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Using conversation to tackle LGBTQ health issues

Using conversation to tackle LGBTQ health issues
Charles Quamina shares his story with the audience during the Baltimore in Conversation: Community Dialogue to Build Empathy Through Storytelling," at Motor House. (Karl Merton Ferron / Baltimore Sun)

Charles Quamina sat in the spotlight on a dark stage with his long, blown-out locks falling over his shoulders and told the story of how he believes he contracted HIV from a cheating boyfriend.

He said he was in love — so much so that he and his beau stopped using condoms. He sighed heavily and raised a red flag as he hit parts of the story where he should have recognized that his boyfriend was not as perfect as Quamina wanted to believe.

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The talk at The Motor House in Station North was part of "Baltimore in Conversation," an initiative by the city's Health Department to better understand the lives of lesbian, gay, bisexual, transgender and queer people and how the obstacles they face affect their health. The hope is that sharing their experiences will help foster better sexual health practices and awareness. Health officials also want to erase stereotypes and stigma about the LGBTQ community.

"Data is very easy, but storytelling brings us to the point where we are human again and we can share our deep-seated issues with each other," said Kehinde Bademosi, who coordinated the conversations initiative and handles social innovation and social marketing for the city's Bureau of HIV Services STD/HIV Prevention Program.

The city recently embarked on an initiative to have an HIV-free Baltimore, but program administrators say obstacles such as homophobia, transphobia and serophobia — fear of and discrimination against people living with HIV — create barriers that contribute to the spread of HIV. Public health officials have begun these conversations to help them understand what prevents Baltimoreans from seeking medical care, Bademosi said.

"Baltimore in Conversation" is focused on the populations most affected by HIV/AIDS in Baltimore: African-American men who have sex with men and African-American transgender persons, Bademosi said.

New HIV infections have declined across the country, including in Baltimore, but are increasing in gay men and transgender people. About 13,400 people in Baltimore have been diagnosed with HIV and more than 40 percent of new infections in the past couple of years were gay men. Infection rates by gender among transgender people are hard to track because they may identify as a man or woman. Contributing to the problem is that one in five infected people don't know they are carrying the virus.

"We are trying to listen to them and come up with ways that address their issues," Quamina said. "The whole idea is that we are breaking silence. We are making people talk."

The storytelling event was a way to get people to discuss their vulnerabilities. For example, a mother discussed accepting her son as a transgender woman, and a physician spoke about learning to better understand her patients' personal lives to better treat them.

As a physician who works with HIV-positive patients, Dr. Renata Sanders, a practicing pediatrician with Johns Hopkins Medicine who specializes in sexually transmitted diseases, HIV and adolescent medicine, said she has learned that the issues her patients are dealing with in their personal lives play a significant role in their health and in their decision whether to seek care.

"The assumption is that people need to just wear a condom," she told the crowd.

"It's not that simple if you need to negotiate a condom in your relationship. If you need a place to stay."

Sanders, an assistant professor at the Johns Hopkins School of Medicine who has a joint appointment at the Johns Hopkins Bloomberg School of Public Health's Department of Health Behavior and Society, said she pushes her patients to be honest with her and lets them know that she's not there to judge.

"I get down and dirty with my patients — and yes: I have been on Adam4Adam," she told the crowd, referring to an online dating site for gay men. "I want them to tell me their most intimate secrets. That is the only way that I can help them."

Quamina told the crowd of his struggle to come to terms with his sexuality.

He always knew he was gay. As a young boy he was attracted to a classmate named Tommy whom he would follow around the playground. He didn't want to play football. He wanted to be on the sidelines cheering. But he also had a father whom Quamina described as homophobic and who referred to gay men in derogatory fashion. To Quamina that was an indictment of himself as well.

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When he met his boyfriend, Quamina was grateful to be loved. Months later, after finding provocative pictures of his boyfriend with another man, he was forced to face reality.

"My head was torn," he told the crowd softly, looking at the floor. "I already fell in love with this man."

He was devastated when he tested positive for HIV.

"I didn't love myself enough to protect myself," he said. "I felt down, vulnerable, stupid."

Quamina suffered from depression initially but learned that HIV is not a death sentence. His family — even his now more-accepting father — helped him to cope. Quamina wanted others to know his story so they know that they too can move on.

Carlton Smith, an LGBTQ activist who attended the conversations event, said he hopes stories like Quamina's help others.

"This helps break down stigmas and open up the dialogue so people aren't suffering alone," he said.

The Health Department hopes to continue the conversation with more events like the recent one in Station North. There is also a photo project that shows LGBTQ people in their everyday lives, rather than in stereotypical images. They are turning the pictures into postcards to give out at malls, train stations and other public places.

"This will make people see our stories from a multidimensional point of view," Bademosi said. "We are also mothers. We are also teachers. We are just like you."

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Correction

An earlier version of this article inaccurately described Charles Quamina's diagnosis.

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