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City of SecretsChristopher Myers

City of Secrets (continued)

Activist Adrian Ross, 26, agrees that a simple, broad test-and-treat message is probably best: “Take a message targeted to the ballroom community. What is a D.L. [down-low] or ‘straight-identifying’ [MSM] going to know about the ballroom scene? Nothing. What he does, he does in the dark, fast and quick.”

Whether Tobin’s efforts have a long-term effect on Baltimore’s MSM HIV crisis remains to be seen, but what all sides agree on is that any inroads will need tremendous community buy-in. Identifying and gaining the trust of the key stakeholders is where the game is really at. MSM are taking leadership positions in the community for their friends and other young men who need support.

In Baltimore, being educated, tested and treated for HIV is a hit-or-miss proposition. The city’s school system barely touches upon the subject. For the inner-city African-American MSM community, comprehensive, one stop test-and-treat shops sensitive to their issues are hard to find. Single-focus, free clinics can be so obvious that to be seen there is the scarlet-letter equivalent of saying, “Oh … you, too.”

It’s no wonder Latkin says, of the overall academic, city and state public health push to engage the African-American MSM community in HIV awareness, there’s no coherent plan. “There’s inadequate monitoring of what’s going on in the community. We don’t know when people drop through the cracks,” says Latkin. “If someone is treated at Hopkins but then goes to University of Maryland, we don’t know, they may be lost. Maybe there’s too much testing in the community and not enough linkage to care. Or maybe one group has been inundated with [“get tested”] messages every day and another hasn’t gotten a message in months. It’s completely fragmented, how we approach it, and this leads to huge inefficiencies and lack of effectiveness.”

Acting Baltimore City Health Department deputy commissioner Patrick Chaulk, MD, MPH ’89, says the city is doing its utmost to provide testing and care. As in other U.S. cities, individuals who receive a positive diagnosis at a Baltimore City health facility are referred to a care provider. “But we take it a step further; if you get diagnosed we have same day referral in which we drive you to a provider, wait for you to get everything done, and then drive you home,” says Chaulk. “We do two of those visits in the first six months [after an HIV diagnosis]. I don’t know of any other city that does that.”

Still, with Baltimore missing a major grassroots African-American MSM-oriented organization like Washington, D.C.’s Us Helping Us, the movement to bring a message of hope and cohesion to those most at-risk has landed squarely on the shoulders of those with the most energy and awareness: the city’s African-American gay youth.

Before he could become an AIDS activist, Tavon Vinson first had to survive the emotional plunge following his diagnosis. Vinson and his doctor believe he was infected by a contaminated needle during a neighborhood cleanup. Regardless of how HIV got into his body, he still had to deal with it. He was nearly driven to suicide by the isolation he felt, but Vinson rallied, thanks in large measure to being invited to a gathering of positive-status youth in Denver by Melody Lynch, an outreach coordinator at Hopkins’ Harriet Lane clinic.

There, Vinson discovered that his status wasn’t a reason to be distraught, that all around him were hundreds of vital young people who could even joke about their status while taking care of themselves. At a talent show there, he read a poem he’d written. It would change his life. The poem, which chronicled his experiences post-diagnosis, won him national recognition and led to a book of poems on lifestyle and HIV titled Positively Me.

Vinson, who was part of the club scene when he first came out, recalls that HIV hung over the crowd like a specter, acknowledged but unspoken. “We were aware, but we didn’t talk about it,” says Vinson, now 22. “And if people were positive, many weren’t going to tell,” and risk being ostracized from having relationships.

“A dear friend became positive, and he never knew until he had full-blown AIDS. It changed my life, and got me out in the community to get people tested.”
—Adrian Ross

Comments

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  • Mary M. Thomas

    Sch. of Public Health 10/03/2012 10:14:47 AM

    Well written and very informative. This is an mind opening article.

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