Predictors of Awareness of Fentanyl Test Strips Among People Who Inject Drugs in Northeast Georgia

Background: Fentanyl test strips may help People who inject drugs in detecting fentanyl in street drugs and thereby reduce the risk of overdose deaths. This study aims to determine the predictors of FTS awareness among PWID living in Northeast Georgia. Methods: Adults (≥18 years) with a recent history of injection drug use (IDU) were surveyed between February and December 2023 (n = 179). FTS awareness was elicited by the question, “Have you ever heard of fentanyl test strips?”. Covariates include age, gender, race, education, syringe services program (SSP) attendance, needle-sharing behavior, IDU-related stigma, frequency of IDU, and primary drugs used. Descriptive, bivariate, and multivariable logistic regression analyses were performed. Results: Less than half (45.3%) of the PWID were aware of FTS. In the multivariable model, the odds of FTS awareness were higher among PWID who attended SSP (adjusted Odds Ratio [aOR]: 2.30, 95% Confidence Interval [95%CI]: 1.10, 4.79) than those who did not. Awareness of FTS was also higher among individuals with high IDU-related stigma (aOR: 2.74, 95%CI: 1.34, 5.60) than those who had low stigma. African American PWID were less likely to be aware of FTS (aOR: 0.26, 95%CI: 0.11, 0.61) than White PWID. Conclusions: FTS awareness is a critical first step for PWID to engage in harm reduction strategies for fentanyl overdose prevention. Findings highlight the need for innovative approaches to educate PWID who are not engaged in SSP services about the benefits of FTS. Tailored approaches for certain communities of people who use drugs are also urgently needed.