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.”