CALIFORNIA ALBUM : A Drugstore Dedicated to AIDS : The Castro Village Pharmacy has a full-time counselor and will carry costs for patients until insurance companies pay. Owner plans to open outlets in Southland.

Here in the heart of the city’s gay and lesbian community is the first drugstore of its kind, a high-tech, state-of-the-art pharmacy dedicated to treating a single disease: AIDS. With the proliferation of costly new medications, a growing number of AIDS cases and the increasing longevity of patients who have the disease, the Castro Village Pharmacy has opened its doors to a community in desperate need of help.

Unlike most conventional drugstores, the new pharmacy has a full-time counselor on the staff, offers home delivery and will carry thousands of dollars in monthly costs for each patient until insurance companies pay up.

Even though the small store has been operating in the Castro District only a month, owner Paul Morabito, a gay 28-year-old former investment banker, is planning to open 11 more across the country, including one in West Hollywood and another in South-Central Los Angeles.

“This drugstore is designed to be a responsible member of the community,” Morabito said. “The community has accepted me. What I want to do is continue to prove that you can’t forget anybody.”

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The Castro District has been changed by AIDS more than any neighborhood in the city. Longtime residents say the gay presence has diminished, and the community optimism that defined the district in the 1970s and ‘80s has given way to gloom.

“There are a lot more straight people in the neighborhood because so many people have died and their apartments have come open,” said Robert Baxter, a counselor at 18th Street Services who was found to have AIDS eight years ago. “You see a lot of baby carriages you never saw before.”

Service agencies have found it harder to recruit volunteers to help care for those with AIDS. With the focus on preventing the spread of the disease, those infected with the human immunodeficiency virus often feel that they have been forgotten.

“I don’t really find a sense of community in the Castro,” said Baxter, who has lived in the neighborhood for five years. “I think it’s changed. I think a lot of people had more hope a few years ago that something more would be done.”

On the average, four people die of AIDS each day in San Francisco. And each day, three more people in the city are infected with the virus, city health officials say.

Altogether, an estimated 27,665 residents carry the virus--nearly 4% of the population, according to the San Francisco Public Health Department’s Office of AIDS. Of these, 3,500 are being treated for full-blown AIDS and as many as 7,000 more have begun taking medications to delay the onset of disease.

Just getting prescriptions filled for as many as nine medications can be an ordeal for some.

For the ill, it can mean exhausting trips to drugstores or the hospital. For the able-bodied it can mean taking valuable time off work. And for those with inadequate insurance, it can mean paying large sums up front.

“It shouldn’t be surprising that an innovative effort such as the Castro Village Pharmacy would originate with San Francisco,” said San Francisco Supervisor Roberta Achtenburg, a lesbian who is Morabito’s lawyer. “Everyone in the community will tell you it is so needed.”

For many people with AIDS and HIV, the new drugstore is one of the few bright spots in the Castro.

“I left feeling that I had found a business that truly cared about our community,” wrote customer Everett Denman in a letter to a local gay newspaper. “Castro Village Pharmacy is not just another business, they are truly a service to the community.”

Along one wall of the pharmacy are dozens of sophisticated automatic pill dispensers that can quickly fill large prescriptions for AIDS-fighting drugs such as AZT, DDI and DDC. Computers and fax machines link the pharmacy with doctors’ offices. Medications and intravenous infusions are delivered to the homebound.

Next to the pharmacist’s counter, a counselor can hook up patients with insurance and health care services. Nearby is a large bulletin board with health information, community announcements and a special place for notices posted by two gay activist groups, Queer Nation and ACT UP.

“You do it right and they’ll come,” Morabito said. “There’s nothing wrong with having a win-win situation, with having a business that’s here to serve people.”

For a small pharmacy to deal in such costly drugs would be impossible without special help from McKesson Corp., the huge San Francisco-based pharmaceutical supplier.

Although McKesson usually requires pharmacies to pay for drugs within 15 days, the company is extending credit to Morabito so that he can hold off payment until the pharmacy is reimbursed by insurance companies, sometimes months down the line.

Marvin Krasnansky, a McKesson vice president, said that as the nation’s population ages and home treatment of illness becomes increasingly common, the Castro Village Pharmacy could provide a model for the health care industry: specialty drugstores for the chronically ill.

Attracted by the idea, McKesson is providing Morabito with financial backing for his plans to expand AIDS-focused pharmacies to Los Angeles, New York, Chicago, Boston, Dallas, Houston, Miami and Washington.

“He has looked at the needs of the clientele and has developed a system and philosophy of doing business that is going to make it convenient,” Krasnansky said.

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Morabito, who moved to San Francisco from Toronto two years ago, said he discovered the problem of getting prescriptions filled when he went to a Walgreens in the Castro District to buy two rare drugs prescribed by his doctor for obesity.

The pharmacy was unable to fill the prescription, he said, leaving him frustrated. Talking with an AIDS patient in line behind him, he learned that some had to pay cash for expensive drugs while others had to wait overnight to get their medications.

Morabito said he left the store and, in a burst of spontaneity, rented a building around the corner to start his own pharmacy. Now the two are competitors.

For years, the Walgreens has been the main source of drugs for AIDS patients in the neighborhood and, according to store officials, the chain store will work hard to keep its business.

“I don’t think they can be more compassionate than we are. I don’t think they can be more knowledgeable than we are,” said Mike Meracle, the Walgreens store manager. “But if there is anything we can improve on, we will improve on it. If it makes us sharper, then good for them.”