The Community Outreach Prevention Effort (COPE) Program is a three-year AIDS prevention demonstration project. COPE was developed by a community-based research and treatment consortium for implementation in Hartford, Connecticut. The purpose of the project is to develop and evaluate the effectiveness of culturally specific educational and counseling interventions in preventing the spread of AIDS and reducing at- risk behaviors among three behaviorally defined groups identified as being at high risk for HIV infection: intravenous drug users, their sexual partners, and postitutes. The project stems from recognition that: a) Hartford is a unique site for the development of culturally specific AIDS prevention because the majority of the city's population is Black and Hispanic and these two groups contribute disproportionately high percentages to the city's AIDS cases; b) the IV drug population in the city currently is the major source for new infection; c) conventional AIDS prevention may be inappropriate and ineffective with ethnic minority populations; and d) there is a national need for the development of evaluation of culturally appropriate AIDS interventions. The project is designed to build a city-wide network for outreach to, referral of, and recruitment efforts with, individuals from the three target populations. This network consists of community outreach workers, community-based organizations, drug treatment agenices, and community health clinics. Referral of these individuals to an assessment center for screening, HIV serum testing, pre- and post-test counseling, and random referral to one of three AIDS prevention projects. The three interventions developed and tested in this project are: a) a standard, nonculturally specific intervention run by a methadone treatment center, b) a culturally targeted intervention designed for Black clients run by a Black community-based organization; and c) culturally targeted intervention designed for Hispanic clients run by a Hispanic community-based AIDS prevention organization. The project will recruit and assign a sample of 700 participants for: education/counseling structured in the following way: 300 Blacks, (200 to the Black intervention and 100 to the standard intervention), 300 Hispanics (200 to the Hispanic intervention and 100 to the standard intervention) and 100 whites (all to the standard intervention). The project research staff will perform both process and outcome evaluations of the three interventions and compare findings across interventions. Outcome measures will include changes in: seropositivity, AIDS knowledge, as-risk sexual practices, needle use/sharing patterns, program participation, morbidity and mortality. Pre- and post-test data for all subjects will be compared and paired comparisons will be made between the culturally targeted and standard interventions. Multivariate linear models will be tested to predict various outcomes. Project findings will be disseminated at the local, state, and national levels and recommendations developed for the implementation of culturally appropriate AIDS prevention for ethnic minority populations.
| Singer, M (1993) Knowledge for use: anthropology and community-centered substance abuse research. Soc Sci Med 37:15-25 |
| Singer, M; Jia, Z; Schensul, J J et al. (1992) AIDS and the i.v. drug user: the local context in prevention efforts. Med Anthropol 14:285-306 |
