Allen Sean T, Keane Edmund, Alexander Clinton, Day Sharon, Kebec Philomena, Medley Andrea, Johnson Frank, Hughes Pam, Barney Brooklynn, Walls Melissa
Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA.
Behavioral Health, White Earth Nation, 33991 Victory Way Drive, Ogema, MN, 56589, USA.
Harm Reduct J. 2025 Aug 19;22(1):143. doi: 10.1186/s12954-025-01296-8.
Few studies have examined the implementation of syringe services programs (SSPs) that serve Indigenous people who inject drugs in the United States (US). There are 574 Federally-recognized tribes in the US, each characterized by unique traditions, values, and customs. Given the diversity of tribes, better understanding SSP implementation in Native contexts first requires examining the degree to which tribes in the US implemented these programs.
This research describes the number of SSPs that are affiliated with Federally-recognized tribes in the US.
From July to September 2022, we conducted an online search of all 574 Federally-recognized tribes to determine how many had affiliated SSPs. We downloaded a list of Federally-recognized tribes from the Bureau of Indian Affairs (BIA) and conducted Boolean searches on Google for the name of each tribe and SSPs. Our searches included several synonyms for SSPs, including "needle exchange," "syringe exchange," and "harm reduction." In instances where "harm reduction programs" were identified, we reviewed website contents to determine if the program was inclusive of a SSP. We considered SSPs to be affiliated with Federally-recognized tribe(s) if they were housed in a tribal health clinic or tribal organization, or via an explicit partnership with a Federally-recognized tribe.
We identified 21 SSPs that were affiliated with Federally-recognized tribes. The majority (85.7%) of SSPs were affiliated with a single tribe. Eight of the SSPs also offered medications for opioid use disorder (MOUD) on-site (e.g., the SSPs operated out of health clinics that offered MOUD).
The results of this study demonstrate that there are at least 21 SSPs that are affiliated with Federally-recognized tribes in the US, with some serving multiple tribes. This research makes a noteworthy contribution to the public health literature given that no systematic exploration of the number of SSPs affiliated with tribes has been conducted. The scale of substance use inequities among Indigenous people underscores the critical importance of communities implementing and managing their own comprehensive harm reduction programs.
很少有研究探讨为美国注射毒品的原住民提供服务的注射器服务项目（SSP）的实施情况。美国有574个获得联邦承认的部落，每个部落都有其独特的传统、价值观和习俗。鉴于部落的多样性，要更好地理解原住民背景下SSP的实施情况，首先需要考察美国各部落实施这些项目的程度。
本研究描述了与美国联邦承认部落相关联的SSP的数量。
2022年7月至9月，我们对所有574个获得联邦承认的部落进行了在线搜索，以确定有多少部落设有相关联的SSP。我们从印第安事务局（BIA）下载了一份获得联邦承认的部落名单，并在谷歌上对每个部落的名称和SSP进行布尔搜索。我们的搜索包括SSP的几个同义词，如“针头交换”“注射器交换”和“减少伤害”。在识别出“减少伤害项目”的情况下，我们会查看网站内容，以确定该项目是否包含SSP。如果SSP设在部落健康诊所或部落组织内，或通过与联邦承认的部落建立明确的伙伴关系，我们就认为这些SSP与联邦承认的部落相关联。
我们识别出21个与联邦承认的部落相关联的SSP。大多数（85.7%）的SSP与单个部落相关联。其中8个SSP还在现场提供阿片类物质使用障碍药物（MOUD）（例如，这些SSP在提供MOUD的健康诊所开展业务）。
本研究结果表明，美国至少有21个与联邦承认的部落相关联的SSP，其中一些为多个部落提供服务。鉴于此前尚未对与部落相关联的SSP数量进行系统探索，本研究为公共卫生文献做出了显著贡献。原住民中物质使用不平等的规模凸显了社区实施和管理自身全面减少伤害项目的至关重要性。
