La Maestra's project "Expanding Access to Substance Abuse and HIV Navigation Services" will target those at the highest risk for HIV and substance use disorders, including low-income, uninsured and underinsured ethnic and racial minority patients. The overall project goal is to provide services to those at highest risk for HIV and substance use disorders throughout San Diego County, California.
The project goal will be achieved by reaching the following objectives: 1) screen a minimum of 1,500 patients annually for substance use disorder services (SUDS) using evidence-based screening tools; 2) provide substance use prevention and HIV risk factor and risk reduction education services to a minimum of 500 individuals annually through internal clinic referrals and community outreach events; 3) screen and test a minimum of 300 individuals annually for HIV and viral hepatitis; 4) provide a minimum of 140 individuals annually with navigation services (including follow-up) for HIV and substance misuse services; and 5) provide at least two training events per year within the first three years of the project period (or a total of 6 training sessions) to SUDS treatment providers and other healthcare providers at La Maestra on the importance of HIV screening and meeting the clinical care needs of people living with HIV (PLWH).
The population of focus for this project is San Diego County residents at highest risk for HIV and substance use disorders with a focus on racial and ethnic minorities. According to 2018 clinic data, 74.4% of La Maestra's 48,545 total patients belong to a racial or ethnic minority group and 59.0% prefer to be served in a language other than English. La Maestra will also outreach to hard-to-reach, at-risk populations including homeless individuals, previously incarcerated persons and members of the LGBTQ community.
In 2018, La Maestra conducted 6,729 SBIRT screenings, provided SUD services to 168 patients, provided mental health services to 1,064 patients, and diagnosed 17 patients with HIV. However, according to UCLA's 2017 Community Health Interview Survey (CHIS), 20.6% of people in the service area needed help for emotional/mental health problems or the use of alcohol or other drugs, but only 74.3% of those people saw a healthcare provider for these issues. Additionally, 2018 data from the San Diego HIV Planning Group estimates that there are 15,132 people living with HIV in the County, but only 47% are retained in care and only 60% are virally suppressed. This data demonstrates the need for better integration of behavioral health and SUDS into primary care, as well as additional HIV preventive services in SUD treatment centers.
La Maestra will adhere to current evidence-based practices and will expand its Wellness Supportive Services department and patient navigation program to ensure that all patients in need of SUD or HIV and viral hepatitis screening and treatment services receive the comprehensive, culturally and linguistically competent care that is vital to long-term health and wellness.