Available online 3 March 2023, 109831

This study validates the first scale to assess experiences of COVID-19-related discrimination among PWID, providing researchers and clinicians a brief tool to assess the impact of COVID-19-related discrimination among a stigmatized and medically vulnerable group.

We found that a 4-item COVID-19-related discrimination scale had modest internal reliability and construct validity among PWID in San Diego County.

Our study found that COVID-19 response-related discrimination was significantly associated with endorsing COVID-19 disinformation and further, that resilience modified this relationship.

Our results suggest that when addressing COVID-19 disinformation directly, efforts should acknowledge existing inequalities and harms that stigmatized groups have endured, as these experiences likely make the messaging in disinformation campaigns seem more plausible.

Our findings suggest that intervening upon COVID-19 response-related discrimination may offset the negative outcomes associated with COVID-19 disinformation.

Due to the persistence of COVID-19, it remains important to measure and examine potential barriers to COVID-19 prevention and treatment to avert additional loss of life, particularly among stigmatized populations, such as people who inject drugs (PWID), who are at high risk for contracting and spreading SARS-CoV-2. We assessed the psychometrics of a novel COVID-19 response-related discrimination scale among PWID, and characterized associations between COVID-19 response-related discrimination, resilience to adversity, and endorsement of COVID-19 disinformation.

We assessed internal reliability, structural validity and construct validity of a 4-item COVID-19 response-related discrimination scale among PWID living in San Diego County, completing interviewer-administered surveys between October 2020 and September 2021. Using negative binomial regression, we assessed the relationship between COVID-19 response-related discrimination and disinformation and the potential moderating role of resilience.

Of 381 PWID, mean age was 42.6 years and the majority were male (75.6%) and Hispanic (61.9%). The COVID-19 response-related discrimination scale had modest reliability (α=0.66, ω=0.66) as a single construct with acceptable construct validity (all p≤0.05). Among 216 PWID who completed supplemental surveys, a significant association between COVID-19 response-related discrimination and COVID-19 disinformation was observed, which was moderated by resilience (p=0.044). Specifically, among PWID with high levels of resilience, endorsement of COVID-19 disinformation significantly increased as exposure to COVID-19 response-related discrimination increased (p=0.011).

These findings suggest that intervening on COVID-19 response-related discrimination may offset the negative outcomes associated with COVID-19 disinformation.

COVID-19

discrimination

people who inject drugs

psychometrics

resilience

disinformation

© 2023 Published by Elsevier B.V.