Willingness to use syringe services programs in a Northern Midwest American Indian community

Background: Syringe services programs (SSPs) deliver harm reduction supplies and services to people who use drugs. Despite their well-established positive impact, few studies have focused on SSP operations in rural and Indigenous contexts. This research explores correlates of willingness to use an SSP among a sample of people living in a rural Northern Midwest American Indian reservation community in the United States. Methods: Using data from a community health survey conducted in a Northern Midwest reservation community (N = 227), we examined self-reported willingness to use an SSP among Indigenous adults who reported having ever used drugs. We tested for associations between willingness to use an SSP and several covariates, including drug use behaviors, overdose experiences, and social network characteristics. Results: Nearly half (43%) of the sample reported a willingness to use an SSP. Among people who had recently used drugs, 56% were willing to use an SSP. Willingness to use an SSP was significantly (p < 0.05) associated with lifetime and recent injection drug use, recent methamphetamine use, having experienced or witnessed an overdose, having friends or family who use drugs, and younger age. Conclusions: These data suggest there is an openness for harm reduction in a Northern Midwest Indigenous community. Given the importance of Indigenous identity and traditional spiritual values to Indigenous communities, harm reduction efforts should be anchored in local culture and context. Future work should examine how harm reduction can best be implemented and tailored to the needs of Indigenous communities.