Accelerating Substance use and Psychiatric Screening among Individuals At-risk or HIV-infected and Facilitated Referral via the Emergency Department at The Ohio State University (ASPIRE - OSU) - Individuals with substance use disorders (SUDs) in the Columbus, Ohio region, especially racial/ethnic minorities, experience disparities in the prevalence of co-occurring mental health disorders (CODs), Human Immunodeficiency Virus (HIV), and Hepatitis C Virus (HCV). Despite increased prevalence for these conditions among racial/ethnic minorities, service gaps remain across the substance use care continuum from initial screening through engagement and retention in appropriate treatment. Project ASPIRE-OSU (Accelerating Substance use and Psychiatric screening among Individuals at-risk or HIV-infected and facilitated Referral via the Emergency Department) at The Ohio State University (OSU) will address health disparities related to the syndemic involving substance use, mental health disorders, and HIV infection. The central premise of Project ASPIRE-OSU is that individuals with SUDs, particularly racial/ethnic minorities, are not reliably screened and linked to needed SUD treatment. Project ASPIRE-OSU will leverage sites of the two high-volume, urban emergency departments (ED) of the OSU Wexner Medical Center (OSUWMC) in conjunction with OSUWMC infectious diseases and comprehensive substance use treatment services to: 1) Implement screening for SUD/COD among patients identified as at-risk for HIV or with HIV infection, most of whom are racial/ethnic minorities; 2) Utilize a multicomponent, comprehensive linkage service with an innovative combination of early, intensive, and sustained efforts to link and retain these patients to culturally-tailored SUD/COD treatment, HIV and viral hepatitis treatment and prevention, and other services as needed. Secondarily, we will leverage the ED Project ASPIRE-OSU program component to recognize patients presenting for emergency care who have not been linked or have fallen out of HIV or substance use treatment. Objectives for Project ASPIRE at OSU include measures to assess each of the project’s primary and secondary goals (e.g., number of patients screened for SUD/COD, linked to SUD treatment, retained in SUD treatment). We project 120 people will be served years 2 through 4 after 90 served in year 1 and 60 served in year 5. By the end of the project, a total of 500 individuals will be served. Of the 500 enrolled, we project >375 (75%) will be racial and ethnic minority individuals who are also medically underserved. Project ASPIRE at OSU utilizes an approach informed by SAMHSA’s Screening, Brief Intervention, and Referral to Treatment (SBIRT) evidence-based practice and will significantly impact the ability to screen and provide an intensive, sustained linkage-to-care intervention to address the needs of predominantly minority populations with substance use and co-occurring mental health disorders who are at high risk for HIV or HIV positive in the Columbus, Ohio region.
