Shaw Leah C, Kumar Anusha, Park Carolyn J, Li Yu, Lenox Catherine A, Collins Alexandra B, Sherman Susan G, Marshall Brandon D L, Macmadu Alexandria
Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02912, USA.
Department of Biostatistics, Brown University School of Public Health, 121 South Main Street, Providence, RI, USA.
Harm Reduct J. 2025 Aug 18;22(1):140. doi: 10.1186/s12954-025-01295-9.
Previous research has documented differing drug use patterns and risk behaviors by gender identity and sex at birth, although variations in harm reduction practices by these characteristics have not yet been fully assessed.
We utilized data from the Rhode Island Prescription and Illicit Drug Study (RAPIDS), which enrolled adults who used drugs from 2020 to 2023. Participants were analyzed based on gender identity: men, women, and other (including those identifying as non-binary or something else). Participants reported which harm reduction practices (e.g., use fentanyl test strips, keep naloxone nearby) they typically engaged in to avoid accidental overdose. Latent class analysis (LCA) was used to identify subgroups of harm reduction practice typologies, and a correlation matrix was generated to understand dyads of typical self-reported harm reduction practices.
Among 503 eligible participants, 64% were men, 34% were women, and 2% were non-binary or something else (n = 9). Harm reduction practices were comparable between men and women, although men were less likely to keep naloxone nearby (p = 0.02). LCA identified three subgroups of harm reduction practice typologies (no/low, moderate, and high utilization). Group membership in latent classes did not vary by gender identity. However, those belonging to the no/low utilization subgroup were significantly more likely to have ever been incarcerated (p = 0.03) and to be single (p < 0.01). Those belonging to the high utilization group were significantly more likely to have ever witnessed an overdose, performed rescue breathing, and administered naloxone (all p < 0.001). Correlations showed several pairwise relationships, with 'use fentanyl test strips' and 'keeping naloxone nearby' being positively and significantly correlated (r = 0.33, p < 0.05).
We found that harm reduction practices and group membership in latent classes were largely comparable between men and women; however, men who use drugs are significantly less likely to keep naloxone nearby. Gender-attentive strategies to increase naloxone carriage and usage among men and enhanced outreach to persons characterized by no or low harm reduction practice utilization, including people who are single and those with a history of incarceration, may be warranted to mitigate overdose risk.
先前的研究记录了按性别认同和出生时的生理性别划分的不同药物使用模式和风险行为，尽管这些特征在减少伤害措施方面的差异尚未得到充分评估。
我们利用了罗德岛处方与非法药物研究（RAPIDS）的数据，该研究纳入了2020年至2023年期间使用药物的成年人。参与者根据性别认同进行分析：男性、女性和其他（包括那些认同为非二元性别或其他身份的人）。参与者报告了他们通常采取哪些减少伤害的措施（例如，使用芬太尼检测试纸、在附近备有纳洛酮）以避免意外过量用药。使用潜在类别分析（LCA）来识别减少伤害措施类型的亚组，并生成相关矩阵以了解典型的自我报告的减少伤害措施的二元关系。
在503名符合条件的参与者中，64%为男性，34%为女性，2%为非二元性别或其他身份（n = 9）。男性和女性在减少伤害措施方面具有可比性，尽管男性在附近备有纳洛酮的可能性较小（p = 0.02）。LCA识别出减少伤害措施类型的三个亚组（无/低、中等和高利用率）。潜在类别的组成成员在性别认同方面没有差异。然而，属于无/低利用率亚组的人曾被监禁的可能性显著更高（p = 0.03），且单身的可能性也更高（p < 0.01）。属于高利用率组的人曾目睹过量用药、进行过心肺复苏和使用过纳洛酮的可能性显著更高（所有p < 0.001）。相关性显示了几种成对关系，“使用芬太尼检测试纸”和“在附近备有纳洛酮”呈正相关且显著相关（r = 0.33，p < 0.05）。
我们发现，男性和女性在减少伤害措施和潜在类别的组成成员方面在很大程度上具有可比性；然而，使用药物的男性在附近备有纳洛酮的可能性显著更低。可能需要采取关注性别的策略来增加男性携带和使用纳洛酮的比例，并加强对无或低减少伤害措施利用率的人群（包括单身人士和有监禁史的人）的外展服务，以降低过量用药风险。
