Optimizing a Bio-behavioral Intervention for Sustained Viral Suppression

Inclusion Criteria: * be at least 18 years of age * be able to provide informed consent * be eligible to receive free HIV care services in Mexico * be HIV positive * have injected drugs in the last 30 days * not be on methadone replacement therapy * be willing to discuss MAT uptake with a peer * sign a medical release form to have medical data abstracted * agree to submit and describe locator information * agree to return to follow-up visits * able to communicate in Spanish * screen positive for depression on the PHQ-2 * have no plans of moving outside the study area in the next 12-months * meet one of the following: 1. not currently in possession of ART or not taking ART but prescribed ART or 2. sub-optimal ART adherence as at least one 4-day treatment interruption in the past 90 days or 3. sub-optimal retention in HIV care - never engaged or disengaged from HIV care as 2 or more missed clinic appointments in the last 9 months or 4. no viral load test done in the past six months or 5. self-reports a detectable viral load within the past 6 months Exclusion Criteria: * has not injected drugs in the last 30 days or do not have a verifiable opioid use disorder * is not HIV positive * is receiving methadone * is unwilling to discuss methadone uptake with a peer * does not screen positive for depression * is not able to provide informed consent * does not speak Spanish * has plans to move out of the city * does not qualify to receive free HIV care services in Mexico * has an appearance of psychological disturbance or severe cognitive impairment that could limit understanding of study procedures as determined by study staff