Street HIV outreach to engage unsheltered populations in treatment (SHOUT) - cornell scott-hill health corporation (CS-HHC) will serve 275 (75 year 1; 100 a year in years 2 and 3) unsheltered…

Street HIV outreach to engage unsheltered populations in treatment (SHOUT) - cornell scott-hill health corporation (CS-HHC) will serve 275 (75 year 1; 100 a year in years 2 and 3) unsheltered individuals with substance use disorder (SUD) who are at-risk for or have HIV/aids by providing integrated behavioral health care, HIV treatment, and prevention services to recipients "where they are"-in the streets, in tent encampments, in parks, under bridges, etc.-to improve their health and quality of life. CS-HHC, a federally qualified health center, offers integrated medical (including infectious diseases [ID]), behavioral health, and dental services to over 55,000 people annually-of whom 2,730 are people experiencing homelessness-in connecticut's greater new haven area. CS-HHC provides street outreach and integrated treatment services to people experiencing unsheltered homelessness (PEUH) in the region. -project name: street HIV outreach to engage unsheltered populations in treatment (SHOUT) -population to be served: the project will offer integrated primary care, ID treatment and prevention, and behavioral health services to PEUH who are at risk of or have HIV. Aidsvu (aidsvu.ORG) shows that the new haven-milford MSA has particularly high rates of people living with HIV (458 per 100,000 people), but that underestimates the risk in the city of new haven alone. In the five city of new haven ZIP codes (06510, 06511, 06513, 06515, and 06519) where most of our services will occur, the rate of people living with HIV is much higher at 1,112; 1,319; 895; 984; and 1,166 per 100,000, respectively. These high HIV prevalence rates coincide with an area with many PEUH, many of whom are at risk of or have HIV. For example, the local united way's coordinated access network (can) estimates that about 600 individuals in new haven are "literally homeless", with 80% camping in parks, under bridges, along roadsides, etc. We anticipate that project clients will consist largely of racial and/or ethnic minorities (black and/or hispanic) who are living in poverty. -strategies/interventions: the project will use evidence-based practices (EBPS), such as SUD and mental health screenings, HIV screening, STI treatment and screening, prep, harm reduction (including condoms), motivational interviewing, case management, recovery coach, and medication assisted treatment (mat). Treatment will be trauma-informed and occur in the field; at our SUD treatment facilities, the recovery and wellness center (RWC), with its 52-bed therapeutic shelter component, and our south central rehabilitation center (SCRC), with its residential detox programming and methadone maintenance services; and at our main care site where our infectious diseases department is based. For those not ready for a higher level of service, we will meet them "where they are" and provide them with harm-reduction services at multiple points of access. -goals and objectives: the project's main goals are to: 1) hire project staff; 2) increase access for PEUH to basic primary care and ID services; 3) provide PEUH with low-barrier SUD/mental health treatments; 4) increase STD screening, testing, education, and treatment for PEUH with SUD who have or are at risk of HIV; 5) provide recovery coach, wraparound services, and/or harm reduction to encourage recovery. Key objectives include: 1) hiring a program coordinator, clinician, street outreach worker, and recovery coach to implement the project; 2) engaging 275 PEUH for primary care and ID treatment in the three-year project period; 3) providing SUD and mental health screenings for 80% of PEUH to determine appropriate level of intervention; 4) providing 80% of PEUH with HIV/STI testing, treatment, and prevention services in the three-year project period; 5) providing PEUH with recovery services, referrals/linkages, and harm reduction materials to keep 75% engaged at their appropriate level of recovery at six months. -number of people served: the project will serve 275 people over the three-year project period.