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Preliminary Efficacy of a Theory-Informed Intervention to Increase COVID-19 Testing Uptake Among People Who Inject Drugs in San Diego County: Findings From a Pilot Randomized Controlled Trial.

  • Bazzi, Angela R1, 2
  • Abramovitz, Daniela3
  • Harvey-Vera, Alicia3, 4, 5
  • Stamos-Buesig, Tara6
  • Vera, Carlos F3
  • Artamonova, Irina3
  • Logan, Jenna6
  • Patterson, Thomas L7
  • Strathdee, Steffanie A3
  • 1 Herbert Wertheim School of Public Health, University of California, San Diego, La Jolla, CA, USA.
  • 2 Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA.
  • 3 Department of Medicine, School of Medicine, University of California, San Diego; La Jolla, CA, USA.
  • 4 Universidad Xochicalco, Facultad de Medicina, Tijuana, BC, Mexico. , (Mexico)
  • 5 United States-Mexico Border Health Commission, Tijuana, BC, Mexico. , (Mexico)
  • 6 OnPoint, Harm Reduction Coalition of San Diego, San Diego, CA, USA.
  • 7 Department of Psychiatry, University of California San Diego, CA, USA.
Published Article
Annals of behavioral medicine : a publication of the Society of Behavioral Medicine
Publication Date
May 23, 2023
DOI: 10.1093/abm/kaad012
PMID: 37029714


People who inject drugs (PWID) are vulnerable to severe COVID-19 disease yet have low rates of COVID-19 testing. We partnered with a syringe service program (SSP) in San Diego County, CA, to develop “LinkUP,” an evidence- and community-informed intervention. Specifically, LinkUP used tailored education, motivational interviewing, and problem-solving and planning strategies to increase COVID-19 testing uptake among PWID. This study was a pilot randomized controlled trial (RCT) designed to assess the preliminary efficacy of LinkUP in increasing PWID COVID-19 testing. We referred participants (PWID, ≥18 years old, San Diego residents without recent voluntary COVID-19 testing) to mobile SSP sites that had been randomized (by week). Trained peer counselors then offered LinkUP or an educational control condition lasting the same length (~30 minutes). After either condition, counselors offered on-site rapid COVID-19 antigen testing. Among 150 participants, our analyses found that the LinkUP intervention was associated with higher COVID-19 testing uptake, especially for participants experiencing homelessness. In summary, our findings from this pilot RCT support the preliminary efficacy of the “LinkUP” intervention in increasing COVID-19 testing among PWID. This study also underscores the importance of academic-community partnerships and prevention service delivery through SSPs and other community-based organizations serving vulnerable populations.

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