Role of emotional social support in COVID-19 booster uptake among drug use disorder communities

<i>Background:</i> Social support is an established determinant of health behaviors, yet its role in COVID 19 booster uptake and general healthcare utilization remains unclear. This gap is especially relevant for drug use disorders (DUDs) communities, who face stigma, disrupted social networks, and barriers to preventive and routine care. Examining how different types of social support relate to preventive behavior and healthcare engagement in this population may clarify whether support operates differently across health behaviors.<i>Objectives:</i> This study examines how social support relate to COVID-19 booster uptake and general healthcare utilization among individuals with DUDs or their family member(s).<i>Methods:</i> Data were drawn from multiple survey components of the NIH All of Us program (2020-2022), a national longitudinal cohort study. The final sample of 3221 respondents, of whom 29.2% were male. We conducted Exploratory and Confirmatory Factor Analyses to derive two dimensions of social support: emotional support, defined as feelings of understanding and companionship, and physical support, defined as practical assistance with routine tasks, such as transportation or chores. These factors were used as predictors in multivariable logistic regression models assessing their associations with COVID-19 booster uptake and general healthcare utilization, adjusting for socio-demographic characteristics and self-reported health.<i>Results:</i> Emotional social support was positively associated with COVID-19 booster uptake (OR = 1.186, <i>p</i> < .05), while physical support was not. Neither type of support was linked to general healthcare utilization.<i>Conclusion:</i> Public health programs serving individuals affected DUDs may benefit from integrating peer and family engagement strategies to support COVID-19 booster uptake.