Migrant Health Center Western Region, Inc. (MHC) is a Community Based, 330 (g) (e) (h), non-profit, 501(c) 3, MHC is Federally Qualified Health Center and Patient Centered Medical Home primary and preventive healthcare facility with a vast array of clinical and support service staff member, distributed across its 13 service sites located throughout the western regions of Puerto Rico (PR). MHC provides primary, preventive, and specialty care, as well as support services that include HIV, Hepatitis and SUD prevention/treatment, group therapy, transportation, case management, health education, general medicine, pediatrics, family medicine, psychological, psychiatric services, oral health, OB/GYN, MAT, PrEP, optometry, radiology, pharmacy, laboratory, vaccination, nutrition, and more. MHC is requesting $500,000 per year for 5 years to give continuity to the CARIB Project. MHC have identified the population of underserved Latino young men who have sex with men (YMSM) ages 15-34, and other high-risk populations such as men who have sex with men (MSM) ages 35 and older, gay, bisexual, and transgender individuals with substance use disorders (SUDs) and/or co-occurring SUDs and mental health conditions (COD) who are at risk for or living with HIV. The proposed catchment area is the Western Region of PR, which is composed of 17 Municipalities. According to the U.S. Census Bureau approximately 530,103 individuals reside in the proposed area, of which 98.8% are Latino, 95% speak Spanish as their primary language, and 40.5% live under federal poverty level. MHC will provide community outreach, case management, substance abuse counseling, SUD/COD screening, treatment and recovery support services, patient navigation, psychological and psychiatric services, HIV and HCV testing, linkage to medical care, linkage to prevention services and PrEP, support groups, and Hepatitis vaccination, among others. The interventions to be utilized include Trauma Informed Care, SBIRT, Personalized Cognitive Counseling, ARTAS, Cognitive Behavioral Therapy, Motivational Interviewing, and Dialectic Behavioral Therapy, among others. Throughout the lifetime of the project MHC is proposing to serve 1,200 persons (FY1 – 240, FY2 – 240, FY3 – 240, FY4 – 240, and FY5 – 240). The project goals are1) Increase access to HIV testing and risk reduction services for individuals who are at risk and increase access to treatment for those living with HIV to antiretroviral therapy (ART), and linkage to care, reducing HIV risk and prevalence. 2) Increase the number of individuals who are at risk for HIV with SUD/COD who access evidence-based screening/assessment, SUD/COD treatment and recovery support services. 3) Increase the number of individuals with SUD/COD who live with HIV who are on ART and linked to HIV care, reducing the impact of behavioral health problems, reducing HIV risk and incidence, reducing trauma related conditions, and increasing access to retention in treatment for individuals with co-existing behavioral health, HIV and Hepatitis condition among the target population. The established objectives are: 1) Conduct a community need assessment; 2) Establish at least 10 MOAs annually; 3) Annually link at least 20 individuals with SUD/COD to treatment and/or recovery services; 4) Annually at least 100 program participants will be linked to psychological or psychiatric services, as needed; 5) Annually at least 50 clients will receive case management and substance abuse counseling services; 6) Annually at least 400 HIV test and 300 Hepatitis (C or B) will be performed; 7) Annually 100% of individuals at risk for HIV receiving program services will be screened for HIV, SUD and for the presence of CODs; 8) 100% of HIV/Hepatitis positive results will be referred/linked to treatment; 9) Annually at least 200 members of the target population will be referred to prevention and essential support services, including PrEP; and 9) Annually at least 50 viral Hepatitis (B or C) v