Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
DC Center for AIDS Research, Department of Psychology, George Washington University, Washington, District of Columbia, USA.
Subst Use Misuse. 2020;55(11):1774-1780. doi: 10.1080/10826084.2020.1762653. Epub 2020 May 22.
Overdose fatality rates in rural areas surpass those in urban areas with the state of West Virginia (WV) reporting the highest drug overdose death rate in 2017. There is a gap in understanding fentanyl preference among rural people who inject drugs (PWID). The aim of this study is to investigate factors associated with fentanyl preference among rural PWID in WV. This analysis uses data from a PWID population estimation study conducted in Cabell County, WV in June-July 2018. Factors associated with fentanyl preference were assessed using multivariable Poisson regression with a robust variance estimate. Among PWID who reported having ever used fentanyl ( = 311), 43.4% reported preferring drugs containing fentanyl. Participants reported high levels of socioeconomic vulnerability, including homelessness (57.9%) and food insecurity (66.9%). Recent increases in drug use and injecting more than one drug in the past 6 months were reported by 27.0% and 84.2% of participants, respectively. In adjusted analyses, fentanyl preference was associated with being younger (PrR:0.98, 95% CI: 0.97-1.00), being female (PrR:1.45, 95% CI:1.14-1.83), being a Cabell county resident (PrR:0.60, 95% CI: 0.45-0.81), increased drug use in the past 6 months (PrR:1.28, 95% CI: 1.01-1.63), and injecting fentanyl in the past 6 months (PrR:1.89, 95% CI: 1.29-2.75). Fentanyl preference is highly prevalent among rural PWID in WV and associated with factors that may exacerbate overdose risks. There is an urgent need for increased access to tailored harm reduction services that address risks associated with fentanyl preference.
农村地区的过量死亡率超过城市地区，西弗吉尼亚州（WV）报告称 2017 年的药物过量死亡率最高。农村地区注射吸毒者（PWID）对芬太尼的偏好存在理解差距。本研究旨在调查与 WV 农村地区 PWID 中芬太尼偏好相关的因素。本分析使用了 2018 年 6 月至 7 月在 Cabell 县进行的 PWID 人群估计研究的数据。使用多变量泊松回归和稳健方差估计来评估与芬太尼偏好相关的因素。在报告曾经使用过芬太尼的 PWID 中（n=311），43.4%的人表示更喜欢含有芬太尼的药物。参与者报告了高水平的社会经济脆弱性，包括无家可归（57.9%）和粮食不安全（66.9%）。分别有 27.0%和 84.2%的参与者报告最近增加了吸毒和在过去 6 个月内注射了一种以上药物。在调整分析中，芬太尼偏好与年龄较小（PRR：0.98，95%CI：0.97-1.00）、女性（PRR：1.45，95%CI：1.14-1.83）、Cabell 县居民（PRR：0.60，95%CI：0.45-0.81）、过去 6 个月药物使用增加（PRR：1.28，95%CI：1.01-1.63）和过去 6 个月内注射芬太尼（PRR：1.89，95%CI：1.29-2.75）有关。西弗吉尼亚州农村地区 PWID 中芬太尼偏好率很高，与可能加剧过量风险的因素有关。迫切需要增加获得针对芬太尼偏好相关风险的量身定制的减少伤害服务。
