Tu Bienestar: Culture, Health, and Empowerment is dedicated to fostering connections between Latinxs with substance use and co-occurring mental health disorders (CODs) who are at risk for or living with HIV and other infections and the healthcare they need. Patients in this Boston-based program often experience social or economic issues associated with HIV and substance misuse (e.g., poverty or trauma) which create significant barriers to recovery and viral suppression. These issues contribute to increased risks for HIV infection or complications; relapses or overdoses; and the onset of concurrent mental or behavioral health issues. Patients with CODs, especially linguistically and culturally underserved individuals, are further obstructed from comprehensive care by silos between SUD services, mental health treatment, and HIV medical care. Tu Bienestar is a bridge linking all three service types.
Tu Bienestar’s patient population is exclusively 18 years of age and older, with most patients between 35-44. About 75% of patients identify as male and about 25% identify as female, with a small number identifying as transgender or gender non-binary. About 90% of patients are Hispanic/Latinx and most are bilingual (English/Spanish). Roughly half of the patient population lacks a complete high school education and about half are unemployed, with roughly 75% of patients unable to meet all their financial needs. Over one-third of patients are involved in the criminal justice system and between 10-20% are HIV positive at intake.
Tu Bienestar assertively identifies and engages hard-to-reach individuals in culturally competent HIV/VH/STI prevention, education, screening, testing, and connection to care and is chiefly concerned with four related goals: (1) improving access to culturally focused, trauma-informed, integrated mental health, opioid use treatment, and primary care for Latinxs; (2) providing case management services to support patients’ full engagement in the development, implementation, and completion of goals in their care plan; (3) providing recovery support services to help increase knowledge of community resources, increase capacities for self-management, and identify and reduce risky behaviors; and (4) designing and promoting a public awareness campaign to address the stigma, discrimination, and barriers to culturally and linguistically proficient treatment and recovery support services faced by Latinxs.
Tu Bienestar will provide integrated services to 300 people over five years, empowering them to make informed decisions about their health, including trauma- and substance use-related HIV risk-behaviors.