Screening and Testing for Racial and Ethnic At-Risk Minorities (STREAM) Project - Summary: Harlem United (HU) proposes a project to increase engagement in preventative care as part of the continuum of care for individuals from racial/ethnic minority communities, particularly those living with HIV/AIDS, or at risk of contracting HIV and/or viral hepatitis. Services will include HIV/HCV/HBV testing, case management, counseling, and linkage to care. The project will conduct 400 annual HIV tests; 300 HCV and 100 HBV screenings per year; 200 baseline and 160 follow-up GPRA interviews per year; and 80 unique client enrollments in 1:1 counseling sessions with a Behavioral Health Specialist, for a total of 960 sessions held annually. Project name: Screening and Testing for Racial and Ethnic At-Risk Minorities (STREAM) Project Target populations: HU will implement the STREAM Project to offer services to individuals, ages 18 and over, of racial and ethnic minorities with substance use disorders (SUD) and/or co-occurring substance use and mental disorders (COD) living with or at risk for HIV and/or hepatitis. This under-resourced population experiences disparities in health care and outcomes due to differences in race, ethnicity, language, culture, and/or socioeconomic factors. HU recognizes the intersectional nature of racism, trans and homophobia, sexism, and social classism; we thus propose serving the priority populations of Black, Indigenous, and people of color (BIPOC) who grapple with substance use disorder (SUD), serious mental illness (SMI), and multiple chronic infections or illnesses (e.g., HIV, diabetes). These communities have been our focus for the last 30 years; and in 2021, the majority of HU clients identified as BIPOC: 69% as Black, 26% as Latino/a. Strategies/interventions: HU’s STREAM Project will entail an expansion of HU’s preexisting prevention and testing service delivery model, with an increase in our testing capacity, as well as the addition of a Behavioral Health Specialist who can develop appropriate treatment approaches by screening and assessing clients individually. Given that people served by our project are ethnic and racial underrepresented individuals living with SUD and/or COD, these services are integral to achieving increased engagement and better health outcomes and experiences for them. Goals: The primary goal of HU’s project will be to increase engagement in care, and thus help control the spread of chronic infections and the consequences of such infections for racial and ethnic underrepresented individuals with SUD/COD who are at risk for or living with HIV/AIDS. This will be achieved through an integrated harm reduction approach, encompassing increased HIV testing; increased HCV/HBV screening; case management; 1:1 behavioral health counseling sessions; motivational interviewing and individualized recovery plans; and building lasting connections for our target population to testing, counseling, and health education. Objectives: 1) conducting 5 days/week outreach to test 400/year unique clients for HIV; 2) screening 300/year clients for HCV; 3) screening 300/year clients for HBV; 4) serving 1,900 unduplicated clients over the 5-year contract period (300 in Year 1, 400 in Years 2–5); 5) linking 100% of HIV+ clients to case management services; 6) linking 100% of clients with HCV/HBV to treatment as well as other HU services; 7) linking 20/year clients to Hep A/B vaccination; 8) inviting 100% of clients consenting to testing to participate in GPRA interviews; 9) conducting 360/year GPRA interviews (200 baseline, 160 follow-up); 10) performing 200/year initial COD screenings to develop appropriate treatment options for clients; 11) providing 80/year unique clients 1:1 evidence-based SUD/COD treatment/recovery support services using motivational interviewing techniques; 12) linking 100% of clients to substance use counseling, Seeking Safety counseling, and FDA-approved medication for treatment of SUD/CODs, when requested.
