Community-based substance use treatment and HIV prevention for African American and Hispanic/Latino men who have sex with men - The purpose of our proposed project, Community-and clinic-based substance use treatment and HIV prevention for African American and Hispanic/Latino men who have sex with men is to increase status neutral access to and engagement in care for racial and ethnic medically underserved individuals at risk for or living with syndemic conditions including substance use, mental illness, HIV, viral hepatitis, and minority stress. With nearly 1.1 million residents, Rhode Island has one of the highest percentages of LGBTQ+ residents of any state in the country and the majority reside in Providence, the capital city. Providence is the epicenter of substance use in Rhode Island and has among the highest rates of illicit drug use in the United States. Disparities exist between the general population and the LGBTQ+ community with higher rates and severity of substance use disorders (SUDs) and co-occurring mental health disorders (CODs) and lower rates of access to- and engagement in- substance use treatment among racial and ethnic minorities with intersectional LGBTQ+ identities.Despite the large percentage of underserved individuals and the knowledge of these disparities, Rhode Island does not have a dedicated treatment program that addresses the important and unique needs of racial and ethnic medically underserved individuals with intersectional LGBTQ+ identities who suffer disproportionate rates of syndemic substance use, co-occurring mental health, medical, and social concerns. . Our proposed community- and clinic-based project will aim to address these unmet needs by providing affirming, evidence-based, status neutral, and inclusive outreach and treatment for SUD and CODs for 225 individuals from this underserved community in Rhode Island. Aligned with our purpose, the goals for our project include: 1) Increasing access to and engagement in culturally congruent SUD care, 2) Decreasing substance use and mental health symptoms among clients who engage in and complete our project services, 3) Increasing knowledge of medical statuses of HIV, viral hepatitis, and STDs, 4) Decreasing HIV infections, and 5) Promoting personal and organizational health literacy to prevent the perpetuation of minority stress, stigma, and discrimination which contribute to SUDs and CODs. Our program goals and design are derived from our process of centering the voices of those with lived experiences. We plan to use a status neutral approach by braiding together existing resources with the new program services across sites to decrease disparities in health and attend to whole person health care. To meet the needs of our community and accomplish our goals, the objectives of our project include:) Screening at least 800 racial and ethnic medically underserved individuals with intersectional LGBTQ+ identities in community and clinic settings; 2) Providing collaborative, culturally congruent, status neutral multidisciplinary care to 225 individuals to address the syndemic of SUD, CODs, medical concerns, and social determinants of health needs, 3) Testing for HIV, viral hepatitis, and STDs in the community and clinics, 4) Providing education about Undetectable = Untransmissible and support for adherence and PrEP care, and 5) Collaboratively creating and engaging in a dynamic educational curriculum to support diversity, equity, inclusion, belonging, and anti-racism across the three program sites.In summary, the project will provide critical services for the screening and treatment of substance use and other co-occurring disorders among racial and ethnic underserved individuals with intersectional LGBTQ+ identities in the state of Rhode Island which has among the highest rates of illicit drug use in the country.
