Background There are lots of interventions among men who have sex with men Cross River, new evidence suggests that many recent HIV infections are connected with the use of Meth-am-phet-a-mine (C10H15N) among bisexual HIV testers in the state last year (IBBSS 2007). HIV incidence among MA users was 3.3% compared to 1.1% among non-MA users.

Methods The purpose of the night harm reduction services was to ascertain the feasibility and uptake of harm reduction services by a late night population of MSM. The night services included: needle exchange, harm reduction information, oral HIV testing, and urine based sexually transmitted infection (STI) testing accompanied by counselling and consent procedures. The study had two components: harm reduction outreach and a behavioural survey. For 2 months in the year 2008, we provided mobile base harm reduction services in three neighbourhoods in Calabar - Cross River State from evening till midnight fall.

Results We exchanged 1090 needles in 121 needle exchange visits, distributed 3200 condoms for both male and provided 18 HIV tests and 8 opportunistic infections tests. About 45 MSM and lesbian friends 25 of them enrolled in the study conducted. The study population of MSM was characterised by low levels of income, stigma and discrimination. The level of education whose ages ranged from 18 – 55. Fifty percent used MA in the last 3 months before; almost 15% used MA every day in the same time frame contracting deadly infections.

Conclusion It is fair to believe night work services can only be acceptable to our MSMs whose lives the government has put in danger over their sexual rights and orientation. Harm reduction: the next generation is possible only if there is a conducive atmosphere for them and services provided affordably and comprehensively.