Supported employment to create a community culture of SARS-CoV-2 rapid testing among people who inject drugs: PeerConnect2Test

Project Summary This Phase III project builds on the successes of our Phase I and Phase II projects but uses a novel approach to adapt to the changing pandemic context; facilitation of rapid testing by people who inject drugs (PWID) via a supported employment program that trains PWID as peer health workers (PHW). PWID are vulnerable to contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and to the effects of the disease caused by SARS-CoV-2, coronavirus disease 2019 (COVID-19) due to structural disadvantage, health vulnerabilities, and stigmatization that prevents adequate access to medical care. While our project has previously processed more than 6,000 self-collected polymerase chain reaction (PCR) tests for PWID across the state of Oregon, the ever-changing nature of the pandemic, including new variants and the availability of SARS-CoV-2 vaccines, calls for additional strategies that can increase access to and uptake of testing among PWID. Rapid tests may offer an advantage over PCR tests for PWID experiencing structural vulnerabilities such as houselessness and lack of access to technology so that they can receive results in real-time and be quickly connected to needed resources. Accessibility of rapid testing for PWID has been previously limited by workforce shortages and the inability to reach PWID who need testing. We propose a novel community- engaged strategy to improve the accessibility of rapid tests through a supported employment program for PWID, Peer Connect2Test (PeerC2T), to become PHW to distribute SARS-CoV-2 rapid test kits to other PWID. We expect that PeerC2T will improve knowledge, self-efficacy, and health behaviors among PHW (Aim 1). We will use the RE-AIM framework in Aims 2 and 3 to evaluate whether PeerC2T improves SARS-CoV-2 testing uptake among other PWID (RE; Aim 2) and identify intervention considerations (AIM; Aim 3). The overall goal of this project is to build on our partnership with HIVA to develop a transformative community- driven intervention to promote widespread access to rapid testing among PWID. We will continue to collaborate with the RADx-UP Coordination and Data Collection Center. Findings will clarify the implications of supported employment programs for PWID for SARS-CoV-2 testing uptake among PWID and other public health efforts to improve health outcomes among PWID. Thus, findings from this study may have broad public health implications for leveraging supported employment programs for PWID to prevent the transmission of other infectious diseases.