Predictors of Adherence to a COVID-19 Serial Testing Program Among University Affiliates in the Deep South.

Objective: Serial testing programs were used at many US universities during the earlier stages of the COVID-19 pandemic to minimize the risk of SARS-CoV-2 transmission among affiliates, though the effectiveness of such programs was contingent on adherence. In this study, researchers sought to determine factors associated with testing adherence.

Design: Cross-sectional analyses were done in Spring and Fall of 2021.

Setting: This study took place at a medium size, private university in the Deep South.

Participants: Participants included university affiliates, including faculty/staff and students.

Main outcome measures: Adherence to a mandated but unenforced serial testing program was assessed. All variables were ascertained through university records. Logistic regression models were used to determine factors associated with testing during both semesters.

Results: In the Spring 2021 semester, staff and faculty had 23% greater odds of being tested compared to students. Paradoxically, the odds of adherence to testing decreased by 4% per year of age. In the Fall 2021 semester, the odds of being tested was 82% greater for staff and faculty compared to students and 27% higher for those who had a previous positive test compared to those who did not. Men had a 13% lower odds of testing than women. In both semesters, those who were unvaccinated had a significantly lower odds of testing compared to those who were vaccinated (86% and 92%, respectively), P < .001.

Conclusions: Testing adherence was associated with vaccination status, suggesting that offering serial testing for those who are not vaccinated may not be an effective strategy in mitigating infection, in the absence of any enforcement. Additional factors such as age, sex, and affiliation status and testing adherence changed over the course of the pandemic suggesting the complexity of testing behaviors.