Project 452105

Background: Thunder Bay has a disproportionately large population of people who inject drugs (PWID) facing ongoing challenges related to substance use which includes a high proportion of street-affected Indigenous people. Engaging Indigenous PWID in harm reduction is critical to reversing the current trends in blood-borne infections. Less is known about the harm reduction practices of Indigenous PWID in Sudbury and Sault Ste Marie, two of our study sites. Our objectives are to: 1) describe the practices, demand for and desired characteristics of harm reduction services and programs, 2) measure substance use and STBBI rates of Indigenous peoples, and 3) measure the association between factors (e.g., non-injection drug use, sexual health practices, demographic) and delayed injection drug use (IDU); and explore how factors affect delayed IDU over two years. We also aim to engage and hire Indigenous people in research. Our research activity involves survey design and an explanatory mixed methods design. Indigenous worldviews will be centred in our research. Outcomes: We expect to describe the harm reduction practices of Indigenous peoples and to identify factors that delay IDU to identify immediate service needs. Our findings may inform harm reduction services, and research and health service capacity building for trainees. Core expertise: Our proposal has Indigenous leadership with Benoit and Young, and Gauvin is an ally. Benoit conducts quantitative and qualitative research, survey design, Indigenous methodologies, and health service systems and intervention research. Gauvin has established harm reduction initiatives, conceptualized how research informs practice, and established Indigenous healing approaches at Elevate. Young has developed harm reduction programming, used Indigenous research methods, and collaborated on Indigenous-led community-based research including using social network analysis to map and measure the depth and directional change of relationships.