SARS-CoV-2 antibody prevalence, correlates, and access to harm reduction services among people who inject drugs living with and without HIV and their partners in Kenya.
SARS-CoV-2 antibody prevalence, correlates, and access to harm reduction services among people who inject drugs living with and without HIV and their partners in Kenya.
复制标题
DOI：
10.1186/s12954-023-00754-5
复制
发表时间：
2023-02-23
影响因子：
4.4
通讯作者：
Farquhar, Carey
中科院分区：
文献类型：
--
作者：
Doshi, Shradha;Kingston, Hanley;Tseng, Ashley S. S.;Chohan, Bhavna H. H.;Sambai, Betsy;Guthrie, Brandon L. L.;Monroe-Wise, Aliza;Mbogo, Loice W. W.;Masyuko, Sarah;Tram, Khai Hoan;Sinkele, William;Macharia, Paul;Bukusi, David;Herbeck, Joshua T. T.;Farquhar, Carey
在撒哈拉以南非洲地区，许多注射吸毒者 (PWID) 感染了未经诊断或未经治疗的艾滋病毒，并经历着严重的贫困和状况，这可能会导致 SARS-CoV-2 感染带来更糟糕的后果。确定吸毒者等边缘人群的 SARS-CoV-2 感染负担可能有助于控制这一流行病。这是一项正在进行的队列研究中的一项嵌套横断面研究，该研究在肯尼亚的针头和注射器项目地点以及美沙酮诊所招募感染艾滋病毒的吸毒者及其注射者和/或性伴侣。在入组时从同意的参与者处采集血液样本，使用 Platellia BioRad SARS-CoV-2 总抗体酶联免疫吸附测定法测定 SARS-CoV-2 抗体。收集了有关艾滋病毒状况、抗逆转录病毒治疗和美沙酮依从性的基线数据。我们使用逻辑回归来确定与抗体阳性相关的因素，并使用描述性统计来报告 SARS-CoV-2 抗体流行率。 2021 年 4 月至 7 月期间注册了 1000 名参与者，其中 323 名 (32.3%) 为女性，677 名 (67.7%) 为男性。参与者的中位年龄为 36 岁（四分位数范围：30、42）。 309 名 (30.9%) 参与者中发现 SARS-CoV-2 抗体阳性。 106 名（24.3%）参与者报告美沙酮服务的获取受到干扰。男性感染 SARS-CoV-2 抗体的可能性显着低于女性（调整后比值比 [aOR] = 0.68，95% 置信区间 [CI] 0.51, 0.95；p < 0.01）报告性伴侣或注射伴侣被诊断患有 SARS-CoV-2 的参与者检测到 SARS-CoV-2 抗体的可能性是女性的两倍（aOR = 2.21，95% CI 1.06，4.58；p < 0.032）。感染 HIV 与 SARS-CoV-2 抗体的存在无关。 该队列中 SARS-CoV-2 的血清阳性率为 30.9%，表明该人群中的传播率很高。感染艾滋病毒和未感染艾滋病毒的人的 SARS-CoV-2 血清流行率相似。据指出，该人群中很大一部分人无法获得减少伤害服务。 我们发现注射吸毒者及其性伴侣和注射伴侣的 SARS-CoV-2 抗体血清阳性率很高。我们还发现，报告性伴侣或注射伴侣被诊断患有 SARS-CoV-2 的参与者更有可能出现 SARS-COV-2 抗体阳性。感染 HIV 与 SARS-CoV-2 抗体的存在无关。据指出，在研究期间，很大一部分注射吸毒者在获得减少伤害服务方面受到干扰。肯尼亚国家医疗保健政策制定者应实施特殊干预措施，例如在当前和未来的危机期间增加获得“带回家剂量”美沙酮的机会，并免除该人群的每日亲自检查，以保持治疗的连续性和获得减少伤害服务的机会。 主要影响
In sub-Saharan Africa many people who inject drugs (PWID) are living with undiagnosed or untreated HIV and experience high levels of poverty and conditions that can contribute to worse outcomes from SARS-CoV-2 infection. Identifying the burden of SARS-CoV-2 infection in marginalized populations like PWID may contribute to controlling the pandemic. This is a nested cross-sectional study within an ongoing cohort study that recruits PWID living with HIV and their injecting and/or sexual partners at needle and syringe program sites and methadone clinics in Kenya. Blood samples were collected from consenting participants at enrollment to determine SARS-CoV-2 antibodies using a Platellia BioRad SARS-CoV-2 total antibody enzyme-linked immunosorbent assay. Baseline data were collected on HIV status, antiretroviral therapy and methadone adherence. We used logistic regression to identify factors associated with antibody positivity and descriptive statistics to report SARS-CoV-2 antibody prevalence. One thousand participants were enrolled between April and July 2021, of whom 323 (32.3%) were women and 677 (67.7%) were men. Median age of participants was 36 years (interquartile range: 30, 42). SARS-CoV-2 antibody positivity was found in 309 (30.9%) participants. Disruption in obtaining methadone service was reported by 106 (24.3%) of the participants. Men were significantly less likely than women to have SARS-CoV-2 antibodies (adjusted odds ratio [aOR] = 0.68, 95% confidence interval [CI] 0.51, 0.95; p < 0.01) Participants who reported a sexual or injecting partner diagnosed with SARS-CoV-2 were twofold more likely to have SARS-CoV-2 antibodies detected (aOR = 2.21, 95% CI 1.06, 4.58; p < 0.032). Living with HIV was not associated with presence of SARS-CoV-2 antibodies. The seroprevalence of SARS-CoV-2 of 30.9% in this cohort suggests high transmission rates within this population. SARS-CoV-2 seroprevalence was similar for people living with and without HIV. A large portion of this population was noted to have had disruption in access to harm reduction services. We found a high seroprevalence of SARS-CoV-2 antibodies in people who inject drugs and their sexual and injecting partners. We also found that participants who reported a sexual or injecting partner diagnosed with SARS-CoV-2 were more likely to have SARS-C0V-2 antibody positivity. Living with HIV was not associated with presence of SARS-CoV-2 antibodies. A large proportion of people who inject drugs was noted to have had disruptions in access to harm reduction services during the study period. Kenya’s national healthcare policymakers should implement special interventions like increased access to ‘take-home doses’ of methadone and waivers for daily in-person check--ns for this population during current and future crises to maintain continuity of treatment and access to harm reduction services. Key implications
登录
查看更多内容
DOI：
10.1126/science.abk0414
发表时间：
2021-11-19
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Brand SPC;Ojal J;Aziza R;Were V;Okiro EA;Kombe IK;Mburu C;Ogero M;Agweyu A;Warimwe GM;Nyagwange J;Karanja H;Gitonga JN;Mugo D;Uyoga S;Adetifa IMO;Scott JAG;Otieno E;Murunga N;Otiende M;Ochola-Oyier LI;Agoti CN;Githinji G;Kasera K;Amoth P;Mwangangi M;Aman R;Ng'ang'a W;Tsofa B;Bejon P;Keeling MJ;Nokes DJ;Barasa E
通讯作者：
Barasa E
DOI：
10.1097/qad.0000000000002836
发表时间：
2021-03-15
期刊：
AIDS (London, England)
影响因子：
--
作者：
Mellor MM;Bast AC;Jones NR;Roberts NW;Ordóñez-Mena JM;Reith AJM;Butler CC;Matthews PC;Dorward J
通讯作者：
Dorward J
影响因子：
11.8
作者：
Dandachi, Dima;Geiger, Grant;Chow, Jeremy
通讯作者：
Chow, Jeremy
DOI：
10.1093/jurban/jti016
发表时间：
2005-03-01
影响因子：
6.6
作者：
Altice, FL;Bruce, RD;Buitrago, MI
通讯作者：
Buitrago, MI
影响因子：
3
作者：
Hoffmann, Christian;Casado, Jose L.;Gervasoni, Cristina
通讯作者：
Gervasoni, Cristina