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Association of Illicit Fentanyl Use with Injection Risk Practices Among People who Inject Drugs

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Abstract

We investigated the association between fentanyl injection frequency and sharing of injection equipment among people who inject drugs. We surveyed 249 people who inject drugs in Toronto in 2019. We estimated predicted probabilities of associations between fentanyl injection frequency and injection risk practices. In prior 6 months, 117 (47.0%) of participants injected fentanyl daily, 49 (19.7%) less than daily, and 78 (31.3%) did not inject fentanyl. Participants who injected fentanyl daily shared syringes more often than those not injecting fentanyl (25.0% vs. 4.9%; χ2 = 11.54, p = 0.0007). Participants who injected fentanyl daily (42.4% vs. 11.3%; χ2 = 18.05, p < 0.0001) and less than daily (37.2% vs. 11.3%; χ2 = 5.88 p = 0.02) shared cookers more often than those not injecting fentanyl. Participants who injected fentanyl daily (30.2% vs. 9.7%; χ2 = 9.05, p = 0.003) and less than daily (30.3% vs. 9.7%; χ2 = 4.11, p = 0.04) shared filters more often than those not injecting fentanyl. No differences in probabilities of sharing equipment were detected between participants who injected fentanyl daily and less than daily. People using fentanyl reported injection practices that increased risk for infectious disease transmission.

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Data Availability

Our data are not publicly available.

Code Availability

Stata and SAS were used to analyze data. Our code is not publicly available.

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Acknowledgements

We would like to thank our Community Advisory Team and the study participants for their time, effort and willingness to share their experiences with us. Funding support was provided by the Canadian Institutes of Health Research through the Catalyst Grant: HIV/AIDS Community-Based Research Program (FRN-156903) and the Canadian Research Initiative in Substance Misuse (SMN-139150). Gillian Kolla is supported by a Banting postdoctoral fellowship from the Canadian Institutes of Health Research and a postdoctoral fellowship from the Canadian Network on Hepatitis C (CanHepC). Kathleen Kenny is supported by a fellowship from the Canadian Institutes of Health Research.

Funding

Funding support was provided by the Canadian Institutes of Health Research through the Catalyst Grant: HIV/AIDS Community-Based Research Program (FRN-156903) and the Canadian Research Initiative in Substance Misuse (SMN-139150).

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Authors

Contributions

KSK, GK, and AMB conceived of the study and developed the analytic strategy. SG, MB, DP, JA and CS contributed to study conceptualization and design. KSK, GK and AMB analyzed the data. KS Kenny led the writing of the manuscript. All authors made significant contributions to the interpretation of the data, drafting of the article, and approved the final version of the manuscript.

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Correspondence to Kathleen S. Kenny.

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The authors declare that they have no conflict of interest.

Ethical Approval

This study holds ethics approval through Unity Health Toronto Research Ethics Board (REB# 18–266).

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All study participants provided informed verbal consent.

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N/A.

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Kenny, K.S., Kolla, G., Greig, S. et al. Association of Illicit Fentanyl Use with Injection Risk Practices Among People who Inject Drugs. AIDS Behav 27, 1757–1765 (2023). https://doi.org/10.1007/s10461-022-03908-x

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