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The Community Outreach Prevention
Effort II: Project COPE II
Research Method:
Basic Research/Intervention Research
Principal Investigators:
Merrill Singer, Ph.D., HHC (PI)
Margaret R. Weeks, Ph.D. (Co-PI)
Grant:
National Institute on Drug Abuse
(#U01 DA07284)
Partners:
Hispanic Health Council (grantee), The Hartford Dispensary,
the Urban League of Greater Hartford, Latinos/as Contra SIDA,
The Hartford Health Department
Dates of Study:
1992-1997
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Abstract
The Hartford Community Alliance for AIDS Prevention (CAAP),
which was established in 1988 and administered Project COPE
I, used lessons from that project to develop this five-year
HIV prevention study that worked with active, out-of-treatment
injection drug users and crack cocaine users in Hartford, CT.
As part of a 22-city, national Cooperative Agreement for AIDS
Community-based Outreach/Intervention Program, the study monitored
the drug use, HIV risks, and prevalence of HIV infection among
participants through interviewing, surveys and HIV antibody
testing. It also tested the efficacy of HIV-risk reduction intervention
programs, comparing a standard AIDS education program with culturally-targeted
enhanced interventions for African Americans and Puerto Rican
Latinos. COPE II also participated in the Needle Hygiene Study,
a targeted ethnographic examination of needle-related risk behavior
among injection drug users, which included observations in high-risk
sites, the collection of life histories among a sub-sample of
the population, and pre-post interviews.
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Project
Goals and Objectives
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Monitor drug use, HIV
risk and prevalence among a targeted sample of active,
out-of-treatment injection drug users and crack
cocaine users 18-years or older from selected Hartford,
CT neighborhoods. |
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Provide the NIDA Standard
Intervention, a two-session AIDS education, counseling,
and risk-reduction skills enhancement program to
all participants. |
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Develop and conduct two,
three-session culturally targeted, enhanced HIV
prevention interventions, one designed for African
Americans and one for Puerto Rican Latinos. |
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Evaluate the effectiveness
of the standard intervention program in comparison
to the culturally-targeted program for reducing
AIDS risk behaviors. |
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Compare risk behavior
reduction outcomes of the intervention programs
for various subpopulations on the basis of sex,
ethnicity, and drug use, monitoring changing patterns
of drug use and HIV risk behavior in the total population
over time. |
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Project Contact:
Margaret
R. Weeks, Ph.D., Co-Principal Investigator
Associate Director, ICR
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Project
Details/Research Findings
Focused on high-risk neighborhoods
in Hartford, project staff recruited 1,299 injection drug and
crack cocaine users into the baseline assessment. All participants
responded to an initial intake survey, received the first session
of the NIDA Standard HIV Intervention on AIDS risk reduction,
and were offered the chance to be tested for HIV. One to three
weeks later, participants were asked to return for a brief assessment
and the second session of the Standard Intervention. Following
the Second Session, participants were randomly assigned to one
of three groups: to a no further intervention group, or to one
of the culturally-based enhanced intervention groups. Approximately
770 participants were assigned to the culturally-based intervention,
and 370 attended the programs. All participants were asked to
return for an interview 6-months after the initial intake; approximately
670 participants returned for the follow-up interview.
The project found high rates of injection
drug use, particularly heroin injection, and significant crack
use in some groups, with poly-drug use by the majority of
participants. At intake, many participants revealed multiple
potential risks for HIV transmission, including use of previously
used injection equipment, unprotected sex with primary or
multiple partners, and insufficient access to sterile syringes
despite the availability of a needle exchange program in the
city and the legal access to nonprescription syringes in pharmacies.
Follow-up assessments showed significant reduction in reported
risk behaviors in all intervention groups. For example, injection
drug users reported to use pre-used needles dropped from 37.7%
at intake to 17% 6 months later. However, many participants
reported continued risk behavior and heavy drug use. Little
significant difference was evident between the two-session
standard and three-session culturally enhanced programs, suggesting
the value of short, intensive intervention, but the need for
more comprehensive and long-term programs in order to reduce
risk beyond standard efforts. The study highlighted the need
for education and intervention targeted to subpopulations
at risk given the different factors affecting women, various
ethnic and age groups, and those facing poverty in addition
to addiction and HIV transmission or other health risks.
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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:
Project COPE: Preventing AIDS Among Injection Drug Users and
their Sex Partners
Project COPE III - Longitudinal Study
of AIDS Risk Among Injection Drug Users
External Links
Hispanic
Health Council
The Urban League of Greater
Hartford
Latinos/as Contra
SIDA
The
Hartford Dispensary
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