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Prevalence and correlates of SARS-CoV-2 seropositivity among people who inject drugs in the San Diego-Tijuana border region.
Strathdee, Steffanie A; Abramovitz, Daniela; Harvey-Vera, Alicia; Vera, Carlos F; Rangel, Gudelia; Artamonova, Irina; Chaillon, Antoine; Ignacio, Caroline; Calderon, Alheli; Martin, Natasha K; Patterson, Thomas L.
  • Strathdee SA; Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, United States of America.
  • Abramovitz D; Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, United States of America.
  • Harvey-Vera A; Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, United States of America.
  • Vera CF; Facultad de Medicina, Campus Tijuana, Universidad Xochicalco, Baja California, Mexico.
  • Rangel G; United States-Mexico Border Health Commission, Tijuana, Baja California, Mexico.
  • Artamonova I; Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, United States of America.
  • Chaillon A; United States-Mexico Border Health Commission, Tijuana, Baja California, Mexico.
  • Ignacio C; Departmento de Estudios de Población, El Colegio de la Frontera Norte, Tijuana, Baja California, Mexico.
  • Calderon A; Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, United States of America.
  • Martin NK; Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, United States of America.
  • Patterson TL; Department of Medicine, San Diego Center for AIDS Research Translational Virology Core, University of California San Diego, La Jolla, CA, United States of America.
PLoS One ; 16(11): e0260286, 2021.
Article in English | MEDLINE | ID: covidwho-1528727
Preprint
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ABSTRACT

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.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Substance Abuse, Intravenous / Drug Users / COVID-19 Serological Testing / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Mexico Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0260286

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Substance Abuse, Intravenous / Drug Users / COVID-19 Serological Testing / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Mexico Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0260286