dbGaP Study Accession: phs002720

NIH Institute/Center: NIDA

RADx Data Program: RADx-UP

Release Date: 08/30/2023

DOI: 10.60773/pkzs-t351

Study Description: In the U.S., women who use illicit drugs (WWUD) have disproportionately high rates of infectious (e.g., HIV, HCV), chronic, and pulmonary diseases that elevate their risk for COVID-19. Their health and disease profile is driven by enduring social conditions (e.g., scarcity of income, food insecurity, access to health services, housing, discrimination). These prevailing social conditions can also undermine WWUDs' ability to protect themselves from COVID-19 (e.g., washing hands, social distancing). Drug procurement and use, which are largely social processes, further challenge these self-protection measures. Testing and future vaccination is vital to reducing COVID-19 among this high-risk population, necessitating accessible testing schemes. Here, a mixed methods study was conducted that draws upon the Andersen Behavioral Model10 and is grounded in eco-social theory. Specifically, the Baltimore-based study aimed to: 1) explore predisposing social factors (e.g., housing, food security), individual-level factors (e.g., drug use, mental health), and beliefs (e.g., medical mistrust) that are facilitators and barriers of COVID-19 testing and perceived risks (e.g., income generation, violence) resulting from a diagnosis through in-depth interviews among WWUD (N=15) and a cultural domain analysis (N=45); 2) gain an understanding of the enabling community-level environment (e.g., medical and social service agencies that currently serve WWUD, existing city-wide COVID-19 testing sites) that could facilitate or hinder WWUDs' COVID-testing uptake through observations (N=8-10) and key informant interviews (N=10); and examine predisposing social factors, individual-level factors, and beliefs that are associated with COVID-19 testing and retesting among a cohort (N=250) of WWUD at baseline and 3-month follow-up. Optional testing offered at both study visits were a self-administered, rapid antigen test. The role of medical mistrust in shaping women's' use of healthcare services were examined, as well as experiences of stigma and discrimination in healthcare settings, particularly among Black participants. In Baltimore, this mistrust was particularly pronounced, with Johns Hopkins Hospital having a long history of mistrust in the Black community owing to experimentation and deception of research engagement. The study was guided by a community advisory board (CAB) who informed its design and implementation as well as engaged in disseminating the results at community meetings to inform COVID-testing scale up.

Updated Date: 04/17/2024

Principal Investigator: Sherman, Susan G

Has Data Files: Yes

Study Domain: At-Home or Over-the-Counter (OTC) Self-Testing; Mental Health; Rapid Diagnostic Test (RDT); Social Determinants of Health; Substance Use; Testing Rate or Uptake

Data Collection Method: Antigen Testing Device; Interview or Focus Group; Survey

Keywords: Medical Mistrust

Study Design: Longitudinal Cohort

Multi-Center Study: No

Data Types: Behavioral; Questionnaire or Survey; Social

Study Start Date: 11/01/2020

Study End Date: 10/31/2022

Species: Human

Sample Size: 226

Study Population Focus: Adults; African Americans; Older Adults or Elderly; People Living with HIV/AIDS; Racial or Ethnic Minorities; Underserved or Vulnerable Populations

Publication URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9770432/

Acknowledgement Statement: This study was supported through funding, 3R01DA041243-05S4, for the National Institute on Drug Abuse (NIDA) as part of the RADx-UP program. Dr. Sherman is supported by an endowment from the Bloomberg American Health Initiative. We would like to thank CARE study participants who trusted us with their stories and experiences. Approved users should acknowledge the provision of data access by dbGaP for accession phs002720.v1.p1, and the NIH RADx Data Hub. Approved users should also acknowledge the specific version(s) of the dataset(s) obtained from the NIH RADx Data Hub.

Funding Opportunity Announcement (FOA) Number: PA-12-281

NIH Grant or Contract Number(s): 3R01DA041243-05S4

Consent/Data Use Limitations: General Research Use