The Special Treatment and Research (STAR) Program of State University of New York (SUNY) Downstate Health Sciences University (DHSU) proposes to conduct the STAR Priority Populations Project, which will be implemented at STAR's flagship clinic site (STAR Health Center) (SHC) at SUNY-DHSU's University Hospital at Downstate in Brooklyn, NY. The SHC is STAR's trauma-informed, co-located outpatient primary care and behavioral health (BH) program for adults ages 18 and older. The populations to be served include Black and Latinx adults (18 and older) with substance use disorder (SUD) and or co-occurring SUD and mental health (MH) conditions (COD) who are at risk for or living with HIV. SUNY-DHSU serves a dense urban service area populated by low income, predominantly Black and Latinx immigrant populations. This area is underserved with respect to primary care and MH care, and HIV rates are disproportionately high. Barriers to care include poverty, homelessness, unemployment, and lack of education and health insurance. Brooklyn ranks first in NYC for new HIV diagnoses and concurrent HIV and AIDS diagnoses. Nearly one quarter of Brooklyn's cumulative AIDS cases among women are directly attributable to injection drug use (IDU) (27% among males); many more heterosexual and MSM cases are indirectly attributable to substance use. Proposed interventions include evidence-based SUD/COD treatment and recovery support services to HIV positive and at risk individuals, including screening and assessment, outpatient services, and the use of FDA approved medication for the treatment of SUD and or COD; on-site preliminary and confirmatory HIV testing; PEP and PrEP; provision for all clients and their partners who use drugs and or sexual partners of HIV rapid preliminary antibody testing at enrollment, including rapid fourth generation HIV diagnostic testing; education, case management, and follow up care and treatment for all clients who have a preliminary positive HIV and confirmatory HIV test result; education, case management, and PrEP and PEP services for individuals who screen negative for HIV but are at increased risk of exposure to HIV; screening and assessing individuals with or at risk for HIV for the presence of COD and use the information obtained to develop appropriate treatment approaches; evidence-based mental and SUD treatment and practices that are trauma-informed and recovery oriented; viral HBV and HCV testing on site and developing continuous outreach with consumer input. Goals are to identify adults with a SUD and or COD living with or at risk for HIV and or hepatitis; implement evidence-based interventions; provide HIV and hepatitis screening and hepatitis vaccinations; and engage and retain those testing positive for HIV and or hepatitis and or SUD or COD in primary care and BH services at the SHC. Objectives include providing inreach and outreach to identify eligible clients; HIV and hepatitis prevention services and linkage to care; case management to coordinate all aspects of care, including MH, primary care, HIV and hepatitis treatment; and other supportive services (e.g., housing, benefits) for 100% of newly-identified positives; implementing CBT for all eligible clients. Nos. to be served: 80 persons in each project year for a total of 400 persons over 5 years.