A cross-sectional analysis of demographic and behavioral risk factors of SARS-CoV-2 antibody positivity among a sample of U.S. college students

Kianersi, S.; Ludema, C.; Macy, J. T.; Garcia, E.; Chen, C.; Luetke, M.; Lown, M. H.; Rosenberg, M.

Background: Colleges and universities across the United States are developing and implementing data-driven prevention and containment measures against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Identifying risk factors for SARS-CoV-2 seropositivity could help to direct these efforts. Objective: To estimate the associations between demographic factors and social behaviors and SARS-CoV-2 seropositivity and self-reported positive SARS-CoV-2 diagnostic test. Methods: In September 2020, we randomly sampled Indiana University Bloomington (IUB) undergraduate students. Participants completed a cross-sectional, online survey about demographics, SARS-CoV-2 testing history, relationship status, and risk behaviors. Additionally, during a subsequent appointment, participants were tested for SARS-CoV-2 antibodies using a fingerstick procedure and SARS-CoV-2 IgM/IgG rapid assay kit. We used unadjusted modified Poisson regression models to evaluate the associations between predictors of both SARS-CoV-2 seropositivity and self-reported positive SARS-CoV-2 infection history. Results: Overall, 1,076 students were included in the serological testing analysis, and 1,239 students were included in the SARS-CoV-2 infection history analysis. Current seroprevalence of SARS-CoV-2 was 4.6% (95% CI: 3.3%, 5.8%). Prevalence of self-reported SARS-CoV-2 infection history was 10.3% (95% CI: 8.6%, 12.0%). Greek membership, having multiple romantic partners, knowing someone in one's immediate environment with SARS-CoV-2 infection, drinking alcohol more than 1 day per week, and hanging out with more than 4 people when drinking alcohol increased both the likelihood of seropositivity and SARS-CoV-2 infection history. Conclusion: Our findings have implications for American colleges and universities and could be used to inform SARS-C0V-2 prevention and control strategies on such campuses.