Drug use and COVID-19 testing, vaccination, and infection among underserved, minority communities in Miami, Florida

Javier A Tamargo; Haley R Martin; Janet Diaz-Martinez; Ivan Delgado-Enciso; Angelique Johnson; Jose A Bastida Rodriguez; Mary Jo Trepka; David R Brown; Nana A Garba; Eneida O Roldan; Yolangel Hernandez Suarez; Aileen M Marty; Zoran Bursac; Adriana Campa; Marianna K Baum

doi:10.1371/journal.pone.0297327

Drug use and COVID-19 testing, vaccination, and infection among underserved, minority communities in Miami, Florida

PLoS One. 2024 Apr 30;19(4):e0297327. doi: 10.1371/journal.pone.0297327. eCollection 2024.

Authors

Javier A Tamargo¹, Haley R Martin¹, Janet Diaz-Martinez¹, Ivan Delgado-Enciso^{2

3}, Angelique Johnson¹, Jose A Bastida Rodriguez¹, Mary Jo Trepka¹, David R Brown⁴, Nana A Garba⁴, Eneida O Roldan⁴, Yolangel Hernandez Suarez⁴, Aileen M Marty⁴, Zoran Bursac¹, Adriana Campa¹, Marianna K Baum¹

Affiliations

¹ Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, United States of America.
² Faculty of Medicine, University of Colima, Las Víboras, Colima, Mexico.
³ Cancerology State Institute, Colima State Health Services, La Esperanza, Colima, Mexico.
⁴ Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States of America.

Abstract

The Coronavirus Disease 2019 (COVID-19) pandemic has disproportionately impacted people who use drugs (PWUD). This study explored relationships between drug use, COVID-19 testing, vaccination, and infection. This cross-sectional study was conducted in Miami, Florida between March 2021 and October 2022 as part of the National Institutes of Health (NIH) Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) initiative and the Miami Adult Studies on HIV (MASH) cohort. Users of cannabis, cocaine/crack, heroin/fentanyl, methamphetamines, hallucinogens, and/or prescription drug misuse in the previous 12 months were considered PWUD. Sociodemographic data, COVID-19 testing history, and vaccination-related beliefs were self-reported. Vaccinations were confirmed with medical records and positivity was determined with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing. Statistical analyses included chi-square tests and logistic regression. Of 1,780 participants, median age was 57 years, 50.7% were male, 50.2% Non-Hispanic Black, and 66.0% reported an annual income less than $15,000. Nearly 28.0% used drugs. PWUD were less likely than non-users to self-report ever testing positive for SARS-CoV-2 (14.7% vs. 21.0%, p = 0.006). However, 2.6% of participants tested positive for SARS-CoV-2, with no significant differences between PWUD and non-users (3.7% vs. 2.2%, p = 0.076). PWUD were more likely than non-users to experience difficulties accessing testing (10.2% vs. 7.1%, p = 0.033), vaccine hesitancy (58.9% vs. 43.4%, p = 0.002) and had lower odds of receiving any dose of a COVID-19 vaccine compared to non-users (aOR, 0.63; 95% CI, 0.49-0.81; p<0.001). PWUD presented with greater difficulties accessing COVID-19 testing, greater vaccine hesitancy, and lower odds of vaccination. Testing and immunization plans that are tailored to the needs of PWUD and consider access, trust-building campaigns, and education may be needed.

Copyright: © 2024 Tamargo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adult
Aged
COVID-19 Testing* / statistics & numerical data
COVID-19 Vaccines / administration & dosage
COVID-19* / epidemiology
COVID-19* / prevention & control
Cross-Sectional Studies
Drug Users / psychology
Drug Users / statistics & numerical data
Female
Florida / epidemiology
Humans
Male
Middle Aged
Minority Groups / statistics & numerical data
SARS-CoV-2* / isolation & purification
Substance-Related Disorders / epidemiology
Vaccination* / statistics & numerical data

Substances

COVID-19 Vaccines

Grants and funding

This work was supported by the National Institute on Drug Abuse [U01DA040381 and 3U01DA040381-05S2] [MKB] [https://nida.nih.gov/] and the National Institute on Minority Health and Health Disparities [U01MD017423] [MKB] [https://www.nimhd.nih.gov/]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.