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Project COPE: Preventing AIDS Among
Injection Drug Users and their Sex Partners
Research Method:
Basic Research and Intervention Research
Principal Investigators:
Jean J. Schensul, Ph.D. (PI), Merrill Singer, Ph.D. (PI)
Grant:
National Institute on Drug Abuse
(#R18-DA05750)
Partners:
Hispanic Health Council (HHC), The Urban League of Greater
Hartford, Latinos/as Contra SIDA, The Hartford Dispensary,
Hartford Health Department
Dates of Study:
1988-1992
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Abstract
The late 1980's showed an increase in HIV infection within urban
communities, and a particularly high rate of risk among injection
drug users (IDUs) and their sex partners. A common belief was
that, unlike gay men, IDUs would be unresponsive to AIDS prevention
education. This four-year, Hartford, CT-based study dispelled
that belief while also examining the drug use patterns and AIDS
risk behavior among IDUs and their sex partners. The project
assessed their AIDS risk, and offered HIV education, antibody
testing and counseling. It also provided and studied the effects
of an enhanced, culturally-specific AIDS prevention intervention
aimed at African Americans and Puerto Ricans/Latinos. The project
developed a five-organization community-based consortium that
included both research and service organizations. COPE was part
of the National AIDS Demonstration Research (NADR) project,
one of 29 similar studies across the nation. |
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Project
Goals and Objectives
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Conduct HIV/AIDS prevention
outreach education with drug users in Hartford. |
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Examine and document
the patterns and lifestyles of active drug users
in the city, including demographic and historical
drug use patterns, sexual behavior, drug treatment
histories, health status and AIDS knowledge. |
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Provide basic AIDS 101
education and HIV counseling and offer voluntary,
free HIV antibody testing to all participants. |
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Test the impact of three
comparative HIV/AIDS counseling enhancement programs;
one culturally targeted for African Americans, one
for Puerto Ricans/Latinos, and one standard, non-culturally-specific
program. |
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Conduct follow-up assessments
with participants six months after baseline to evaluate
the programs' effectiveness in reducing AIDS risk
behaviors. |
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Project Contact:
Margaret
R. Weeks, Ph.D.
Associate Director, ICR, and Director, Project Cope
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Project
Details/Research Findings
Through the use of street outreach, Project COPE provided HIV/AIDS
outreach education to over 4,000 drug users in Hartford, and
recruited 934 active injection drug users and their sex partners
into the study. Participants were interviewed at in-take and
then again at 6-months to assess the impact of the intervention
on their behavior. All participants received AIDS 101 education,
and nearly 400 received an additional, enhanced intervention
in one of the comparative programs. The project found high frequency
of drug injection and use of multiple drugs with most participants
injecting cocaine, heroin and speedball (a combination of heroin
and cocaine) on a daily basis. There were differences in drug
use patterns by sex and ethnicity. Women in the project consumed
more drugs than men and were more likely to inject every day.
Of female drug injectors, 74% used heroin, 61% cocaine, and
66% speedball on a daily basis. In comparison, the percentage
of male drug injectors using daily heroin, cocaine, and speedball
was 59, 51, and 50, respectively. African Americans in the study
were more likely to inject cocaine while Latinos and Whites
favored heroin. Latino study participants reported the highest
overall injection drug use frequencies: 57% injected cocaine,
72% heroin, and 61% speedball on a daily basis. The study also
found low rates of condom use, and a relatively high prevalence
of HIV, particularly among injection drug users. There were
slightly better outcomes for AIDS risk reduction behavior changes
among those who received the culturally enhanced counseling
programs than among those who received the Standard or just
the AIDS 101.
The project resulted in two subsequent
projects, Project COPE II, which
ran from 1992-1997, and continued the implementation and evaluation
of an enhanced model of AIDS prevention against a standard
program for lowering AIDS risk among injection drug users
and crack cocaine users in Hartford. Project COPE
III was a Longitudinal Study of AIDS Risk Among Injection
Drug Users, tracking COPE II participants to assess their
HIV risk reduction behaviors over time.
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Link
to Research Methods page
Link
to Basic Research Methods page
Link to Intervention
Research Methods page
Links to other ICR projects:
Project COPE
II - Testing Standard versus Enhanced Interventions
Project COPE III - Longitudinal Study
of AIDS Risk Among Injection Drug Users
Links to other related
sites (external links)
Hispanic
Health Council
The Urban League of Greater
Hartford
Latinos/as Contra
SIDA
The
Hartford Dispensary
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