Health service providers should provide late night servicesfor gay men, concludes a study which tested the feasibility of offering suchthings as HIV testing, counseling and needle exchange during predawn hours.

Rose and her research team from the city's AIDS Officenicknamed their work the "Late Night Breakfast Buffet" study. Thebuffet - offered inside the confines of a van parked in the Castro, PolkStreet, and South of Market areas on different nights - included harmreduction counseling, clean needles, condoms, lube, water, juice, and Clif barsdonated by the company.

The research team conducted its street outreach last fall,working between the hours of 2 and 5 a.m. Over the course of a six-week period,they saw 600 clients, had 233 people request needle exchange services, exchanged2,000 needles, and handed out 4,500 condom and lube packets.

"There are hundreds of men out and about between 2 and5 a.m. I was very surprised by how many people we saw," said Rose, who,along with her team, presented the study results at the October 13 meeting ofthe HIV Prevention and Planning Council.

"The Castro can be quite hectic at 2 a.m. in themorning," added Ari Max Bachrach, project coordinator for the study."The Castro proved to be a spot to do it. Maybe that population is notgetting hit by those services."

The team suggested Magnet, the gay men's health center on18th Street, as an ideal place to offer late night services. The team parkedits van Fridays in the Castro right outside Magnet's doors. HPPC members agreednot only would Magnet make the most sense, but also funding should be set asideto pay for late night services.

However, when asked how many of the HPPC member's agencieswould offer late night services, few raised their hands. When asked if any hadincluded such services in their funding proposals, none said they had. HPPCmember Frank Strona suggested the city make offering late night services arequirement in order for agencies to receive funding.

Steve Gibson, Magnet director, said during Magnet's planningprocess, what hours to be open was a key part of the discussion. Its advisoryboard said the center needed to be open and accessible when gay men are in theCastro, and Gibson said that does include late hours.

"We can't be a 24-hour clinic even though people wouldcome to us 24 hours," said Gibson. "I have always had as a goal latenight or extended hours."

While he would not disclose the details because no agreementhas been finalized, Gibson did say he is in talks to find a partnership withanother agency to offer late night needle exchange at Magnet.

"I am trying to get creative with resources to helpmake services, including access to needles, more widely available to gay men inthe Castro," he said.

Stop AIDS Project Executive Director Mark Utterback said hisagency "absolutely" would offer late night services if it had thefunding and capability to do so. The agency is looking to purchase a van and isasking private donors to cover the estimated $40,000 cost to buy the vehicle.Stop AIDS plans to offer both HIV and STD testing, but would not be equipped todo needle exchanges, inside the van.

Over the course of the six weeks, the researchers noted thatsome of the men made repeat visits to the van, bringing along friends. If thestudy was longer, Bachrach speculated that the results would be even moretelling of the need for late night services.

While the 600 clients in the late night services study had"a minimal uptake" of testing services for HIV and sexuallytransmitted diseases, 21 people did test for HIV, with six returning for theirresults. Two people tested positive, with one "successfully linked"to HIV health and social services. As for STDs, only 12 people got tested, withfour returning for their results. All tested negative.

According to the study, the low interest in testing stemmedfrom the fact it was confidential. Most clients preferred anonymous testing aswell as rapid testing. Rather than having to return for test results, the studyfound most of the men said they wanted to have their results that night.

"It is not anonymous primarily because it is easier forthem as well as us. Our clients really aren't that concerned about confidentialtesting," said Gibson, who noted clients are only required to provide aname.

As part of its research, the team did interview 55 men andasked them questions on a number of issues. The men had to be older than 18,had engaged in sex with a man within the last three months, and able to belocated, whether at an address or street corner, for a follow-up interviewthree months later.

A majority, 51 percent, were white men, with 24 percentLatino, 15 percent black, 7 percent Native American, 2 percent Asian, andanother 2 percent citing other ethnicities.

Regarding the men's socioeconomic status, 38 percent fellunder the federal poverty level. Thirteen of the men said they dealt drugs tomake a living while 25 reported sex work, four of whom were HIV-positive. Asfor their living situations, 12 reported owning a home, 23 were homeless or onthe streets and 20 said they were marginally housed either at hotels or stayingwith friends.

On average, the men reported having nine sexual partners(whether male or female) in the past three months. All 55 of the men reported"ever" being tested for HIV, while 17 said they had never been testedfor an STD. Eleven had had an STD in the past year. Sixteen were HIV-positive,nine of whom were currently receiving care.

When asked about using drugs, 78 percent had used speed inthe last 90 days, 69 percent alcohol, 40 percent poppers, and 29 percent GHB.Thirty-two had been in drug treatment, while 17 said they needed treatment now.However, of those, eight said they did not want treatment while three said theywere on waiting lists.

"At the Castro site what surprised me was it was themost often site for needle exchange. People were using it," said Bachrach."We also had a couple of groupies who were really psyched to see us outthere. They would come by every week to chat."

One problem the researchers faced, which an agency with asecure setting presumably would not, stemmed from the fact they did not have astorefront to work out of and instead used a mobile van. The team had to loadand unload the van every night, cutting down on the number of hours they couldbe present on the streets; the van was broken into; and one night they foundthemselves locked out of the van.

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