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...

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Autores principales:	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
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ea6f0b1c70034888aa021f988d57c973
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spelling	oai:doaj.org-article:ea6f0b1c70034888aa021f988d57c9732021-12-02T20:16:15ZPrevalence and correlates of SARS-CoV-2 seropositivity among people who inject drugs in the San Diego-Tijuana border region.1932-620310.1371/journal.pone.0260286https://doaj.org/article/ea6f0b1c70034888aa021f988d57c9732021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0260286https://doaj.org/toc/1932-6203<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.Steffanie A StrathdeeDaniela AbramovitzAlicia Harvey-VeraCarlos F VeraGudelia RangelIrina ArtamonovaAntoine ChaillonCaroline IgnacioAlheli CalderonNatasha K MartinThomas L PattersonPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11, p e0260286 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q 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.
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.
format	article
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
title	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_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_sort	prevalence and correlates of sars-cov-2 seropositivity among people who inject drugs in the san diego-tijuana border region.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/ea6f0b1c70034888aa021f988d57c973
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Prevalence and correlates of SARS-CoV-2 seropositivity among people who inject drugs in the San Diego-Tijuana border region.

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