The purpose of this proposal, Treatment engagement for SUD and co-occurring mental health
disorders to medically underserved racial/ethnic individuals at risk for or living with HIV in the
Charleston Tri-County Area: REACH clinic is to enhance the capacity of the EMPOWERR
Program in the Charleston-North Charleston metropolitan area of South Carolina (a state labeled
as an EHE priority jurisdiction) to provide comprehensive culturally-informed, integrated,
evidence-based substance use disorder (SUD) treatment and related mental health and HIV
services for racial/ethnic minority adults with co-occurring SUD and traumatic stress in a Ryan
White clinic to meet currently unmet treatment needs in this catchment area. The Charleston-
North Charleston area has consistently been in the top 10 metropolitan areas in the Southeast for
new HIV infections, with racial/ethnic minority men and women making up the largest number
of new infections. SC also has high rates of interpersonal violence (e.g., traumatic stress highly
co-occurring with SUD) and substance misuse. The services proposed through this grant will
include screening, assessment, outpatient evidence-based treatment, case management (inclusive
of linkage services and recovery support), and outreach strategies targeting continuous
engagement of underserved racial/ethnic minorities in SUD/HIV/COD related services. The
proposed activities in this application, which fully align with the required activities outlined in
FOA T1-23-008, address this “risk triad” (SUD, traumatic stress, and HIV)—through expansion
of EMPOWERR services to establish the REACH clinic: Resiliency, Engagement, and
Access for Co-Occurring HIV/SUD/PTSD populations. Specifically, this grant will
provide the necessary resources for the EMPOWERR Program, in conjunction with our Ryan
White clinic partner, to address critical service gaps in the EHE priority jurisdiction Charleston-
North Charleston area, including but not limited to: 1) Implementation of SBIRT [Screening,
Brief Intervention (motivational enhancement), and Referral to Treatment (for evidence-based
SUD and co-occurring traumatic stress services)] to people living with HIV presenting to local
HIV clinic; 2) Implement COD screening; 3) Provide evidence-based treatment for co-occurring
SUD (SBIRT, Motivational Enhancement Therapy + Cognitive Behavioral Therapy/MET +
CBT, including MOUD as needed) and traumatic stress (Cognitive Processing Therapy/CPT) for
adults living with HIV or at risk for living with HIV through clinic-based and telehealth services;
4) Provide HIV testing through rapid preliminary antibody HIV testing to the population of
focus, linkage to care as needed, and/or referrals to PrEP services for those with HIV negative
results; 5) Establish Patient Engagement Groups (PEGs) to incorporate strategies for engagement
and community education needs; 6) Provide recovery and support services; 7) Administer
education sessions, outreach strategies, and linkage services for Hepatitis testing, PEP services
for HIV exposure, and education on PrEP and related services. Outcomes will be closely and
regularly monitored, including: SUD and HIV-related behavioral outcomes reported on the
CSAT GPRA Client Outcome Measures for Discretionary Programs; number of individuals
tested for HIV/VH and referred for services, number of participants receiving SBIRT and other
identified evidence-based interventions for SUD and traumatic stress (e.g., MET/CBT, CPT),
number of individuals receiving case management services through REACH (e.g., linkage to
PrEP, PEP). By the end of the five-year period, 500 will receive evidence-based assessments
and/or interventions (100 annually). The overarching goal of the project is to reduce SUD and
traumatic stress through increased service engagement among racial/ethnic minority PLWH, in
the Charleston-North Charleston area via co-located mental health services in a trusted Ryan
White clinic.
