A Cross-Sectional Analysis of Demographic and Behavioral Risk Factors of Severe Acute Respiratory Syndrome Coronavirus 2 Seropositivity Among a Sample of U.S. College Students

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. This study aimed to estimate the associations between demographic factors and social behaviors and SARS-CoV-2 seropositivity and self-reported positive SARS-CoV-2 diagnostic test. In September 2020, we randomly sampled Indiana University Bloomington 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. 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% confidence interval: 3.3%, 5.8%). Prevalence of self-reported SARS-CoV-2 infection history was 10.3% (95% confidence interval: 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 a week, and hanging out with more than five people when drinking alcohol increased both the likelihood of seropositivity and SARS-CoV-2 infection history. Our findings have implications for American colleges and universities and could be used to inform SARS-CoV-2 prevention and control strategies on such campuses.