Intentional and Unintentional Fentanyl Use Among a Cohort of Sexual and Gender Minorities Assigned Male at Birth in Chicago

Background: Fentanyl use in the Midwest is rising, and there is data to suggest that this is a particular area of concern among sexual and gender minorities assigned male at birth (SGM-AMABs). However, little is known about intentional and non-intentional use among this population. The goal of this study was to document rates of fentanyl use and associated indicators (e.g., mode of administration) among a cohort of SGM-AMABs. Method: Participants (N = 924) were drawn from the RADAR cohort study of SGM-AMABs recruited from the Chicago metropolitan area. All cohort members were designated male at birth and were required to be a sexual minority (i.e., individuals who are gay, bisexual, queer; have same-sex attraction/behavior; or endorse another non-heterosexual identity), a gender minority (i.e., individuals who are transgender, nonbinary, or another non-cisgender identity), or both. All participants completed a urine drug screen as well as self-report items regarding fentanyl use, mode of administration, opioid use, injection history, and overdose via REDCap survey instrument. Results: Of the 924 total participants, 0.3% (N = 3) self-reported fentanyl use, and 0.5% (N = 5) tested reactive via urine drug screen for fentanyl. Other substances of use were relatively common, and self-report fentanyl use was non-overlapping with urine drug screens for fentanyl. Conclusions: Although preliminary, these analyses suggest that fentanyl exposure is rare in this population. However, better screening methods to identify those who are using fentanyl by other modalities—including unintentional use—may be warranted.