Family Health Centers of San Diego (FHCSD) and subcontractor, Vista Community Clinic (VCC), both non-profit, federally qualified health centers (FQHCs) located in San Diego County, California, will engage in care (over the 5-year project period) 480 individuals from the Population of Focus (POF), racial and ethnic underrepresented individuals (particularly African Americans and Hispanics) 18+ years with substance use disorders (SUD) and/or co-occurring disorders (COD) who are at high risk for or living with HIV/AIDS. According to local epidemiological data , HIV continues to disproportionately impact African Americans and Hispanics in the County: African Americans who constitute less than 6% of the county’s population, represent 12% of all recent HIV diagnoses, 13% of all PLWH, and 13.2% of those unaware of their infection. Hispanics constitute 34% of the population and represent 48% of all recent HIV diagnoses, 42.2% of PLWH, and 49.6% of those unaware of their infection. In the proposed Lotus Project, FHCSD and VCC will deploy Health Navigators (HNs) who will conduct outreach throughout the County and in-reach through our combined 34 (FHCSD-24 and VCC-10) primary clinics (completing 700 in year 1 and 800 in years 2-5 encounters) to recruit the POF, including men who have sex with men (MSM), people who inject drugs (PWID), MSM+PWID, cis- and transgender women, and their sexual and drug-using partners. HNs will provide HIV/HCV (preliminary and confirmatory) testing and counseling, completing (600 in year 1 and 700 in years 2-5 HIV and 150 in year 1 and 200 in years 2-5 HCV) tests, and as many SUD/COD screenings. HNs will link 80% HIV+ and 95% of HCV reactive or high-risk (for HIV) negatives (HRNs) to care, including in-house HIV/viral Hepatitis primary care, Ryan White medical and non-medical case management, and PrEP, within hours and no more than 30 days, reporting all HIV/HCV positives to local and state officials as required. HNs will also provide SUD/COD screenings and referrals/linkages to in-house providers, enrolling (80 in year 1 and 100 in years 2-5) from all groups willing to participate and screen positive for an SUD/COD into Choosing Life, Empowerment, Action, Results (CLEAR), an evidence-based, goal setting, risk reduction, and multi-session intervention. 75% of CLEAR enrollees referred for SUD/COD care will receive comprehensive SUD/COD screening and assessments, develop Individual Service Plans (ISPs), and participate in evidence-based SUD/COD treatment and recovery support services. 70% of CLEAR completers will realize at least one beneficial life change. Most of the Lotus Project’s key personnel, the Program Director, Program Manager, Program Coordinator, Health Navigators, are bi-cultural and bi-lingual. All staff have experience working with the POF and are trained in Trauma Informed care and Motivational Interviewing. The external evaluator, who is from the Institute of Public Health at San Diego State University, has collaborated with FHCSD for over 25 years. VCC will focus on reaching and linking to care the POF in San Diego’s North County.