Health Behavior
Conditions
Brief summary
PWIDs have been an underserved population in the context of the current pandemic; thus, little is known about the prevalence of COVID-19 and the acceptability and possible reach of testing for COVID-19 among PWIDs. To address this gap, this study leverages a current partnership with HIV Alliance (HIVA) in Oregon and our Community and Scientific Advisory Board to support implementation and sustainability of a COVID-19 testing program. Specifically, we will use community-based participatory approaches to develop, implement, and evaluate a COVID-19 testing program offered through HIVA's Syringe Services Programs (SSP), a natural point of care for PWIDs. The COVID-19 testing program will include procedures for sample collection, transmission of specimens to the University of Oregon CLIA-certified laboratory, and results reporting. Our clinical trial is a randomized control trial focused improving the uptake of testing through a motivational enhancement intervention: Connect2Test.
Detailed description
People who inject drugs (PWIDs) are a socially vulnerable population and are exposed to risk factors including unstable housing and underlying medical conditions such as human immunodeficiency virus (HIV), tuberculosis (TB), and viral hepatitis that put them at increased risk for severe COVID-19 symptoms, including death. PWIDs also experience barriers such as a history of stigmatization and discrimination by health care systems and exposure to misinformation about testing that reduces access to health care services and testing. Because timely receipt of services relative to symptoms onset is critical for positive health outcomes and to reduce SARS-CoV-2 transmission, lack of testing has significant implications for PWID, highlighting an urgent need to increase testing uptake among this population. Despite this, PWIDs have been an underserved population in the context of the current pandemic; thus, little is known about the prevalence of COVID-19 and the acceptability and possible reach of testing for COVID-19 among PWIDs. To address this gap, this study leverages a current partnership with HIV Alliance (HIVA) in Oregon and our Community and Scientific Advisory Board to support implementation and sustainability of a COVID-19 testing program. Specifically, we will use community-based participatory approaches to develop, implement, and evaluate a COVID-19 testing program offered through HIVA's Syringe Services Programs (SSP), a natural point of care for PWIDs. Moreover, SSPs may offer a natural venue for dissemination and delivery of a vaccine, once available. The COVID-19 testing program will include procedures for sample collection, transmission of specimens to the University of Oregon CLIA-certified laboratory, and results reporting. For aim 1, we will assess the testing program utilization. For aim 2, we will develop and test a brief motivational enhancement intervention to optimize testing utilization among PWIDs. Using a randomized control trial, we will evaluate intervention effects on utilization of COVID-19 testing resources. For aim 3, we will collect data from syringe exchange staff and key volunteers on program acceptability, feasibility, appropriateness, adoption, and implementation barriers and facilitators related to the testing program and intervention. The current project has the potential to enhance COVID-19 testing access and reach among a significantly underserved population who experience multiple risks that make it difficult to prevent SARS-CoV-2 exposure and transmission and who are at increased risk for severe COVID-19 symptoms, if they were to contract the disease.
Interventions
Brief assessment based feedback and motivational interviewing intervention
Sponsors
Study design
Eligibility
Inclusion criteria
* Aged 18 and over * Attend Syringe Services Program * English speaking
Exclusion criteria
\-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Individual Participation in COVID-19 Testing | Immediately post-intervention assessment of whether clients participated in COVID-19 testing following either the brief intervention or services as usual | Binary outcome, yes/no participated in COVID-19 tested, reported by CLIA laboratory |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Connect2Test Intervention A brief MI intervention to motivate individuals to participate in COVID-19 testing after receiving syringe exchange services
Connect2Test Intervention: Brief assessment based feedback and motivational interviewing intervention | 105 |
| Control Services as usual | 100 |
| Total | 205 |
Baseline characteristics
| Characteristic | Control | Total | Connect2Test Intervention |
|---|---|---|---|
| Age, Continuous | 42.9 years STANDARD_DEVIATION 13.7 | 43.1 years STANDARD_DEVIATION 18.6 | 43.2 years STANDARD_DEVIATION 13.6 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 12 Participants | 23 Participants | 11 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 71 Participants | 148 Participants | 77 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 17 Participants | 34 Participants | 17 Participants |
| Participants Tested Previously for SARS-CoV-2 | 66 Participants | 144 Participants | 78 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 7 Participants | 12 Participants | 5 Participants |
| Race (NIH/OMB) Asian | 2 Participants | 2 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 1 Participants | 5 Participants | 4 Participants |
| Race (NIH/OMB) More than one race | 13 Participants | 28 Participants | 15 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 1 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 17 Participants | 34 Participants | 17 Participants |
| Race (NIH/OMB) White | 59 Participants | 123 Participants | 64 Participants |
| Region of Enrollment United States | 100 participants | 205 participants | 105 participants |
| Sex/Gender, Customized Man | 60 Participants | 125 Participants | 65 Participants |
| Sex/Gender, Customized Other or Unknown | 12 Participants | 23 Participants | 11 Participants |
| Sex/Gender, Customized Woman | 28 Participants | 57 Participants | 29 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 105 | 0 / 100 |
| other Total, other adverse events | 0 / 105 | 0 / 100 |
| serious Total, serious adverse events | 0 / 105 | 0 / 100 |
Outcome results
Individual Participation in COVID-19 Testing
Binary outcome, yes/no participated in COVID-19 tested, reported by CLIA laboratory
Time frame: Immediately post-intervention assessment of whether clients participated in COVID-19 testing following either the brief intervention or services as usual
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Connect2Test Intervention | Individual Participation in COVID-19 Testing | 25 Participants |
| Control | Individual Participation in COVID-19 Testing | 21 Participants |