Project S.A.F.E. (Stay AIDS Free through Education), the HIV prevention arm of the Cleveland Treatment Center, was established as a research program in 1989. It was a joint effort with Cleveland State University, the Cuyahoga Drug Addiction Services Board, and the City of Cleveland, Department of Health, to become one of twenty-one national sites for the National AIDS Demonstration Research (NADR) Projects. The project was funded by the National Institution on Drug Abuse (NIDA). The primary purpose of the NADR Project was to determine whether a single street intervention performed by street and community outreach workers was as effective as multiple interventions performed at the site office. Project S.A.F.E. operated as a street and community based outreach program that encouraged high-risk individuals to participate in the research portion of the project. Outreach workers distributed culturally specific pamphlets, condoms, bleach and provided health education and risk reduction interventions regarding HIV/AIDS/STDs/TB to hard-core African American injection drug users and their sexual partners in the Greater Cleveland area. The NADR project ended in 1992 and Project S.A.F.E. changed is operation focus from research to service.

Since that time, Project S.A.F.E’s outreach teams have provided health education and risk reduction interventions to the hard-core injection and non-injection substance abusers and their sexual partners, heterosexuals and at-risk youth in the Greater Cleveland area. Our teams know the city, the copping areas, and the target population. Additionally, CTC utilizes the Diffusion of Effective Behavioral Interventions (DEBI) strategies to provide HIV/STD prevention services. The DEBI project was established by the Center for Disease Control in 1999 and incorporated into Project S.A.F.E’s outreach and prevention efforts in 2001. DEBI interventions have proven effective through research studies that showed positive behavioral and/or health outcomes. The implementation of effective interventions related to effective HIV prevention has been a critical part of building capacity at Project S.A.F.E. and to successfully engage populations at risk to HIV/STD/Viral Hepatitis and Tuberculosis. For example Project S.A.F.E operates the Being A Responsible Teen (B.A.R.T.) DEBI program, which is designed as a risk reduction intervention/education strategy that primarily works with youth ages 14-18, male and female, who reside in the Cuyahoga County Detention Facility. Other diffusion of Effective Behavioral Interventions utilized are: Safety Counts, and RAPP. (See attachment 1 for description).

What is your agencies experience in providing services to the target population?

As an Opioid Agonist outpatient Treatment Program CTC has served injection drug users and other substance abusing populations for over 35 years. Cleveland Treatment Center was incorporated as a non-profit organization in 1971. The Cleveland Treatment Center is located in the downtown business district where it has operated since its inception. The Cleveland Treatment Center is certified by the Ohio Department of Alcohol and Drug Addiction Services. CTC is the only fully accredited service provider in Northeast Ohio by the Commission on Accreditation on Rehabilitation of Facilities (CARF) as an Opioid Treatment Program (O.T.P.) and Prevention/Diversion: Alcohol and other Drug Addictions-Adults Program.

The Cleveland Treatment Center provides the following services: Individual Group Counseling, Assessment, Medical Evaluation/Social Vocational Rehabilitation, and Case Management for addicted pregnant women, Outpatient Opioid Treatment and Educational/Prevention Services and, through Project S.A.F.E., HIV/AIDS Outreach and Prevention services that includes testing.

What is the experience and training of your HIV prevention staff.

The Cleveland Treatment Centers, Project S.A.F.E staff, collectively has over 37 years of experience in the HIV/AIDS behavioral health field. Each staff member has received “Basic” HIV/AIDS Training from the American Red Cross. The staff has also received the following trainings: Ohio Department of Health-HIV Prevention Counseling, Center for Disease Control-(D.E.B.I. training) Diffusion of Effective Behavioral Intervention, Center for Disease Control and the Academy of Educational Development, California STD/HIV Prevention and Training Center-Healthy Relations, Ohio Department of Alcohol and Addiction Services-Rapid Testing. Additionally, the staff regularly receives in-service training from HIV/AIDS service providers, treatment facilities and health care providers. Listed below are the DEBI Intervention trainings that the current staff have received.

Project S.A.F.E. has been an Ohio Department of Health (ODH) approved HIV testing site for several years. Project S.A.F.E. works closely with the Disease Intervention Specialist (DIS) at the Cleveland Department of Public Health. When our testing efforts locate a positive individual, the DIS department is contacted and all efforts are made to link the client with the DIS in efforts to provide partner notification. A newly identified positive individual can experience several emotions. Several times the outreach worker who tested them is the only person that knows their HIV status. The newly identified person relies on the Project S.A.F.E. staff member to link them to services and other opportunities. The outreach worker will accompany the positive individual to meet with the DIS and often to other linked services. This ensures that the client enters into the systems available to positive individuals. It also provides reassurance to the outreach worker that the linkage to services was followed through.