Nexus project - COPE community services, INC. (COPE) proposes the nexus program in maricopa and pima counties, AZ

Nexus will expand prevention and treatment services for historically underserved individuals at risk for substance use disorder (SUD), CO-occurring mental health disorders (COD), and infectious diseases such as HIV. Nexus will serve the community and 280 clients with overlapping concentric circles of care to reduce risk and improve the intended outcomes. Both substance use, particularly opioid use, and HIV incidence have increased arizona in the last five years. Opioid deaths in AZ have skyrocketed from 1761 in 2017 to 4076 in 2024. The increase in fentanyl use exacerbates the increase in HIV incidence; research demonstrates that use of opioids increases the likelihood of HIV transmission and accelerates disease progression (krishnan, J.M. ET AL, 2023). Pima and maricopa counties combined see the highest proportion of overdose deaths (80% of deaths in 2023 [adhs, 2024]) and HIV incidence (81% of new cases in 2022 [adhs, 2023]) in the state, and maricopa county is a priority ending the HIV epidemic (EHE) jurisdiction. Exacerbating these needs, access to coordinated care is a key GAP and top priority for both pima and maricopa counties. In response to these needs, COPE proposes to implement nexus. Nexus will expand the number of providers serving the target population, increase access to harm reduction services, and critically, provide integrated services for the conditions of focus. Nexus's syndemic approach creates multiple layers of services comprising of community prevention strategies; SUD/COD screening and treatment; and screening and referral for HIV, viral hepatitis, and stis. This approach enables the program to serve clients directly and have a broader impact by serving the communities in which they live. Based on county demographics and previous programming, IT is anticipated that clients will identify as follows: 67% men, 33% women; 40% hispanic/latino and 60% non-hispanic/latino; 70% white, 12% black, 10% two or more races, 6% american indian/alaska native, 1% asian, and 1% pacific islander. Four evidence-based treatment practices will be implemented by the fourth month of the program: motivational interviewing, smart recovery, case management, and harm reduction. The combination of experienced providers, COPE's extensive experience working with the focus population, and the effectiveness of the proposed services will ensure success of nexus's goals: 1) expand prevention and treatment services designed to reduce behavioral health and HIV disparities; 2) provide substance use prevention, treatment, and HIV and viral hepatitis prevention and treatment to vulnerable populations; and 3) improve behavioral health and risk reduction outcomes for enrolled clients. Research shows that the identified practices demonstrate effectiveness in achieving the intended outcomes: 80% maintained or improved substance use and mental health symptoms; 70% maintained abstinence or reduction in risky sexual behaviors; and 85% maintained or improved social connectedness. The targeted treatment approach will be combined with community-level harm reduction and environmental prevention strategies to affect broader change. COPE is ready to expand its current services to strengthen the intersection between traditionally siloed services. Implementation of nexus is crucial to meet the unmet need for evidence-based services to reduce SUD, COD, and infectious disease in maricopa and pima counties, AZ.