Meta House's (MH) Prevention, Access, Treatment, and Health (PATH) program will serve women with the highest risk of HIV infection in Milwaukee, Wisconsin: women (primarily minority women) with substance use disorders (SUDs) and co-occurring disorders (CODs). The proposed outpatient program will integrate SUD treatment, trauma and mental health treatment, HIV/Hepatitis testing and risk reduction, Hepatitis vaccination, health education, case management, recovery support services, and a comprehensive array of wraparound services into MH's outpatient program. The program expects to serve 250 women during the five years of the grant (50 each year of the grant). The women served will be racially/ethnically diverse, low-income, and typically have multiple special needs in addition to SUDS and CODs, such trauma history, low literacy, unstable housing/homelessness, and employability concerns. The goals/objectives of the PATH project are to: 1) serve primarily African-American and other racial/ethnic minority women who have SUDs and are at risk for contracting HIV in outpatient SUD/COD treatment; 2) provide population appropriate, evidence based, trauma informed treatment for women (specifically, that all women will be screened for trauma and receive trauma services, 80% of women will receive peer services, all women and their partners will be offered testing for HIV and Hepatitis, 80% of the women will receive HIV/Hepatitis testing and risk-reduction services, and all those with positive results will be receive confirmatory testing and receive follow-up counseling, case management, and medical care); 3) improve women's level of functioning related to recovery from substance use, mental health and trauma symptoms, and access to health care (specifically, women will show statistically significant decrease in substance use and mental health/trauma symptoms and will have access to health care at follow-up), 4) reduce women's risk of HIV/Hepatitis infection and transmission (specifically, women will show decreased risk behaviors). Meta House has provided gender-responsive, trauma-informed, culturally-competent substance abuse and mental health treatment for 55 years. To achieve these goals, the PATH project will collaborate with Ascension (an experienced health care provider) to integrate the following evidence-based practices into its outpatient treatment program: 1) Motivational Interviewing to treat SUDs and reduce substance-related risk behaviors; 2) Seeking Safety to reduce substance use, the effects of trauma, and risk behaviors associated with both substance use and violence/trauma exposure; and 3) RESPECT to address HIV/Hepatitis risk behaviors.. The performance assessment for the PATH project will be conducted by an external evaluator with more than 25 years of experience evaluating SAMHSA grants. The performance assessment will use findings from intake and 12 month follow-up interviews, as well as qualitative and process data, to examine the extent to which the PATH project meets its goals.