Based Organizations in the Medical
Social Sciences: A Case Study of a
Gay Community's Response to the
Johannes P. Van Vugt
The purpose of this chapter is to examine the effectiveness of community based organizations ( CBOs) in AIDS (acquired immunodeficiency syndrome) prevention. The subject studied is the response in the Orange County, California, "gay1 community"2 to the AIDS epidemic in a community based program, the Stop AIDS Project.3 By reviewing the formation of this CBO, attending its meetings, and conducting follow-up interviews with participants, data are collected on the experience that gay men have of the AIDS epidemic and what they perceive to be the effectiveness of the community based project. By allowing the participants to speak for themselves, this study illustrates how, through community based programs, information on AIDS and human immunodeficiency virus (HIV) transmission can be communicated in a form culturally acceptable to that community. It also provides the researcher with information on sexual behaviors, attitudes, and meanings needed for designing a culturally sensitive prevention program.
I begin by defining community based organization as used in this chapter, contrasting it to an approach of a centralized authority that merely disseminates information. Next, the history of CBOs, similarities with group therapy and models of behavior change, and earlier indications of the requisite and effectiveness of CBOs in AIDS prevention are reviewed. I then describe this case CBO, the subject population, method of data collection, analysis, and results. This chapter concludes with suggestions for designing effective prevention programs.
By CBO I mean a self-directed organization whose goal is to meet the community's self-defined needs. The CBO is located within the community, its leadership comes from the community, and it is staffed by members of the community being observed. In this case the goal is to halt the trans-