Background:
To enhance the sexual health of gay/bisexual men and other men who have sex with men and to reduce the sexual transmission of HIV in San Francisco, community, university and public health leaders created a gay men's health center, Magnet.

Objective:
To describe the establishment of the center and the impact on community STD rates.

Method:
During July 2003, Magnet began providing free sexual health services that include: rapid HIV testing, syphilis testing, and rectal, pharyngeal and urethral (urine-based) chlamydia and gonorrhea testing using nucleic acid amplification tests. Magnet is located in the heart of the cultural center for gay men in San Francisco and provides an empowering, alternative to traditional clinical settings. For example, a concierge offers a menu of screening services from which clients select. The clinician discusses selections with clients and provides additional suggestions based on the client's reported behaviors. Magnet promotes the health of the gay community by offering cultural events such as art exhibits and open-mike nights. The original target was to provide testing services to 1500 men per year.

Result:
During its first full year in 2004, Magnet provided 18,947 tests during 3,622 visits. Positivity among those tested was: 3.2% HIV infection, 1.8% new syphilis, 7.5% rectal chlamydia, 4.4% urethral chlamydia, 4.5% rectal gonorrhea, 4.3% urethral gonorrhea, and 8.5% pharyngeal gonorrhea. Half of men tested at Magnet had never visited the municipal STD clinic. During 2004, Magnet identified 17% of reported cases of gonorrhea among San Francisco residents, 8% of syphilis and 7% of chlamydia.

Conclusion:
Magnet provided services to 2.4 times more men than originally anticipated and identified a large proportion of STDs in San Francisco.

Implications:
Through collaborative partnerships it is possible to create a well received and actively used gay men's health center that has substantial impact on gay men's sexual health.