: No funding.Declaration of Interests: The authors report no relevant conflict of interest ordisclosures relevant to this manuscript.Ethics Approval Statement: The Ethics Committee of investigation of Cantabria approved this study (code 2020.176) and written informed consent was obtained from all participants.
Subject(s)
COVID-19ABSTRACT
Background: Containment policies and other restrictions introduced by the Spanish government in response to the COVID-19 pandemic present challenges for marginalised populations, such as people who use drugs. Harm reduction centres are often linked to social services, mental health services, and infectious disease testing, in addition to tools and services that help to reduce the harms associated with injecting drugs. This study aimed to explore the impact of the pandemic on these services in four autonomous communities in Spain. Methods: : This is a cross-sectional study that employed a seven-section structured survey administered electronically to 20 centres in July 2020. Data from the most heavily affected months (March–June) in 2020 were compared to data from the same period in 2019. Averages were calculated with their ranges, rates, and absolute numbers. Results: : All 11 responding centres reported having had to adapt or modify their services during the Spanish state of alarm (14 March–21 June 2020). One centre reported complete closure for two months and four reported increases in their operating hours. The average number of service users across all centres decreased by 22% in comparison to the same period in the previous year and the average needle distribution decreased by 40% in comparison to 2019. Most centres reported a decrease in infectious disease testing rates (hepatitis B and C viruses [HBV, HCV], human immunodeficiency virus (HIV), and tuberculosis [TB]) for March, April, and May in 2020 compared to the previous year. Reported deaths as a result of overdose did not increase during the state of alarm, but 2/11 (18%) centres reported an increase in overdose deaths immediately after finalisation of the state of alarm. Conclusion: Overall, Spanish harm reduction centres were able to continue operating and offering services by adjusting operating hours. The number of overall service users and needles distributed fell during the Spanish state of alarm lockdown period, suggesting that fewer clients accessed harm reduction services during this time, putting them at greater risk of reusing or sharing injecting equipment, overdosing, acquiring infectious diseases with decreased access to testing or discontinuing ongoing treatment such as methadone maintenance therapy, hepatitis C treatment, or antiretroviral therapy.