Luz de Esperanza (Light of Hope) (LdE) - ABSTRACT
The United Community Center’s (UCC) proposed Luz de Esperanza (Light of Hope) (LdE) project will increase engagement in care for racial and ethnic underrepresented adult residents of Milwaukee County, WI, for 308 racial and ethnic underrepresented adults (48 in Year 1 and 65 in Years 2-5) with substance use disorders (SUD) and/or co-occurring substance use and mental disorders (COD) who are at risk for, or are living with HIV/AIDS and receive HIV/AIDS services/treatment.
While the UCC SUD treatment program serves individuals of all races/ethnicities, in 2019 , 30% of those served were Hispanic, about twice the proportion (15.6%) of Hispanics who live in the County as a whole. UCC also serves a significant percentage of African Americans (AAs). In UCC’s near south side zip code, 53204, Hispanics and AAs comprise 80.8% of the population, almost twice the percentage of 42.8% in MC as a whole. In 2021, 643 people died from opioid overdose in MC, the highest annual total ever recorded, representing a 17.8% increase from the 546 deaths in 2020, which was the previous annual high. The ZIP code with the most deaths in 2021 was 53204, which is where UCC is located. Project services will be delivered via a collaboration between UCC and Federally Qualified Health Center (FQHC) and Ryan White HIV/AIDS Program Medical Provider Sixteenth Street Community Health Centers (SSCHC), which serves the same near south side neighborhoods as UCC. UCC will provide behavioral health treatment, onsite rapid HIV testing, and HIV prevention education, while SSCHC provides an array of HIV and hepatitis services. LdE will employ the following evidence-based practices: 1) the Matrix Model, a framework that integrates aspects of several treatment approaches, 2) Seeking Safety, a model that considers the context of historical trauma within which a large proportion of both men and women develop SUD/COD, and 3) Motivational Interviewing. LdE will also offer a CDC-listed evidence-based HIV prevention programs, ConnectHIP. Clients will be provided with an array of recovery support services (RSS) to enhance recovery. Project objectives are 1) Provide 308 individuals over the five-year grant period with SUD and HIV services. 2) Participants will be retained in the project for an average of 60 days; 3) Participants will demonstrate a significant pre-post decrease in their substance use; 4) Participants will demonstrate a significant pre-post decrease in the frequency and/or severity of their overall mental health symptoms; 5) Participants will demonstrate a significant pre-post decrease in frequency and/or severity of trauma symptoms; 6) 80% of participants will report interaction with family &/or friends supportive of their recovery at 6 mo. follow-up; 7) 100% of those who remain in the program for 15 days will complete the HIV prevention /education component of the project; 8) Participants completing the HIV prevention /education component of the project will report a pre-post decrease in perceptions of condom use barriers; 9) 80% of participants who complete the HIV prevention /education component of the project will report refraining from engaging in sexual risk behaviors at six-month follow-up; 10) 85% of participants who report, at intake, injection drug use (IDU) in past 30 days, who complete the HIV prevention /education component of the project, will report (at the six-month follow-up) abstinence from IDU or having used a new needle/syringe (in past 30 days); 11) 100% of HIV-negative participants who meet CDC criteria will be provided with information about PrEP and (if interested) referred to a PrEP provider within 30 days of enrollment; 12) 100% of participants will be offered HIV rapid preliminary antibody testing at intake and (if needed) referral for confirmatory testing and treatment for themselves and their partners; and 13) 100% of participants will be offered testing for hepatitis B and C and referred as necessary for treatment.
