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Community Outreach Prevention Effort COPE III - Longitudinal Study of AIDS Risk Among Injection Drug Users
Research Method: Basic Research
Principal Investigators: Merrill Singer, Ph.D., HHC (PI),
Margaret R. Weeks, Ph.D. (Co-PI)
Grant: National Institute on Drug Abuse (R01 DA11359)
Partners: Hispanic Health Council
Dates of Study: 1998-2001

Abstract
Research on HIV risk with out-of-treatment injection drug users (IDUs) has led to considerable understanding and implementation of effective, short-term intervention programs that reduce risk for HIV/AIDS and other sexually-transmitted diseases among this high-risk population. However, there is little understanding about the factors (individual, peer and community) that affect sustained risk reduction and/or relapse into high risk behavior among IDUs. This three-year study focused on understanding the patterns of individual and group risk among out-of-treatment IDUs in Hartford, CT, and the factors that influence the shifts towards both higher and lower risk cycles. Working with participants from Project COPE II, the study used structured surveys and ethnographic interviews and observations to track risk behavior changes over time, evaluating how factors such as drug availability, health status, criminal justice involvement, the cycle of addiction, and drug treatment history affect HIV risk. The study also looked at the causes of study attrition which is frequently high in drug using populations.

Project Goals and Objectives


	Assess individual, peer, and social context factors promoting sustained HIV risk reduction or risk behavior despite intervention, and HIV risk relapse among out-of-treatment injection drug users and non-injection crack cocaine users.
	Examine HIV risk and drug use patterns over time and in relationship to life events and changes not specifically related to formal risk reduction efforts
	Assess the factors contributing to study attrition and/or continued participation in intervention and data collection, and assess the potential impact of attrition on research findings.

Project Contact:
Margaret R. Weeks, Ph.D., Co-Principal Investigator
Associate Director, ICR

Merrill Singer, Ph.D., Principal Investigator
Hispanic Health Council

Project Details/Research Findings
The project used the 1,299 participants of Project COPE II, recruited between 1992-1996 through street outreach to targeted neighborhoods, as the sample cohort for Project COPE III. As part of COPE II, all of the participants completed an intake interview on drug use, HIV risk behavior and health status, and 882 returned for follow-up interviews 6 months later. For Project COPE III, staff worked to recruit the original 1,299 participants for two interviews, the first upon relocation and the second 4 months later. The interviews discussed the individual, peer and social factors that affected HIV risk behavior, cycles of risk, and factors affecting research attrition. Staff recruited a total of 518 of the original participants (42%) for the first relocation interview and most returned for the 4-month follow-up. The ethnicity and gender of returning participants matched those of COPE II. Staff are currently finalizing analysis of results to better understand factors affecting HIV risk behavior and research attrition over time. However, an initial key finding indicated a significant mortality rate among participants from COPE II to COPE III: over 100 (approximately 10%) of COPE II participants had died in the two to four year period between contact.

Link to Research Methods page

Link to Basic Research Methods page

Links to other ICR projects
Project COPE: Preventing AIDS Among Injection Drug Users and their Sex Partners
The Community Outreach Prevention Effort II: Project COPE II

External links
Hispanic Health Council