SYRINGE EXCHANGE GROUP REACHES GAY MEN

Positive Health Project, though not typically gay-focused, finds meth users
coming forward

Late on a Monday afternoon, as the temperature was dropping, three clients
were smoking outside the offices of the Positive Health Project (PHP) on
West 37th Street.

Inside the building, staffers were meeting with clients, cleaning the
agency's drop-in center where it delivers its needle exchange services, or
busily working at computers.

It was just another day at the AIDS service organization and there was
little that indicated that PHP has joined the ranks of those agencies
battling AIDS among gay and bisexual men.

PHP and the Lower East Side Harm Reduction Center, which also offers needle
exchange services, have seen growing numbers of gay and bisexual men who are
using needles to inject meth sign on as clients to take advantage of their
needle exchange services. Both agencies have responded aggressively to meet
the needs of these men.

"In the beginning of the spring last year is when we started seeing the
numbers increasing," said Rafael Ponce, PHP's director of health promotion
services.

An estimated 45 such men signed on as PHP clients last year and the agency
has run two focus groups with ten of them to learn how to best serve this
new client population.

"There are two issues they were having with traditional gay organizations,"
Ponce said. "They were already using needles and having problems discussing
that openly. The other issue was around sex. They were having difficulty
discussing sex."

Many of the guys do not readily admit to using needles to inject meth.

"One of the things that we have seen here is guys take a while to disclose
that they are injecting crystal meth," Ponce said. "Part of the reason is
they don't want to be identified as a drug addict."

The injecting can happen when they are alone or at a private party or a sex
club. It can be part of a larger social scene with men enjoying getting high
together, injecting each other and having sex.

"The stories that I have heard are about the connection, the feeling of
connection." Ponce said. "The whole use is about being able to explore,
sexually and other things."

Ponce said that while the gay and bisexual men knew not to share needles,
they did not necessarily know that they should not share other items, such
as the water used to clean a needle or a dish in which the meth is mixed
with water before shooting.

No agency that traditionally serves the gay male community offers needle
exchange services and these meth injectors appear to be mostly interested in
getting clean needles and instruction on how to shoot safely.

Megan Beard, client services coordinator, does the intake interviews for all
of PHP's new clients. She said that most of these men came to the agency to
get free needles and to discard their used ones. The men learned about PHP
on the Web or by word of mouth.

A 2001 state law that made it legal to obtain and possess syringes though it
limits purchases to ten needles per transaction. Anyone over 18 can purchase
needles.

Given the influx of gay and bisexual men into his agency, Jason Farrell,
PHP's executive director, was struck by the recent gay community focus on
crystal that paid little attention to agencies like PHP.

"When the community was addressing this issue it reminded me of the early
days of the epidemic," he said. "It was 'It's our problem, we're going to
take care of it.' We were never asked to sit at the table."

Farrell, a former injector and a person with AIDS, founded PHP in 1993.
Currently, the agency employs 17 people and has an annual budget of $1.8
million.

In addition to needle exchange services, PHP offers health and dental care,
counseling, testing for HIV, hepatitis C and sexually transmitted diseases,
hepatitis A and B vaccinations and support groups. The agency serves a range
of clients including the transgender community.

Beginning on January 21, PHP, located at 301 W. 37th Street, will start
"drop-in hours" every Friday between 5 and 7 p.m. for gay and bisexual men
"with concerns about crystal meth." PHP wants to make its offices a more
hospitable environment for these men.

"We are not a traditional gay agency and a lot of guys are not going to be
comfortable coming here," Farrell said.

PHP has reached out to some sex clubs that serve gay men and asked to have
information about its needle exchange program and other services distributed
at the clubs. The agency has not been able to work directly with customers.

"I think it is a very difficult network to penetrate," Ponce said. "They
have not allowed us to do outreach during business hours."