Prevention of Substance Use in At-risk Students: A Family-centered Web Program

PROJECT SUMMARYPeople who inject drugs (PWIDs) are a socially vulnerable population and are exposed to risk factors includingunstable 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, includingdeath. PWIDs also experience barriers such as a history of stigmatization and discrimination by health caresystems 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 toreduce SARS-CoV-2 transmission, lack of testing has significant implications for PWID, highlighting an urgentneed to increase testing uptake among this population. Despite this, PWIDs have been an underservedpopulation in the context of the current pandemic; thus, little is known about the prevalence of COVID-19 andthe acceptability and possible reach of testing for COVID-19 among PWIDs. To address this gap, this studyleverages a current partnership with HIV Alliance (HIVA) in Oregon and our Community and Scientific AdvisoryBoard to support implementation and sustainability of a COVID-19 testing program. Specifically, we will usecommunity-based participatory approaches to develop, implement, and evaluate a COVID-19 testing programoffered through HIVA's Syringe Services Programs (SSP), a natural point of care for PWIDs. Moreover, SSPsmay offer a natural venue for dissemination and delivery of a vaccine, once available. The COVID-19 testingprogram will include procedures for sample collection, transmission of specimens to the University of OregonCLIA-certified laboratory, and results reporting. For aim 1, we will assess the testing program utilization. Foraim 2, we will develop and test a brief motivational enhancement intervention to optimize testing utilizationamong PWIDs. Using an interrupted time series design, we will evaluate intervention effects on utilization ofCOVID-19 testing resources. For aim 3, we will collect data from syringe exchange staff and key volunteers onprogram acceptability, feasibility, appropriateness, adoption, and implementation barriers and facilitatorsrelated to the testing program and intervention. The current project has the potential to enhance COVID-19testing access and reach among a significantly underserved population who experience multiple risks thatmake it difficult to prevent SARS-CoV-2 exposure and transmission and who are at increased risk for severeCOVID-19 symptoms, if they were to contract the disease.