Trends in COVID-19 testing, infection, vaccination, and housing assistance among people who inject drugs in Los Angeles and Denver

IntroductionWe examined COVID-19 trends and the socio-structural correlates of infections and vaccinations among people who inject drugs (PWID).MethodsWe collected retrospective survey data from PWID (n = 472). We examined changes in COVID-19 testing, infection, and housing assistance for the first year of the pandemic, and then used multivariate logistic regression to examine factors with ever having an infection and receiving at least one vaccination from April 2020-March 2021.ResultsThe sample was mostly male, White and Latinx, and unhoused. Testing by quarter ranged from 46% to 33%. Housing assistance declined from 10% to 7% by the last quarter, while infections ranged from 6% to 4%. Ever being COVID-19 positive was associated with being male, having an income source, and being arrested in the last 3 months. Almost half of participants reported vaccination (47%). Receiving a vaccination was associated with prior U.S. armed forces service, older age, receiving substance use disorder treatment, and having ever received COVID-19 testing.DiscussionEfforts to vaccinate PWID fell short and housing assistance declined. Receiving targeted assistance, including better access to housing and medication treatments for opioid use disorder, could be important efforts to mitigate the heightened risks of COVID-19 and the ongoing harms PWID face that predate the pandemic.