Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, United States of America.
Facultad de Medicina, Campus Tijuana, Universidad Xochicalco, Baja California, Mexico.
PLoS One. 2021 Nov 22;16(11):e0260286. doi: 10.1371/journal.pone.0260286. eCollection 2021.
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.
由于吸毒者的生活条件和/或在寻求或使用毒品时的暴露，他们可能面临更高的 SARS-CoV-2 风险。迄今为止，尚无研究报告吸毒者感染 SARS-CoV-2 的危险因素。
2020 年 10 月至 2021 年 6 月期间，来自美国加利福尼亚州圣地亚哥和墨西哥下加利福尼亚州提华纳的年龄≥18 岁、过去一个月内注射过毒品的参与者接受了 SARS-CoV-2 RNA 和抗体检测，并进行了访谈。二项回归分析确定了 SARS-CoV-2 血清阳性的相关因素。
在 386 名参与者中，SARS-CoV-2 血清阳性率为 36.3%（95%CI：31.5%-41.1%）；92.1%检测到 IgM 抗体。只有 37.5%的人之前接受过检测。血清阳性率不因居住国而异。没有检测到 RNA 阳性。大多数（89.5%）人报告采取了≥1 种保护措施[例如，戴口罩（73.5%）、保持社交距离（46.5%）或增加洗手/使用消毒剂（22.8%）]。在控制了性别、年龄较大和西班牙裔/拉丁裔/墨西哥裔种族的多变量模型中，与 SARS-CoV-2 血清阳性相关的因素包括从事性工作（调整后的 RR：1.63；95%CI：1.18-2.27）和过去六个月内被监禁（调整后的 RR：1.49；95%CI：0.97-2.27）。合并症和物质使用行为与 SARS-CoV-2 血清阳性无关。
在圣地亚哥-蒂华纳边境地区进行的这项基于社区的吸毒者研究中，超过三分之一的人 SARS-CoV-2 血清呈阳性，超过了这两个城市的一般人群的估计值。我们没有发现证据表明物质使用行为与 SARS-CoV-2 感染的风险增加有关，但观察到风险环境中的情况，特别是性工作和监禁，与更高的 SARS-CoV-2 血清阳性率独立相关。我们的研究结果表明，除了关闭美墨边境之外，还需要采取两国联合政策来减轻 COVID-19 的影响。此外，将性工作和吸毒合法化可以减轻吸毒者感染 COVID-19 的负担。
