Health Services Center, Inc. (HSC) proposes Project STAR (Strategies to Advance Recovery) to provide LGBTQ+ focused, peer engaged substance use disorder(SUD) and HIV linkage and risk reduction services to reduce substance-and related harm in an underserved rural, high poverty area of the rural Deep South that experiences significant negative consequences related to substance use, including overdose, poor health outcomes, family disruption, and legal system involvement. The target service area is large, covering 9,000 square miles and 14 Alabama counties (Blount, Calhoun, Coosa, Cleburne, Chambers, Calhoun, DeKalb, Etowah, Randolph, Shelby, St. Clair, Tallapoosa, Talledega, Clay Counties, AL). HSC has provided SUD, HIV and harm reduction services in the target area for over 25 years and has the cultural knowledge, infrastructure, and community partnerships necessary to expand and enhance services for LGBTQ+ populations. Project STAR will implement the evidence-based practice, Cognitive Behavioral Therapy (CBT) to serve the priority population of LGBTQ+ rural/non-urban populations. The STAR Project will particularly focus on LGBTQ+ young adults and populations of color, as these groups are perennially underserved in the target area. Project STAR has three main goals: 1. increase access to substance disorder and behavioral health services for LGBTQ+ populations through targeted individual and group behavioral health and case management services, 2. provide HIV/harm reduction services to at risk LGBTQ+ populations through HIV counseling, testing, referral (HIV CTR), linkage to HIV medical and supportive services, PrEP services, HIV education, and access to prevention supplies, and 3. increase peer support and recovery community building services, and community awareness activities. Annually, Project STAR will serve 1,150 persons through SUD, harm reduction, and community awareness/outreach activities (3,450 over course of project). Measurable outcomes include reduction in service area substance-related overdoses and incarcerations, numbers of persons receiving harm reduction education and awareness activities, persons receiving HIV testing and PrEP services, and screening/referrals for harm reduction needs. Innovative service provision components include incorporation of telehealth approaches to reduce barriers to treatment access for low-income rural persons, trauma-informed care, peer support and linkage services, leverage of a "mobile safe space" to enhance rural recovery communities, and an area-wide LGBTQ+ focused mini-conference to increase area competence and capacity for service provision. The proposed Project STAR will provide critical substance use service expansion and enhancement for a population that faces significant stigma, discrimination, and lack of access to services in the rural South.