African Americans remain at much higher risk of acquiring HIV, are more likely to be unaware of their HIV-positive status, are less likely to be linked to and retained in care, and are less likely to have suppressed viral loads than are Whites. The MAI - High Risk Populations "Reachable, Teachable, and Inclusive" (RTI) project will address these health disparities by increasing engagement in care for African Americans in Montgomery County, Ohio who have substance use disorders (SUD) and/or co-occurring substance use and mental health disorders (COD) who are at risk for or living with HIV/AIDS. The Substance Abuse Resources and Disability Issues (SARDI) Program in the Boonshoft School of Medicine at Wright State University will partner with Mt. Olive Baptist Church, Urban Minority Alcoholism & Drug Abuse Outreach Program (UMADAOP) of Dayton, Public Health Dayton & Montgomery County (PHDMC), and Samaritan Behavioral Health, Inc. (SBHI) to deliver this project in Montgomery County. The incidence of HIV for African Americans is twice the incidence rate for the county and three times the rate for Ohio, and the incidence of HIV for Black men is nearly four times the county rate. In particular, RTI's efforts will be focused in the 45417 zip code area in West Dayton, where Mt. Olive, UMADAOP, and SBHI are located. This catchment area is 76.4% Black compared to Montgomery County as a whole which is 20.9% Black.
For the proposed RTI project, health promotion and HIV testing events will be held at Mt. Olive three times per week, as well as larger monthly events at Mt. Olive and at other community sites. At these events, RTI staff will conduct HIV testing and pre/post counseling, mental health and SUD screens, and case management. Individuals screening positive for SUD/COD will be referred to UMADAOP and/or SBHI for treatment services including peer recovery support services. PHMDC will provide Pre-Exposure Prophylaxis (PrEP) to individuals at risk for HIV and will provide HIV and hepatitis treatment services as needed. The goals of this RTI project are to: 1) provide HIV/Hepatitis prevention and treatment services to residents of West Dayton; 2) provide SUD and/or COD treatment and recovery services to individuals with SUD and/or COD in West Dayton; 3) provide peer recovery support services to individuals with SUD and/or COD; 4) implement outreach strategies to inform individuals of available behavioral health services and available HIV and hepatitis primary care and prevention services; and 5) provide case management services to coordinate all aspects of care, including behavioral health, primary health care, HIV and hepatitis treatment, and other supportive services. To achieve these goals, SARDI, Mt. Olive, UMADAOP, PHDMC, and SBHI staff will utilize numerous EBPs, including evidence-based screening (AUDIT, DAST, ASSIST, GAIN-SS, PHQ-9, and SBIRT), prevention (Self-Help in Eliminating Life-Threatening Disease, Sisters Informing Sisters about Topics on AIDS, Trauma Recovery and Empowerment Model, PrEP, and Post-Exposure prophylaxis), SUD/COD treatment (motivational interviewing, Matrix Model, Cognitive Behavioral Therapy, Medication Assisted Treatment, and Contingency Management), HIV treatment (counseling, testing and referral and antiretroviral therapy), and recovery (Case Management and Peer Recovery Support) practices. RTI will provide annually: 1) screening and risk assessment for 500 individuals; 2) HIV testing and pre- and post-test counseling to 500 individuals; 3) SUD/COD treatment services to 60 individuals; 4) Strengths-based case management and peer recovery support services to 90 individuals; and 5) PrEP for all individuals at high risk for HIV and linkages to HIV/hepatitis treatment services for clients who test positive. SARDI and partnering agencies have the capacity and expertise to successfully meet the goals of this important RTI project.