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Meta House’s (MH) ReVIVE (Reduce Violence and Immunodeficiency Virus for Every woman) aims to reduce HIV/Hepatitis infection and transmission for minority women while helping women recover from substance use disorders (SUDs), co-occurring mental health disorders, and the effects of violence and trauma. Partnerships with local healthcare providers will allow MH to provide on-site HIV/Hepatitis testing, treatment, case management, and risk reduction counseling as well as Hepatitis vaccination for women and their partners. ReVIVE will integrate these services with substance abuse treatment, tobacco cessation, trauma/mental health treatment, intimate partner violence (IPV) screening/intervention, and a wide array of recovery support services. The goals of ReVIVE are closely aligned with the goals of the TCE-HIV FOA: 1) serve 192 women (52 women in Year 1 and 70 women in Years 2 and 3), primarily African-American, with SUDs and a high risk for HIV/Hepatitis; 2) provide culturally appropriate, woman- and family-centered, trauma-informed treatment for women and HIV/Hepatitis services for women and their partners; 3) reduce women’s substance use; 4) decrease the impact of trauma and IPV; 5) reduce women’s risk of HIV/Hepatitis infection and transmission; 6) improve women’s health and reduce tobacco use; and 7) minimize subpopulation disparities in access to, use of, and outcomes of project services. To achieve these goals, ReVIVE incorporates five evidence based practices (EBPs): 1) Gender-Responsive Treatment and 2) Motivational Interviewing, to address substance use; 3) Seeking Safety, to address substance use and the effects of violence/trauma; 4) RESPECT, to address HIV/Hepatitis risk reduction; and 5) WINGS, to address IPV. ReVIVE will implement these EBPs in the context of MH’s outpatient treatment program along with an array of 100+ possible services to support recovery, including group and individual substance abuse and mental health treatment, comprehensive biopsychology.

The Village Virgin Islands/Susanna’s Place is a behavioral health home for 135 Afro-Caribbean and Hispanic substance abusing adult women on Virgin Islands. By blending onsite behavioral health, primary healthcare and health promotion with intensive care coordination of community-based health and social services, Susana’s Place will optimize its clients’ substance abuse, mental health and other health outcomes, and positively impact VI’s alarming HIV/AIDS burden. Susana’s Place, a project of The Village Virgin Islands Partners in Recovery, Inc./Westcare, will serve 45 clients annually in its efforts to positively impact the significant health and behavioral health disparities faced by the women of VI. The Virgin Islands has the third highest rate of people living with HIV/AIDS in the country with a rate of 688.7/100,000. While there is significant burden of substance abuse among the target population, there is limited capacity to provide treatment services on the island. VI women face other health and social disparities related to conditions such as trauma, poverty, and limited and disjointed health care. The goals of this project, each with measurable objectives, are to (1) Increase territory-wide access to minority women that reduce alcohol, marijuana, cocaine, heroin, injecting drug use (IDU), and prescription drug misuse. (2) Reduce HIV infection and transmission rates among high-risk Afro-Caribbean and Hispanic/Latina Caribbean women. (3) Address the impact of violence and trauma on Afro Caribbean and Hispanic/Latina Caribbean women’s increased risk of SUD and HIV infection. (4) Increase access to HIV/viral hepatitis services for Afro-Caribbean and Hispanic/Latina Caribbean women (5) Educate and empower Afro Caribbean and Hispanic/Latina in the USVI to increase their awareness of safer sex practices. (6) Implement evidence-based interventions.

Serving Children and Adults in Need, Inc. (SCAN) is proposing to implement its Mujeres Sanas en la Frontera (Healthy Women on the Border) program to expand and enhance trauma-informed substance use disorder treatment, behavioral health, HIV/AIDS, Hepatitis, intimate partner violence, peer support and other services for high risk Hispanic/Latina women in Webb County, ages 18 years and older, including heterosexual, lesbian, bisexual, transgender, previously incarcerated women, and their significant others, who have substance use or co-occurring substance use and mental disorders and are living with or at risk for HIV/AIDS. The program will serve a total of 450 participants and their families who live in underserved areas of Webb County and will utilize evidence-based practices (EBP’s) with a high degree of fidelity. The EBP’s are Seeking Safety, Respect, Acceptance and Commitment Therapy (ACT) and Motivational Interviewing which have been modified to meet the cultural and linguistic needs of the Hispanic/Latina women. The project will provide integrated services of behavioral health treatment and HIV medical care. The program will reduce HIV infection and transmission rates among Webb County adult Hispanic/Latina women and other racial/ethnic minority groups by providing HIV and Hepatitis B and C Testing, HIV counseling and education and linkages to primary and behavioral care. The project will also link participant to psychiatric care, primary HIV care and antiretroviral treatment (ART), HIV pre-exposure prophylaxis (PrEP), primary health care, and other recovery support services. The project places high priority on addressing the impact of violence and trauma on women’s increased risk of substance use disorder and HIV infection by screening all participants for intimate partner violence assessing the level of risk, implementing safety planning and linking them to appropriate domestic violence resources.

The Targeted Substance Abuse Disorder (SUD) Treatment Capacity Expansion for Minority (Latina and Native American) women at high risk for HIV/AIDS in vulnerable U.S.-Mexico Border Communities. project (09/2016- 08/2019) aims to create a sustainable targeted capacity expansion for Substance Use Disorder treatment, behavioral health and HIV/AIDS services for minority women (Mexican-American and Native American) ages 18 years and older at high risk for HIV/AIDS in disadvantaged U.S.-Mexico border communities in El Paso County, TX(Population 835,593; 81% Latino/Hispanic). The services expansion areas include four U.S.-Mexico border communities in El Paso County, TX with little or no access to services: Clint, Fabens, San Elizario and Socorro including the women from the Ysleta del Sur Pueblo (Tigua), a federally recognized Native American Tribe. The project uses a trauma-informed approach to (1) reduce HIV infection and transmission rates and substance abuse rates among community women through implementing Evidence Based Strategies guided by the SAMHSA principles of recovery (https://www.samhsa.gov/recovery) and (2) address impact of violence and trauma on priority communities’ women’s risk for SUD, HIV and Hepatitis through culturally and regionally appropriate women and family-centered trauma-informed Evidence Based Practices to reach an estimated 5212 individuals (unduplicated for specific prevention, referral treatment and/or recovery support services). Primary, secondary and tertiary prevention strategies and services will help advance project goals. The project’s objectives are: (i)To educate and empower community women to reduce risk related to unsafe sex practices through culturally and regional appropriate, women-centered evidence-based promotora (peer) outreach education intervention;(ii) To increase access to culturally and regionally appropriate , women and family-centered HIV, Hep B&C testing and SUD and mental health prevention and/or care for at l

Although 20% of Montgomery County is African American, they account for over 50% of all HIV/AIDS cases, and the greatest increase in infection rate is recorded among African American women. In addition, over 50% of diagnosed Hep C occurs among African American residents of the county, and women are an especially high-risk group for Hep C. To address these disparities, the Substance Abuse Resources and Disability Issues (SARDI) Program at Wright State University will implement the Sisterline Project in partnership with Mount Olive Baptist Church, two African American-owned and operated behavioral health treatment agencies (Day-Mont and Cornerstone), the Public Health Department of Montgomery County, and Equitas Health (the largest HIV treatment agency in the state).

HER TURN for Health Project Summary Project H.E.R. T.U.R.N. (H = Health; E = Empowerment; R = Resiliency; T = Treatment; U = Understanding; R = Recovery; N = Network) uses a partnership model to deliver gender-specific outreach, engagement, and trauma-informed evidence-based programming (called Seeking Safety) to substance-using Black and Latino women who are at heightened risk of contracting and/or transmitting HIV. Serving the high-needs communities of Hempstead (11550), Roosevelt (11575) and Uniondale (11553) in Nassau County, NY, the program will reach and serve a total of 6,700 individuals (1,700 in the first year and 2,500 in years two and three). The proposed program, led by nonprofit Family & Children’s Association in partnership with NuHealth, Northwell Health, The Safe Center LI, and other providers will: (a) conduct mobile outreach via vehicle, using staff reflective of our communities of focus (Black/Latino women who speak Spanish and English) to identify and build relationships of trust with substance-using women; (b) assess and honor each woman’s/mother’s state of readiness for change, while rendering gender- and parent-specific programming that’s culturally attuned, (c) systematically neutralize/overcome barriers to their accessing counseling and services needed to treat trauma, mental health disorders, substance use disorders, and HIV/AIDS or HIV risk; and (d) enhance specific health outcomes by addressing financial/logistical obstacles such as childcare and transportation hurdles. The project will connect HIV+ and others to needed medical care. Projected services and outcomes: 2,500 women and/or their significant others annually will be: (1) educated / told about the services available to them, the connection between trauma and SUD, and the reasons why/how Substance Use Disorder (SUD) increases risk for HIV/AIDS; and (2) offered testing for HIV and/or Hepatitis B & C and access to this program’s other services,

Continuing its longstanding history of addressing the needs of minority HIV-positive and/or HIV/AIDS-at-risk women, The Family Center (TFC) proposes to build on its successful TCE-HIV program, Brooklyn Women Enjoying Life (B-WEL). Partnering with two local substance abuse treatment providers, B-WEL will serve 260 racial/ethnic minority adult women, including heterosexual, lesbian, bisexual, previously incarcerated women, and their significant others, who have substance use or co-occurring substance use and mental disorders and are living with or at risk for HIV/AIDS. B-WEL will serve the Central Brooklyn neighborhoods of Bedford-Stuyvesant, Crown Heights, Prospect Heights, and Brownsville, a region of profound social need. Central Brooklyn residents are 76% African American; 13% of Hispanic origin; less than 10% are non-Hispanic white. The population of focus is more likely to be unemployed, living in poverty, receiving public income support, homeless and minimally educated. Most will be mothers and most will have traumatic individual/family histories (e.g., abuse, violence, incest, rape, trafficking, repeated loss, dislocation, familial incarceration, familial drug/substance abuse, and immigration issues). B-WEL will use evidence-based interventions, including Motivational Interviewing (MI); Seeking Safety and SISTA and WILLOW. B-WEL will incorporate peers to provider Peer Recovery Coaching, case management, treatment adherence and HIV/hepatitis testing and counseling. B-WEL will serve 260 unduplicated women over 3 years. The Goals (G) and Objectives (O) are to: (G1) Reduce alcohol, marijuana, cocaine, heroin/injecting drug use and abuse of prescription drugs through implementing EBP’s; (G2) Increase women’s access to and use of trauma-informed, woman- and family-centered treatment for SUD, MH, co-occurring disorders and trauma; (G3) Address the impact of violence, trauma, substance abuse and co-occurring health needs, including HIV/Hepatitis;

Funding Opportunity: Engaging Incarcerated Minority Women at Risk for HIV/STIs during Transition into Community Health Clinics: Implementing a group-based, HIV/STI prevention intervention with linkage to trauma-informed care. Title: WORTH (Women on the Road to Health) Transitions Program Substance use disorder (SUD) prevalence in the US is up to 91.7% among women recently released (RR women) from incarceration compared to the general population at 10.0-15.4%. Yet 20.2 million people (90.1%) in the US who need treatment for a substance use disorder do not receive it. Accessing treatment is particularly challenging for women, increasing HIV and other health risks. Women’s needs are gender-specific with regard to SUD, co-occurring mental health disorders (MHD), HIV risk, and trauma treatment. This study will examine multi-level implementation factors influencing feasibility, acceptability and effectiveness of an evidence-based, trauma-specific intervention WORTH in healthcare settings serving formerly incarcerated women. The WORTH intervention is a culturally-specific, peer-based, post-incarceration model for underserved women recently released from incarceration, and who are at risk for HIV (and other infections) with co-occurring SUD and MH disorders in two Transitions Health Clinics in Rochester, NY and New Haven, CT. Additionally, the WORTH Transitions program will develop infrastructure service delivery through enhancing substance use disorder (SUD) services to women at risk in two ways. For our collaborating SUD programs, we will provide training in the evidence-based TREM system of care. Trauma-informed SUD treatment focuses on avoiding retraumatization through giving clients more control, being supportive, and ensuring physical and emotional safety, often including separate groups for women.

The Lower Eastside Service Center Inc. (LESC) Women’s Wellness Program (WWP), will enhance SUD treatment, behavioral health, and HIV/AIDS services for high risk women primarily of African American and Hispanic/Latinas (ages 18 years and older; who have an SUD and are living with or at risk for HIV/AIDS; by providing an intensive gender-specific program. Their demographic and clinical characteristics will be: 50% African-American; 30% Latino;100% will be female; either presently in treatment for their SUD; or found to be in need of treatment for an SUD; 21% will report having had unprotected sex in the past three months; 20% will report having exchanged sex for money or drugs; 19% will be found to be HIV+; nearly 50% will state they had been a victim of physical or sexual assault. The goals of the proposed WWP are: increase access to treatment specifically for disadvantaged women and therefore reduce substance use; increase motivation among target population to accept care and therefore improved health outcomes especially for those living with HIV/AIDS; through the use of Evidence-Based Practices (Seeking Safety, Motivational Interviewing, and RESPECT), decrease trauma and thereby decrease the risk of violence/intimate partner violence (IPV); decrease HIV and viral hepatitis risk and other STD-related risk through the use of education and support in the form of peer-led mutual aid support groups. It is anticipated that 225 clients will be located and screened annually for the WWP; 675 clients over the three-year span of the grant. We anticipate the first year 175 women will be encouraged to participate in the WWP; a total of 525 women over the 3-year period; 40 women will be screened and offered HIV and HCV testing as well as (1) Risk Reduction session even if they are unwilling to be enrolled in the full WWP protocol.

Project Name/Populations To Be Served: The SAMHSA funded Bronx Women’s Collaborative (BWC), expands the capacity for BOOM!Health and the partnering agencies to improve HIV-related health outcomes, and to reduce HIV-related health disparities for Black and Latina women, including transgender women, in the Bronx, New York City, who are disproportionately affected by HIV/AIDS, substance use, traumatic life events and homelessness/unstable housing. Strategies: Clearly, minority women living in the Bronx communities require adequate, flexible and integrated care incorporating and coordinating SUD and mental disorder treatment. Therefore successful intervention with minority women hinges on a combination of low threshold services (shower, meal, laundry, haircut, clean syringe, no judgment, compassion) which solidify outreach and engagement, coupled with core stabilization services that integrate HIV and HCV testing, prevention, substance abuse treatment, stable housing, health care access, and social development opportunities as part of a comprehensive approach to change the trajectory of poor health outcomes. Strategies are aligned with the Congressional Minority AIDS Initiative, the National HIV/AIDS Strategy, and will advance SAMHSA’s Strategic Initiative and the NYS Governor’s Plan to End AIDS – intentionally increasing awareness and understanding of mental and substance use disorders, and promoting emotional health and wellness for Bronx high risk minority women. Specific Interventions will involve trauma-informed approaches to HIV and HCV testing, linkage to care and retention services; evidence-based practices (Seeking Safety, RESPECT, and SISTA/T-SISTA), increasing access to ongoing recovery support, effective substance use disorder and mental health disorder treatment, and for health and social connectedness. Goals/Measurable Objectives.

PROCEED proposes to implement the Women’s Wellness and Recovery Care (WWRC) Program, a Targeted Capacity Expansion HIV: Substance Use Disorder (SUD) Treatment initiative in Union County, NJ. The WWRC Program expands SUD, behavioral health, HIV and viral hepatitis (VH) prevention and treatment services for Black women, Latinas, and their significant others residing in Union County, NJ. The purpose of the WWRC Program—a woman-centered, trauma-informed comprehensive wellness program—is to increase and enhance the number of integrated SUD/co-occurring substance use and mental disorders (COD) treatment slots and HIV/VH testing and treatment services available in Union County by employing culturally congruent and gender-responsive evidence-based, best practices to: 1) enhance outreach and engagement; 2) reduce risk of HIV/VH acquisition and transmission; 3) reduce substance misuse; 4) build life skills to support behavioral health; 5) increase access to, and availability of peer-based recovery support services; and, 6) monitor and evaluate the delivery and impact of WWRC Program activities. Using HIV and VH counseling, testing and referral (CTR) as a point of entry to the WWRC Program, the proposed initiative will provide at least 800 population of focus members (200 in Year 1, 300 in Years 2–3) with HIV testing and VH-B and VH-C screening. Participants who test HIV or VH-B/C positive will be provided with patient navigation/case management services to link them to care within 3 days and to support their retention in care. Program participants testing HIV negative but high-risk for HIV will be linked to partner sites for PrEP/nPEP services. All participants provided with CTR services will be screened for SUD/COD by counselors using Motivational Interviewing and referred to the psychiatric nurse practitioner for further evaluation. Participants diagnosed with a SUD/COD will be offered enrollment in the WWRC Program. Of the 800 women screened over the three years of the

Odyssey House Louisiana, Inc. (OHL) submits this proposal to implement the “Odyssey House Minority Empowerment Group for Addiction (OhMEGA)” project to expand and enhance substance abuse treatment and HIV prevention services for African-American, Hispanic/Latino, or other minority women who are high-risk substance abusers. OHL proposes to provide HIV testing, counseling and prevention; trauma-informed residential and outpatient substance abuse treatment; case management; and access to wraparound services, including primary health care, HIV/AIDS case management, housing support, and employment services. OHL proposes to serve 125 minority women with grant funds over the entire project period (40 in year one, 42 in year two and 43 in year three). OHL will hire a Program Manager, two Licensed Counselors, a Case Manager, and an Outreach Coordinator for the project. The project will be based in Mid-city New Orleans, LA, and will recruit the population of focus from OHL’s substance abuse treatment programs; the criminal justice system; and other community-based referral sources. Participants will have access to the full range of primary and behavioral health care services provided at the Odyssey House Community Health Center, an on-site Federally Qualified Health Center (FQHC). OHL will conduct extensive outreach in African American and Hispanic/Latina communities; and enhance services by implementing trauma-informed, evidence-based interventions. OHL’s program will be part of a continuum of care that includes comprehensive social, educational, vocational, medical, psychological, housing, and rehabilitation services. Expected outcomes include decreased rates of substance abuse and HIV risk behaviors for all project participants.HIV infection rates in New Orleans are over nine times the national median; New Orleans has the third highest rate of HIV in the country, and the HIV infection prevalence is four times greater in Orleans Parish than in the state overall

McDermott Center dba Haymarket Center, Chicago’s largest provider of SUD treatment, proposes to enhance and expand access to residential treatment for 275 primarily African American women who are addicted to opiates or other drugs, at high risk for HIV, and have experienced trauma. The project will stabilize the women’s multiple conditions and provide Medication Assisted Treatment, an evidence-based trauma intervention and recovery support.Fifteen predominantly African American communities in Chicago—from which many Haymarket clients come—have uncommonly high rates of drug arrests, violent crime, poverty, and HIV rates including new infection rates. Through this project Haymarket will fill an identified gap in services by enhancing its 13-bed Transforming Women’s Lives residential treatment program to a medication assisted treatment (MAT) unit to help reduce HIV risk in predominantly African American women addicted to heroin and other drugs (Goal 1). While in treatment, the women will receive HIV counseling and testing on an opt-out basis and will be screened and receive testing for hepatitis C (HCV) and B (HBV). A project-funded registered nurse will assist in stabilizing the women’s HIV, hepatitis, and other medical conditions; will provide education on chronic disease management and medication adherence; and will administer MAT medications under the direction of a certified physician; and help them to navigate the complex health care systems in a culturally competent manner. Women testing positive for HIV or hepatitis will be linked for medical care to Heartland Health Outreach, Test Positive Aware Network, the Cook County Health and Hospital Systems (CCHHS), or another provider of their choice. The CCHHS Department of Psychiatry will assist in recruiting women for the project and will accept women for ongoing MAT maintenance in the community once they transition from Haymarket’s residential treatment program.

New Horizons Community Service Board, Inc. intends to expand and enhance our Comprehensive Adult Treatment System Program to serve 72 minority women (annually) ages 18 years and older and their families in the West Central Health District of Georgia. As a highly experienced behavioral health services provider, we can help to reduce substance abuse and related incidences of HIV/STIs by increasing capacity and access to services. In our area, a growing trend of drug abuse like methamphetamines are increasing among adults, especially women. It is estimated that nearly 18,000 adults ages 18 years and older in the county have used an illicit drug in the past month, but less than 2% are receiving treatment. Substance abuse treatment providers, who work with and understand these adults, are ideally situated to reach out and help provide the services these consumers need. Treatment providers, through comprehensive care services can (1) screen and assess for co-occurring disorders and develop treatment plans, (2) provide evidence-based outpatient treatment and HIV and Hepatitis B/C testing and counseling; (3) provide case management including access to HIV care services; and (4) provide recovery support services. The goal of the program is to reduce substance abuse among adults by providing evidence-based services and practices. This program expands services to more at-risk adults with a primary focus on reaching more adult women of color and their families, an underserved population. The program is enhanced by adding recovery support services to all participants served. Our comprehensive, multi-strategy approach includes a number of culturally-competent strategies that include evidence-based practices like: (1) Targeted Outreach; (2) Screening, Assessment and Pre-treatment Planning integrating rapid HIV and Hepatitis B/C Testing ; (3) The Boston Consortium Model; (4) Seeking Safety; (5) Motivational Enhancement Therapy (MET); (6) Case Management; a

The Advantage Care Project Collaborative proposes to expand and enhance substance abuse treatment and recovery support services to African American Females with or at-risk of HIV living within the Northeast Georgia region. Three main components of this approach will include: expanded outreach/education and testing of the population; co-locating substance abuse and co-occurring behavioral health intervention services within HIV partner clinics; and providing peer-led care coordination and recovery support services. We expect to provide HIV/Hep (B&C) testing and community outreach to 2,250 African American females, and those who identify as such, throughout the 3-year grant period. In addition, an HIV-specific substance abuse treatment track will be developed targeting 96 HIV Positive and high risk negative individuals. The demographic characteristics of the target population include low income African American women with a history of substance abuse, trauma, and/or who have been previously incarcerated. Community partners who have committed involvement in this project include: AIDS Athens, Ryan White Specialty Care Clinic, and Athens Nurses Clinic. Project Goals & Primary Objectives include: Goal 1: Reduce HIV infection and transmission rates among high risk African American women, including reducing alcohol, marijuana, cocaine, heroin, injecting drug use (IDU), and prescription drug misuse Reduce the probability of newly diagnosed clients infecting others by (1) using evidence based interventions and best practices for HIV prevention including those specific to re-engagement in HIV care, medication adherence and risk reduction (2) linking 90% of clients to medical care within 90 days, (3) provide ongoing HIV education and be available to client as needed. Goal 2: Address the impact of violence and trauma on African American women’s increased risk of SUD and HIV infection.

WestCare Georgia’s The Woman’s Place (TWP), a non-profit program, will provide trauma-informed, substance abuse and/or co-occurring mental health and HIV/AIDS services to the most vulnerable, underserved, minority women from the greater Atlanta area, living with or at high risk for HIV/AIDS. Primarily African American women along with other minorities (ages 18 and older) will enter TWP for enhanced treatment, using evidence based practices. Women will include heterosexual, lesbian, bisexual, transgender, previously incarcerated and unemployed women, those with criminal histories, women veterans and homeless women. Women identified by WC-GA include those living with HIV/AIDS, along with those who are at high risk for HIV/AIDS and viral hepatitis (VH) from engaging in risky behaviors associated with substance abuse disorder (SUD) and/or mental illness. Women whose children are removed from their custody by the State, and those living with multiple children in shelters come to TWP. Women have sexual trauma, sexual exploitation (and trafficking) and commercial sex industry backgrounds, having sex with men for money, drugs, housing and survival. Women have a moderate to severe substance use disorder (SUD) diagnosis, and/or a co-occurring substance use and mental disorder meeting standard ASAM patient placement criteria for treatment at the outpatient level of care. Women need SUD treatment, integrated behavioral health treatment (substance abuse and/or co-occurring mental health disorder treatment), and enhanced HIV and Hepatitis C testing, as well as case managed, wraparound services with linkages to other community providers. Linkage to primary medical services and confirmatory testing for HIV and VH will be available through the local health department. Minority women enrolled in TWP have experienced behavioral health disparities and benefit from the implementation of strategies to decrease gaps in service use, increase access to care, and improve treatment and

Recovery Consultants of Atlanta (RCA) is a lead provider of behavioral health, healthcare, and HIV services to 6,000 persons in the metro Atlanta area annually (30,000 since 1999). RCA plans to enhance services with evidence-based, gender-specific, culturally-competent, trauma-informed residential treatment for 216 high-risk minority women to reduce their substance use, improve their mental health, and address other risk factors (i.e., trauma) to prevent HIV. RCA is CARF-accredited, faith-based, and peer-led and is one of Atlanta’s leading providers of behavioral healthcare and HIV services for hard-to reach populations. RCA is a multiple SAMHSA grantee, HRSA NAP grantee, and Federally Qualified Health Center (FQHC) that provides underserved populations with primary and specialized medical services. Its programs result in reduced substance use, decreased risk for HIV, housing stability, and improved health. The population of focus (PoF) is African American women living in Clayton, DeKalb, and Fulton Counties who have co-occurring substance use and mental health disorders and high risk for HIV due to homelessness, victimization from domestic violence and human trafficking, a history of other trauma exposure (i.e., ACEs), prior incarceration or institutionalization, and poverty. The catchment area accounts for 66% of total AIDS cases in GA, with 49% of cases that are not MSM. Sixty-three percent (63%) of persons with AIDS in Atlanta are Black, and 87% of all women with AIDS are Black. Substance use is highly correlated with HIV infection and transmission. Helping high-risk minority women recover from substance abuse is a critical step to preventing HIV. However, women face more barriers to treatment than men. But upon treatment completion, women have better long-term recovery outcomes than men. RCA will mitigate barriers to treatment for the PoF by developing residential substance abuse treatment that will address their unique, multiple, complex needs.

Volunteers of America of Los Angeles (VOALA), in partnership with AIDS Healthcare Foundation and Southern California Alcohol and Drug Programs, will enhance SUD treatment, behavioral health, and HIV services for adult, high risk women ages 18 and over of African American/Black, Hispanic/Latina, and other racial/ethnic minority groups who have a SUD or co-occurring disorder and are living with or at risk for HIV/AIDS in Los Angeles County, CA. Population: While a minimum of 75% of participants will be racial/ethnic minority populations, the primary focus is on African American/Black and Hispanic/Latina populations with behavioral health disorders and at high risk for or living with HIV, particularly in Service Planning Area (SPA) 8 - South Bay in LA County. Key subpopulations include heterosexual, lesbian, bisexual, transgender, previously incarcerated women, and their significant others. It is anticipated that the largest percentage of participants will be heterosexual females with 30% who are injection drug users. The service area has among the county's highest rates of binge drinking, drug use, hepatitis infection and HIV diagnosis as well as persons living with HIV. Interventions: The project aligns its treatment philosophy with the principles of the disease and problem-solving models of which client interaction will be conducted through the EBPs of Motivational Interviewing, Seeking Safety, and the Healthy Living Project for People Living with HIV. In addition to residential substance use treatment with step-down outpatient, clients will receive integrated mental health and trauma-informed care (including IPV groups), HIV prevention/testing and care, medical care, case management, and wraparound recovery-oriented supportive services and three months of aftercare to promote stability and improved outcomes. Goals & Objectives: The project will serve 40 participants in year 1 and 50 annually in years 2-3 for a total of 140 participa

St. John’s Well Child and Family Center’s (SJWCFC) Transgender Women Seeking Recovery (Trans*WSR Program) will integrate, enhance, and expand SUD treatment, behavioral health, and HIV/AIDS services in L.A. County for high-risk transgender (trans) women 18 years and older through linking in-house HIV services to in-house substance abuse disorder treatment services at both SJWCFC and Children’s Hospital Los Angeles (CHLA). With a high level of cultural and linguistic competency, the Trans*WSR program will achieve this through intentional screening, peer recovery social support services, and case management/linkage to care using trauma-informed, evidence-based interventions and practices (EBPs). Trans*WSR will leverage community partnerships to bolster infrastructure and create access to MAT, in-patient substance use treatment services, and other community resources through case management linkage such as needle exchange and legal services. The two-agency collaboration will allow Trans*WSR an opportunity to create intentional and tailored screening and services for the target population across a wide geographic area of L.A. County. The population of focus for the Trans*WSR program are low-income trans, racial/ethnic minority women (male-to-female) ages 18 years and older (and their significant others), who have substance use or co-occurring substance use and mental health disorders and are living with or at risk for HIV/AIDS who reside in L.A. County Service Planning Areas (SPA) 4 (Metro/Downtown) or 6 (South). The target population experiences substance use and/or co-occurring substance use and mental disorders, trauma, and HIV infection at disproportionately high rates compared to the general female population. The overall goal of the Trans*WSR Program is to expand integrated SUD treatment, behavioral health, and HIV/AIDS services for high-risk racial/ethnic minority women.

The HealthRIGHT 360 (HR360) Transwomen’s Residential & Networked Services (TRNS) project is an enhancement of existing residential treatment for substance use and/or co-occurring substance use and mental disorders among transwomen of color in San Francisco. TRNS creates a dedicated treatment track for transwomen, with focus on addressing trauma’s effects on the substance use, mental health, and HIV/AIDS risks of this extremely vulnerable population. The participant population will be approximately 35% African American, 20% Hispanic/ Latina, 20% more than one race, 10% Asian/Pacific Islander, and 15% non-Hispanic White. They will typically have histories of trauma (familial abuse, intimate partner violence [IPV], and assault); survival sex; homelessness and unemployment; criminal justice involvement; and substance use (primarily stimulants and alcohol). Approximately 90% will have co-occurring mental disorders. At least 10% will have known HIV infection. HIV risk behaviors, such as unprotected sex and sex work, are prevalent among transwomen of color in San Francisco. TRNS will serve 30 unduplicated individuals each year, for a total of 90 transwomen. The project will enhance existing services by providing targeted peer outreach and engagement (using motivational interviewing), onsite HIV and hepatitis testing (with linkage to medical care and care management), and a dedicated transwomen’s residential treatment track. The treatment track will include two evidence based practices to address the high need for trauma-informed services among transwomen; Acceptance and Commitment Therapy (ACT) will help reduce dysfunctional thoughts, feelings, and behaviors and alleviate the psychological distress associated with traumatic experiences; and the Boston Consortium Model (BCM) will reduce substance use, reduce PTSD symptoms, and reduce HIV sexual risk behaviors. Goal 1 is to reduce HIV infection and transmission rates as affected by substance use, measured by reported red

Epidaurus dba Amity Foundation’s Almas de Amistad project (Almas) proposes this expansion grant to provide high quality intensive outpatient substance abuse treatment to serve women and women and their children who are primarily ethnic minorities disproportionately impacted by the HIV/AIDS epidemic in the Albuquerque Metropolitan area inclusive the Five Sandoval Indian Pueblos, and the Santo Domingo Pueblo, both federally recognized tribes. Almas will provide a women-specific, trauma-informed, evidence based substance abuse and trauma curriculum (Seeking Safety) group and individual counseling; veteran-specific groups, 12-step meetings; referrals; onsite rapid HIV testing, referrals for confirmatory testing and treatment; referrals for viral hepatitis B and C testing and treatment referrals; referrals for hepatitis A & B Vaccinations; evidence-base interventions for HIV (SISTA), assistance with finding housing; adult basic education including GED prep classes, tutoring and testing; access to vocational training; workshops; and job readiness. In addition, women will receive parenting classes, family sessions, and seminars on women-specific topics such as domestic violence. Almas will also provide referrals for primary medical care, prenatal education and care, childcare education services, mental health services, and, as needed, housing assistance, food and clothing assistance, education and vocational assessments and placements as well as other wrap around services. Treatment length will vary from 3 to 12 months. Almas will collaborate with community based outreach partners that are rooted in the culture of our target population to conduct outreach. All of Almas’ services will be bilingual (Spanish/English) and will be inclusive of individuals regardless of age, gender, race, ethnicity, culture, literacy, sexual orientation, or disability. The unduplicated total of women we plan to serve is 270 over three years (90 per year). Expected objectives/outcomes

The University of Arkansas for Medical Sciences is partnering with Better Community Development (BCD) to expand and enhance prevention and treatment services available to low income, adult African American (AA) women in Pulaski County, Arkansas (AR) who

The Health Services Center, Inc. (HSC) is a non-profit 501(c)3 AIDS Services Organization that has provided HIV, viral hepatitis care, and behavioral health services in a under-served area of northeast Alabama at the epicenter of the HIV epidemic for over 20 years. In the proposed 4-HER (Health, Empowerment, and Recovery) Program, HSC will improve area behavioral health (BH) services, particularly targeting women of color and their sex and drug-using partners who are living with BH disorders (substance abuse [SA] or mental health [MH], are trauma survivors, and are living with or at increased risk of HIV disease and/or viral hepatitis [VH]). The 4-HER project also will target LGBTQ populations and veterans at increased risk of BH and trauma issues, and HIV/VH. Annually, the program will provide 150 BH screenings and 300 HIV and VH tests. A minimum of 100 persons annually (300 over course of project) will be enrolled into evidence-based, trauma-informed BH treatment and individual MH, and case management (CM) services. Ongoing linkage and retention to HIV/VH care will be provided via partnership with HSC’s Ryan-White funded Medical Care Division. The 4-HER Program will enhance and expand service access to care in an impoverished and under-resourced 14-county rural/non-urban area of northeast Alabama that currently experiences gaps in care on the HIV/VH Care Continuum. The 4-HER Program will address these issues in several ways. First, HSC will build on partnerships with local communities of color and community providers to increase networking and marketing of services. Second, HSC will provide BH screenings, assessments, and referrals and HIV/VH testing, screening, and linkage services. Third, HSC will provide enrollees two evidence-based models of behavioral health treatment, "Living in Balance," (LIB) and "Seeking Safety." Fourth, HSC will integrate HIV/VH medical care services and BH care to reduce disparities and improve client access and health outcomes. Finally