House and Ball Community in Baltimore Maryland: The Benefits of Targeted Testing in an Age of Universal Testing

issues: The CDC recommends routine HIV testing for all people ages 15 – 65 years old.  However there may be benefits to targeted testing for high-risk populations such as young African American men who have sex with men (AAMSM), transgender and especially members of the House and Ball community. We describe the experiences of a Health Department’s (HD) annual “Mini-Ball” for members of this population.

description: Since 2010, the HD has sponsored a “Mini-Ball” for members of the local House and Ball community. The event attracts over 500 attendees with over 100 participants agreeing to dual HIV/syphilis testing each year.  The annual number of new HIV infections at the event ranges from 4%-6%. This rate is higher than the annual yield for new HIV diagnoses from other HD testing strategies: STD clinics – 0.75%; Emergency departments – 0.33%, and non-Mini Ball outreach – 0.5%.

lessons learned:  Targeted testing focused on the House and Ball community has produced the highest yield in new HIV infections identified over the past 5 years.  Consistent with national trends, we found that young AAMSM continue to have the highest rates of new HIV infections. Targeted testing at the Mini-Ball has continued to be successful, thanks to the relationship fostered with the House and Ball community through focus groups and key informant interviews.

recommendations:  Other urban health departments should consider targeted outreach to organizations representing sexual minorities, specifically AAMSM, to expand access to HIV testing.  Such strategies can effectively complement universal testing efforts in other settings.