Alabama is among the states hardest hit by the HIV epidemic and has seen an increase in substance use and co-occurring disorders (SUDs/CODs) since the onset of the COVID-19 pandemic. Alabama is already among the states with high rates of SUDs/CODs among its population. The AIDS Action Coalition of Huntsville d/b/a Thrive Alabama (TA), a 501(c)(3) non-profit organization, FQHC, and Ryan White provider located in Huntsville, Alabama, requests funding for TA’s Den Intensive Outpatient Program (IOP) to meet the SUD/COD treatment needs of minority adults at-risk or positive for HIV in TA’s north Alabama service area. The Den IOP’s overall goal is to provide accessible, effective, evidence-based intensive outpatient SUD/COD treatment for at-risk minority adults that addresses their needs, including HIV/HCV/HBV testing and treatment services, in a caring, trauma-informed, and culturally competent environment.
The Den IOP will provide ASSERT, a clinic-based screening and brief treatment intervention, to at least 120 participants per year (600 over five years) to identify and refer clients in need of SUD or COD treatment to the Den’s IOP or other partnering resources. All participants are offered tests to screen for HIV and viral hepatitis B and C testing at multiple points in the program. The Den IOP expects sixty-five of those screened to enter the IOP program each year for a total of 325 over five years.
The Den IOP uses the Matrix Model, an evidence-based program originally designed for stimulant abuse and dependence. Developed through 20 years of experience in real-world treatment settings, the Matrix model is also used for treatment of other substance use disorders including opioids. The intervention consists of a cognitive behavioral approach using motivational interviewing, relapse-prevention groups, education groups, social-support groups, individual counseling, and referrals to needed community resources (e.g., primary medical care, housing assistance, vocational rehabilitation services). Patients learn about issues critical to addiction and relapse, receive direction and support from trained therapists and substance use counselors, become familiar with self-help programs, and are monitored for drug use by urine and breathalyzer testing
The Den which is certified by the Alabama Department of Mental Health, has operated through SAMHSA funding for the past ten years. The Den provides evidence-based, trauma-informed, and culturally competent care with screening, testing, and treatment for at-risk minority men and women and individuals who identify as LBGTQIA+ and men who have sex with men (MSM). The populations of focus are at high risk of HIV and viral hepatis, and often lack access to medical and behavioral healthcare. In addition to SUD/COD treatment through the Den project, Thrive Alabama has the experience and resources to provide treatment, case management and support services for client who need HIV or viral hepatitis B or C treatment.