{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T18:02:48Z","timestamp":1784916168898,"version":"3.55.0"},"reference-count":80,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["43512"],"award-info":[{"award-number":["43512"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Indigenous people using substances experience health disparities that are compounded by systemic inequities shaped by colonialism. The WHiSE 2.0 study aims to describe substance use patterns and harm reduction approaches among Indigenous people who use drugs in Thunder Bay, Sudbury, and Sault Ste Marie. A community-based research approach was used and guided by Indigenous leadership. Eligible study participants self-identified as Indigenous, lived in the study regions, and used substances within the last 3 months. Participants completed an interviewer-administered 1-hour questionnaire. Descriptive statistics were conducted to summarize participant demographic and cultural characteristics, impacts of colonization, substance use and health behaviours, and harm reduction knowledge, stratified by city. A total of 356 participants were enrolled: 173 in Thunder Bay, 101 in Sault Ste. Marie, and 82 in Sudbury. Most identified as First Nations with 93.1% in Thunder Bay, 76.8% in Sudbury, and 75.2% in Sault Ste. Marie. The percentage of participants across all sites with precarious sleeping situations was high, with 39.0% sleeping on the street, 28.3% staying in a shelter, and 23.3% couch surfing as well as 41.9% staying at a family or friend\u2019s home. Across all sites, 43.3% of participants injected drugs, 31.5% ingested drugs, 92.1% smoked drugs, and 38.5% snorted or inhaled drugs. Importantly across all sites, 84.0% knew what harm reduction was, and 82.3% of respondents had ever had HIV screening test and 84.3% hepatitis C testing. Also, 71.3% of all participants engaged in ceremonies and 22.2% reported that cultural teachings affected their harm reduction practices. WHiSE 2.0 is the first prospective cohort study examining the harm reduction needs of Indigenous people using substances in northern Ontario. Through a culturally grounded, community-led study, urgent service gaps are highlighted and the importance of locally tailored harm reduction strategies rooted in Indigenous knowledge and leadership.<\/jats:p>","DOI":"10.1371\/journal.pone.0354477","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T17:41:46Z","timestamp":1784914906000},"page":"e0354477","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cohort profile: Walking for harm reduction through street engagement (WHiSE 2.0)"],"prefix":"10.1371","volume":"21","author":[{"given":"Geena","family":"Verma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muna","family":"Aden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Hartman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer D.","family":"Walker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaela","family":"Pelland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Mushquash","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savitri","family":"Persaud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan","family":"Young","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly","family":"Gauvin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9863-0278","authenticated-orcid":true,"given":"Anita C.","family":"Benoit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Ontario Aboriginal HIV\/AIDS Strategy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Elevate Northwestern Ontario","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"pone.0354477.ref001","doi-asserted-by":"crossref","DOI":"10.4324\/9781003173342","volume-title":"Indigenous statistics: from data deficits to data sovereignty","author":"C Andersen","year":"2025"},{"key":"pone.0354477.ref002","volume-title":"Research is ceremony: indigenous research methods","author":"S Wilson","year":"2020"},{"issue":"1","key":"pone.0354477.ref003","article-title":"Embodied in indigenous research: how indigeneity, positionality, and relationality contribute to research approaches and understanding","volume":"3","author":"D Simon","year":"2023","journal-title":"Health Popul J"},{"key":"pone.0354477.ref004","volume-title":"Supervised injection services feasibility study report: Thunder Bay, ON","author":"T Kerr","year":"2017"},{"key":"pone.0354477.ref005","volume-title":"Opioid use and impacts in thunder bay district","author":"E Sawula","year":"2018"},{"key":"pone.0354477.ref006","volume-title":"Walking for Harm Reduction through Street Engagement (WHiSE)","author":"WHiSE Advisory Committee","year":"2020"},{"key":"pone.0354477.ref007","author":"L Casey","year":"2025"},{"key":"pone.0354477.ref008","author":"For immediate release","year":"2025"},{"key":"pone.0354477.ref009","volume-title":"Moving towards a healthier community \u2013 2019 report to community","author":"Thunder Bay Drug Strategy","year":"2019"},{"key":"pone.0354477.ref010","volume-title":"Infectious disease trends in Ontario","author":"Public Health Ontario","year":"2021"},{"key":"pone.0354477.ref011","volume-title":"HIV Outbreak","author":"Thunder Bay District Health Unit","year":"2023"},{"issue":"11","key":"pone.0354477.ref012","doi-asserted-by":"crossref","first-page":"2364","DOI":"10.3390\/microorganisms12112364","article-title":"Hepatitis C diagnosis and treatment among indigenous people in a canadian context: challenges and community-led solutions","volume":"12","author":"KPR Dunn","year":"2024","journal-title":"Microorganisms"},{"issue":"3","key":"pone.0354477.ref013","doi-asserted-by":"crossref","first-page":"115","DOI":"10.3138\/canlivj.2018-0009","article-title":"In the eyes of Indigenous people in Canada: exposing the underlying colonial etiology of hepatitis C and the imperative for trauma-informed care","volume":"1","author":"ST Fayed","year":"2018","journal-title":"Can Liver J"},{"issue":"6","key":"pone.0354477.ref014","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1155\/2013\/380963","article-title":"The epidemiology of hepatitis C in a Canadian Indigenous population","volume":"27","author":"J Uhanova","year":"2013","journal-title":"Can J Gastroenterol"},{"issue":"14","key":"pone.0354477.ref015","doi-asserted-by":"crossref","DOI":"10.1503\/cmaj.220717","article-title":"Characterizing the cascade of care for hepatitis C virus infection among Status First Nations peoples in Ontario: a retrospective cohort study","volume":"195","author":"AB Mendlowitz","year":"2023","journal-title":"CMAJ"},{"issue":"11","key":"pone.0354477.ref016","article-title":"First Nations hepatitis C virus infections: six-year retrospective study of on-reserve rates of newly reported infections in northwestern Ontario","volume":"63","author":"J Gordon","year":"2017","journal-title":"Can Fam Physician"},{"issue":"2","key":"pone.0354477.ref017","doi-asserted-by":"crossref","first-page":"174","DOI":"10.17269\/s41997-018-0058-1","article-title":"Syringe sharing among people who inject drugs in London, Canada","volume":"109","author":"AI Scheim","year":"2018","journal-title":"Can J Public Health"},{"key":"pone.0354477.ref018","volume-title":"I-Track: Enhanced surveillance of HIV, hepatitis C and associated risk behaviours among people who inject drugs in Canada - Phase 2 report","author":"Government of Canada","year":"2018"},{"issue":"1","key":"pone.0354477.ref019","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1186\/s12905-021-01470-7","article-title":"Women in the 2019 hepatitis C cascade of care: findings from the British Columbia Hepatitis Testers cohort study","volume":"21","author":"ME Pearce","year":"2021","journal-title":"BMC Womens Health"},{"issue":"2","key":"pone.0354477.ref020","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1111\/jvh.12628","article-title":"Higher incidence of HCV in females compared to males who inject drugs: a systematic review and meta-analysis","volume":"24","author":"A Esmaeili","year":"2017","journal-title":"J Viral Hepat"},{"key":"pone.0354477.ref021","volume-title":"Designing and conducting health surveys - a comprehensive guide","author":"LA Aday","year":"2006","edition":"3"},{"key":"pone.0354477.ref022","volume-title":"Surveys in social research","author":"D De Vaus","year":"2014","edition":"6"},{"issue":"5","key":"pone.0354477.ref023","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1093\/poq\/nfq065","article-title":"Total survey error: past, present, and future","volume":"74","author":"RM Groves","year":"2010","journal-title":"Public Opinion Quarterly"},{"key":"pone.0354477.ref024","year":"2021"},{"key":"pone.0354477.ref025","volume-title":"Ontario aboriginal HIV\/AIDS strategy","year":"2022"},{"key":"pone.0354477.ref026","volume-title":"Canadian definition of homelessness","author":"A Turner","year":"2012"},{"key":"pone.0354477.ref027","volume-title":"Indigenous definition of homelessness in Canada","author":"JA Thistle","year":"2017"},{"key":"pone.0354477.ref028","doi-asserted-by":"crossref","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: Building an international community of software platform partners","volume":"95","author":"PA Harris","year":"2019","journal-title":"J Biomed Inform"},{"issue":"2","key":"pone.0354477.ref029","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"PA Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"pone.0354477.ref030"},{"issue":"1","key":"pone.0354477.ref031","first-page":"80","article-title":"Ownership, control, access, and possession (OCAP) or self-determination applied to research: A critical analysis of contemporary First Nations research and some options for First Nations communities","volume":"1","author":"B Schnarch","year":"2004","journal-title":"International Journal of Indigenous Health"},{"key":"pone.0354477.ref032","doi-asserted-by":"crossref","DOI":"10.5334\/dsj-2020-043","article-title":"The CARE principles for indigenous data governance","volume":"19","author":"SR Carroll","year":"2020","journal-title":"Data Science Journal"},{"issue":"10107","key":"pone.0354477.ref033","doi-asserted-by":"crossref","first-page":"2022","DOI":"10.1016\/S0140-6736(17)32755-1","article-title":"Indigenous health data and the path to healing","volume":"390","author":"J Walker","year":"2017","journal-title":"Lancet"},{"key":"pone.0354477.ref034","author":"Ontario Brain Institute","year":"2020"},{"key":"pone.0354477.ref035","volume-title":"Data and information governance - Case study report","author":"First Nations Health Authority","year":"2019"},{"key":"pone.0354477.ref036","author":"Indigenous Primary Health Council","year":"2022"},{"key":"pone.0354477.ref037","volume-title":"Initiative II. Nindokiikayencikewin: To seek learning or knowledges - Indigenous knowledges & data governance protocol","year":"2021"},{"key":"pone.0354477.ref038","doi-asserted-by":"crossref","first-page":"942","DOI":"10.3389\/fgene.2019.00942","article-title":"Data management in health-related research involving indigenous communities in the United States and Canada: a scoping review","volume":"10","author":"RB Woodbury","year":"2019","journal-title":"Front Genet"},{"issue":"19","key":"pone.0354477.ref039","doi-asserted-by":"crossref","first-page":"10318","DOI":"10.3390\/ijerph181910318","article-title":"Indigenous and tribal peoples data governance in health research: a systematic review","volume":"18","author":"KE Griffiths","year":"2021","journal-title":"Int J Environ Res Public Health"},{"issue":"4","key":"pone.0354477.ref040","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-024748","article-title":"Indigenous and non-Indigenous people experiencing homelessness and mental illness in two Canadian cities: a retrospective analysis and implications for culturally informed action","volume":"9","author":"B Bingham","year":"2019","journal-title":"BMJ Open"},{"issue":"44","key":"pone.0354477.ref041","doi-asserted-by":"crossref","DOI":"10.1503\/cmaj.160778","article-title":"The cedar project: mortality among young indigenous people who use drugs in British Columbia","volume":"189","author":"K Jongbloed","year":"2017","journal-title":"CMAJ"},{"issue":"1","key":"pone.0354477.ref042","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1186\/s12954-023-00883-x","article-title":"Peer-led safer supply and opioid agonist treatment medication distribution: a case study from rural British Columbia","volume":"20","author":"M Scow","year":"2023","journal-title":"Harm Reduct J"},{"key":"pone.0354477.ref043","doi-asserted-by":"crossref","first-page":"103910","DOI":"10.1016\/j.drugpo.2022.103910","article-title":"A scoping review of qualitative research on barriers and facilitators to the use of supervised consumption services","volume":"111","author":"A Ivsins","year":"2023","journal-title":"Int J Drug Policy"},{"issue":"1","key":"pone.0354477.ref044","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1186\/s12954-023-00817-7","article-title":"Impact of safer supply programs on injection practices: client and provider experiences in Ontario, Canada","volume":"20","author":"M Gagnon","year":"2023","journal-title":"Harm Reduct J"},{"issue":"7","key":"pone.0354477.ref045","doi-asserted-by":"crossref","first-page":"1825","DOI":"10.1111\/dar.13745","article-title":"\u201cI don\u2019t chase drugs as much anymore, and I\u2019m not dead\u201d: client reported outcomes associated with safer opioid supply programs in Ontario, Canada","volume":"42","author":"RA Schmidt","year":"2023","journal-title":"Drug Alcohol Rev"},{"key":"pone.0354477.ref046","doi-asserted-by":"crossref","first-page":"104869","DOI":"10.1016\/j.drugpo.2025.104869","article-title":"Necropolitics of the North: a rapid ethnography examining the effects of the closure of one of Northern Ontario\u2019s only supervised consumption sites","volume":"143","author":"L Tucker","year":"2025","journal-title":"Int J Drug Policy"},{"key":"pone.0354477.ref047","author":"K Armstrong","year":"2024"},{"key":"pone.0354477.ref048","author":"Public Health Ontario","year":"2025"},{"key":"pone.0354477.ref049","volume-title":"OCC opioid mortality summary Q4 2024","author":"Office of the Chief Coroner","year":"2025"},{"issue":"2","key":"pone.0354477.ref050","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1177\/070674371105600202","article-title":"From benzos to berries: treatment offered at an Aboriginal youth solvent abuse treatment centre relays the importance of culture","volume":"56","author":"CA Dell","year":"2011","journal-title":"Can J Psychiatry"},{"issue":"2","key":"pone.0354477.ref051","doi-asserted-by":"crossref","DOI":"10.32799\/ijih.v16i2.33346","article-title":"Putting Indigenous Harm Reduction to Work: Developing and Evaluating \u201cNot Just Naloxone\u201d","volume":"16","author":"A Medley","year":"2021","journal-title":"IJIH"},{"key":"pone.0354477.ref052","doi-asserted-by":"crossref","first-page":"112597","DOI":"10.1016\/j.drugalcdep.2025.112597","article-title":"A scoping review of harm reduction practices and possibilities among indigenous populations in Australia, Canada, and the United States","volume":"269","author":"C Zolopa","year":"2025","journal-title":"Drug Alcohol Depend"},{"issue":"1","key":"pone.0354477.ref053","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1186\/s12913-022-08406-3","article-title":"Community trial evaluating the integration of Indigenous healing practices and a harm reduction approach with principles of seeking safety in an Indigenous residential treatment program in northern Ontario","volume":"22","author":"KA Morin","year":"2022","journal-title":"BMC Health Serv Res"},{"issue":"8","key":"pone.0354477.ref054","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1016\/S1701-2163(16)32237-X","article-title":"Prevalence and correlates of cervical cancer screening among injection drug users","volume":"28","author":"B McKnight","year":"2006","journal-title":"J Obstet Gynaecol Can"},{"issue":"3","key":"pone.0354477.ref055","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1177\/08465371221147307","article-title":"Barriers to screening at-risk populations in Canada","volume":"74","author":"DJ Cao","year":"2023","journal-title":"Can Assoc Radiol J"},{"issue":"6","key":"pone.0354477.ref056","doi-asserted-by":"crossref","first-page":"2123201","DOI":"10.1080\/21645515.2022.2123201","article-title":"Vaccine confidence among people who use drugs: a cross-sectional survey","volume":"18","author":"PM Frew","year":"2022","journal-title":"Hum Vaccin Immunother"},{"issue":"10","key":"pone.0354477.ref057","doi-asserted-by":"crossref","DOI":"10.1016\/S2666-7568(23)00174-5","article-title":"Age-friendly care for older adults with substance use disorder","volume":"4","author":"KF Jones","year":"2023","journal-title":"Lancet Healthy Longev"},{"issue":"2","key":"pone.0354477.ref058","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/s00392-021-01945-5","article-title":"Drug overdose and the risk of cardiovascular diseases: a nested case-control study","volume":"112","author":"WQ Gan","year":"2023","journal-title":"Clin Res Cardiol"},{"key":"pone.0354477.ref059","doi-asserted-by":"crossref","first-page":"109132","DOI":"10.1016\/j.drugalcdep.2021.109132","article-title":"Risk of cardiovascular diseases in relation to substance use disorders","volume":"229","author":"WQ Gan","year":"2021","journal-title":"Drug Alcohol Depend"},{"issue":"6","key":"pone.0354477.ref060","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1007\/s00038-015-0698-3","article-title":"Cardiovascular disease among people with drug use disorders","volume":"60","author":"B Thylstrup","year":"2015","journal-title":"Int J Public Health"},{"issue":"1","key":"pone.0354477.ref061","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1111\/jgs.16205","article-title":"The prevention of infections in older adults: vaccination","volume":"68","author":"PP Coll","year":"2020","journal-title":"J Am Geriatr Soc"},{"issue":"8","key":"pone.0354477.ref062","doi-asserted-by":"crossref","DOI":"10.1002\/jia2.25577","article-title":"Addressing treatment and care needs of older adults living with HIV who use drugs","volume":"23","author":"KL Chayama","year":"2020","journal-title":"J Int AIDS Soc"},{"key":"pone.0354477.ref063","doi-asserted-by":"crossref","first-page":"103112","DOI":"10.1016\/j.drugpo.2021.103112","article-title":"I don\u2019t even want to go to the doctor when I get sick now: Healthcare experiences and discrimination reported by people who use drugs, Arizona 2019","volume":"93","author":"BE Meyerson","year":"2021","journal-title":"Int J Drug Policy"},{"issue":"8","key":"pone.0354477.ref064","doi-asserted-by":"crossref","first-page":"4555","DOI":"10.3390\/ijerph19084555","article-title":"Cancer screening among rural people who use drugs: colliding risks and barriers","volume":"19","author":"WD Jenkins","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"pone.0354477.ref065","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.socscimed.2017.01.053","article-title":"\u201cThey treated me like crap and I know it was because I was Native\u201d: the healthcare experiences of Aboriginal peoples living in Vancouver\u2019s inner city","volume":"178","author":"A Goodman","year":"2017","journal-title":"Soc Sci Med"},{"issue":"1","key":"pone.0354477.ref066","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/s12954-019-0285-7","article-title":"\u201cMaybe if I stop the drugs, then maybe they\u2019d care?\u201d-hospital care experiences of people who use drugs","volume":"16","author":"S Chan Carusone","year":"2019","journal-title":"Harm Reduct J"},{"key":"pone.0354477.ref067","doi-asserted-by":"crossref","first-page":"21501319231225996","DOI":"10.1177\/21501319231225996","article-title":"Building authentic connection in the patient-physician relationship","volume":"15","author":"S Fuehrer","year":"2024","journal-title":"J Prim Care Community Health"},{"issue":"5","key":"pone.0354477.ref068","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.annemergmed.2020.11.021","article-title":"\u201cThe Coats That We Can Take Off and the Ones We Can\u2019t\u201d: the role of trauma-informed care on race and bias during agitation in the emergency department","volume":"77","author":"IK Agboola","year":"2021","journal-title":"Ann Emerg Med"},{"key":"pone.0354477.ref069","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/1747-597X-9-34","article-title":"Cultural interventions to treat addictions in Indigenous populations: findings from a scoping study","volume":"9","author":"M Rowan","year":"2014","journal-title":"Subst Abuse Treat Prev Policy"},{"key":"pone.0354477.ref070","author":"Canadian Aboriginal AIDS Network (CAAN), Interagency Coalition on AIDS and Development (ICAD)","year":"2019"},{"issue":"8","key":"pone.0354477.ref071","doi-asserted-by":"crossref","first-page":"3607","DOI":"10.1002\/jcop.22859","article-title":"Harm reduction acceptability and feasibility in a North American indigenous reserve community","volume":"50","author":"SC Goldstein","year":"2022","journal-title":"J Community Psychol"},{"issue":"3","key":"pone.0354477.ref072","doi-asserted-by":"crossref","DOI":"10.9778\/cmajo.20150076","article-title":"Impact of a methadone maintenance program on an Aboriginal community: a qualitative study","volume":"4","author":"M Landry","year":"2016","journal-title":"CMAJ Open"},{"key":"pone.0354477.ref073","doi-asserted-by":"crossref","first-page":"104631","DOI":"10.1016\/j.drugpo.2024.104631","article-title":"\u201cThey talk about it like it\u2019s an overdose crisis when in fact it\u2019s basically genocide\u201d: The experiences of Indigenous peoples who use illicit drugs in Vancouver\u2019s Downtown Eastside neighbourhood","volume":"134","author":"J Lavalley","year":"2024","journal-title":"Int J Drug Policy"},{"key":"pone.0354477.ref074","volume-title":"Health inequalities and the social determinants of Aboriginal peoples\u2019 health","author":"CL Reading","year":"2009"},{"key":"pone.0354477.ref075","author":"C Loppie","year":"2022"},{"key":"pone.0354477.ref076","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/1477-7517-8-17","article-title":"Harm reduction, methadone maintenance treatment and the root causes of health and social inequities: an intersectional lens in the Canadian context","volume":"8","author":"V Smye","year":"2011","journal-title":"Harm Reduct J"},{"key":"pone.0354477.ref077","volume-title":"Measures respecting premises with illegal drug activity act","author":"Government of Ontario","year":"2025"},{"issue":"1","key":"pone.0354477.ref078","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1093\/pch\/13.1.53","article-title":"Harm reduction: an approach to reducing risky health behaviours in adolescents","volume":"13","year":"2008","journal-title":"Paediatr Child Health"},{"key":"pone.0354477.ref079","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2020-023523G","article-title":"Principles of harm reduction for young people who use drugs","volume":"147","author":"SD Kimmel","year":"2021","journal-title":"Pediatrics"},{"key":"pone.0354477.ref080","doi-asserted-by":"crossref","first-page":"103857","DOI":"10.1016\/j.drugpo.2022.103857","article-title":"Child-centred harm reduction","volume":"109","author":"D Barrett","year":"2022","journal-title":"Int J Drug Policy"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0354477","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T17:41:56Z","timestamp":1784914916000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0354477"}},"subtitle":[],"editor":[{"given":"David T.","family":"Zhu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,7,24]]},"references-count":80,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,24]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0354477","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,24]]}}}