Keith Holt, 25, is a youth outreach coordinator for the Baltimore… (Kim Hairston, Baltimore…)
The party for some 400 of Baltimore's gay and transgender community of color, held at a downtown hotel, included fishnet stockings and stilettos, music and dancing — as well as bowls of condoms and free HIV testing.
Inside the Sheraton Inner Harbor hotel, workers from the city and local universities were stationed at tables, armed with pamphlets about dental services, food stamps and housing, plus free goodies such as water bottles. Before guests could enter the main hall, workers approached them, promoting the benefits of HIV testing.
"If you have not gotten tested, they're doing HIV testing out there," said one of the emcees, known as Jay Blahnik, reminding partygoers to take advantage of the private tests in a quiet room off the main hall. "Please know that condoms do not protect you against everything," he added. "I'll be giving you public service announcements all night."
The November event, held for an underground scene called the "ballroom" or "house and ball" community, was sponsored by the Baltimore City Health Department in hopes of making a dent in stubbornly high HIV infection rates among young, black, gay men.
Make testing and other services easy and even fun to access, the thinking goes, and you might make inroads with this normally hard-to-reach group.
"Instead of asking for people to come to the Health Department," said Keith Holt, a 25-year-old youth outreach worker who has spearheaded the agency's initiative, "why don't we take its resources to the community?"
About 45 percent of a sample of black men who have sex with men in Baltimore were HIV-positive, a 2008 Johns Hopkins University study found, and in at least one federal study, Baltimore ranked highest among other cities in the proportion of young, black men who have sex with men who have HIV.
"It's a public health emergency," said Carl Latkin, a Hopkins epidemiologist who studies HIV prevention. In Baltimore, "if you're an African-American man and having a same-sex partner, there's a good chance, whoever they are, they're going to be infected."
Frequented largely by black and Hispanic gay and transgender youth, the ballroom scene has long been a prime target for prevention efforts in other cities. The scene is structured around "houses," groups that compete in dance and performance at "balls" for cash, trophies and status. Established in New York in the 1970s, the scene expanded to Philadelphia, Baltimore, Los Angeles and Atlanta, and was chronicled in the 1990 documentary "Paris Is Burning."
"Mothers" and "fathers" lead each house as a loose association, an alternative family in which members share an adopted, often fashion- or beauty-related last name such as Revlon, Milan or Mizrahi.
The November ball cost about $6,000 and was paid for using federal funds dedicated to disease screening, said Brian Schleter, a Health Department spokesman. At least 100 people got tested, and about 10 percent of those were HIV-positive, Schleter said. Typically, at such screening events, about 60 percent of those who test positive are successfully linked to care, he said.
'A touchy topic'
Daniel Mclean, 22, joined the local ballroom scene last year and found it a "comfortable place" where he could simply be himself in a city that has few safe spaces for openly gay men to socialize, he said.
The Health Department's efforts have helped encourage his usually reluctant peers to get tested, Mclean said. Slowly, attitudes seem to be changing.
"It used to be a touchy topic for people to even talk about getting tested," Mclean said. He was recently tested because "it just makes you feel like you know yourself."
Ballroom participants are often young, poor and have been rejected by their families after coming out as gay or transgender. A 2008 study in New York found almost half had incomes of less than $10,000. That "cluster of factors" with a potential impact on health, said Susan Sherman, another epidemiologist at Hopkins, makes outreach to the ballroom community a clever strategy for the city Health Department.
"There's a big bang for your buck when you target segments of the population that particularly have high rates of disease," Sherman said.
Tia Jenkins, a former mother of Baltimore's House of St. Clair and, at 34, a veteran of the scene, said she started attending balls at 14, during a period in which she had become alienated from her family.
"I felt different and I felt guilty," said Jenkins, a transgender woman with manicured nails and long, straight hair. Unauthorized hormones off the street or from friends helped her turn a boyish figure into a more voluptuous body, she said.
"I learned about where to get [the hormones] through the ballroom community," said Jenkins, now a student at the University of Baltimore. "The desire outweighed the risks at the time."
And, to afford the heels, dresses, makeup and travel costs needed to compete at balls weekend after weekend, Jenkins said, many transgender youth turn to prostitution.