BEAT HIV/AIDS - WestCare California, Inc.’s proposed program, BEAT HIV/AIDS, will increase engagement in care for a population of focus consisting of low-income racial and ethnic minority adults with substance use disorders (SUD) or co-occurring substance use and mental health disorders (COD) who are living with or at high-risk for contracting HIV/AIDS in Fresno County, California. The highest risk populations in Fresno include men who have sex with men (MSM) and intravenous drug users (IDU). Participants for the proposed program will be identified via internal referrals from WestCare’s residential and outpatient SUD treatment programs, as well as external referrals from community partners. Staff will assess clients using the PTSD Checklist-5 (PCL-5) for trauma, the HIV Knowledge Questionnaire (45-item version – HIV KQ-45) for HIV knowledge, and The ASAM Criteria for substance use. The Treatment Team will use the results from the assessment tools to work with each client to create an Individualized Service Plan. A single, comprehensive plan will integrate the goals and objectives for substance use with the goals and objectives for mental health treatment, primary care, and HIV/HBV/HCV risk reduction, to prevent parallel and uncoordinated treatment. All participants will receive case management services with linkages to HIV primary care, Hepatitis treatment, PrEP, and recovery supports including housing, vocational training, job placement, literacy, education, public benefits, and other vital services needed to achieve stability. BEAT program staff will provide individualized linkages to each client depending upon their needs using a linkage model rather than a referral model to ensure the client receives the services. Clients will participate in residential SUD treatment for 90 days and then step down into outpatient services and sober living for another 90 days. Although most participants will receive SUD/COD treatment services at WestCare through Drug Medi-Cal, a small portion of the grant budget will be allotted to cover residential bed days for those participants who are uninsured/underinsured. Participants engaged in SUD/COD treatment will participate in group and individual counseling sessions following evidence-based, manualized curricula (Seeking Safety and Living in Balance). All clients will receive integrated HIV/HBV/HCV testing following a structured protocol in accordance with state and local requirements and CDC recommendations. When an individual receives a preliminary positive HIV test result, WestCare will provide immediate post-test counseling and contact the Fresno Department of Public Health (FDPH) to provide a confirmatory test prior to the individual leaving the site. Clients will also receive enhanced case management services, linkage with Ryan White services, and linkage with the Special Services Clinic at Community Regional Medical Center for HIV primary care. Any client who tests positive for viral Hepatitis (HBV/HCV) will be linked with Clinica Sierra Vista for HBV/HCV treatment. WestCare is partnered with and will link to Avita Pharmacy to provide PrEP services for clients who screen negative for HIV. Additionally, all clients will receive CLEAR – an evidence-based HIV prevention and health promotion curriculum – during case management sessions, and all clients will complete the five (5) core sessions. Finally, clients will be linked with WestCare’s Alumni Support Group during step down counseling in outpatient and the aftercare phase. Sober living homes will be offered during the step-down phase of treatment and clients will be assisted in locating a sober living environment. WestCare’s BEAT HIV/AIDS program will serve 300 participants over the 5-year grant term. The program’s primary goals are to increase engagement in care and reduce the spread of HIV/HBV/HCV. At least 70% of clients will show reductions in substance use and high-risk behaviors, improvements in their mental health, and increased life stability.