Status Update is a public health campaign that encourages HIV and syphilis testing and safe sex among those most at-risk for infection—black gay men. We targeted the Baltimore ball scene as key influencers in the community. The ball scene is an underground LGBT subculture in which people "walk" (i.e. compete) for trophies at events known as balls. Competitors often dance and vogue while others compete in various genres of drag. Black and white photos of ball members act as testimonials on posters, transit ads, and a website. A "play safe" package of condoms and lube was also developed.

Working with representatives from the Baltimore City Health Department to develop and design ways to decrease risky sexual behavior and increase HIV and syphilis testing among men who have sex with men (MSM) at high risk for HIV and syphilis. The Bureau of STD/HIV Prevention is a program within Baltimore City Health Department charged with preventing HIV by providing testing, education, and services focused on HIV prevention. In Baltimore City, MSM are at significant risk of acquiring HIV and syphilis. According the Infectious Disease and Environmental Health Administration, there has recently been a resurgence in the proportion of newly reported HIV cases occurring in MSM in Baltimore, with a near doubling of this proportion from 15% to 30% in the last 5 years. In the BESURE study conducted in Baltimore City in 2004-2005, 40% of MSM who participated in the study were HIV-positive and 62% of HIV-positive individuals were unaware of their status. According to BCHD surveillance data, rates of syphilis are on the rise in Baltimore City in 2010 compared to 2009. The Bureau of STD/HIV Prevention has worked for over 20 years employing a variety of outreach strategies to increase rates of testing for and decrease rates of transmission of HIV, syphilis and other STDs in these high-risk men.

Our point of view was one of pride and celebration in the LGBT and ball community but at the same time promoting a desperate need for action. We wanted to create a multiplatform campaign capable of reaching young gay men that celebrated the Baltimore ball scene, provoked action, and promoted testing. Through high-fidelity photography and an in your face tagline, "Have Balls, Get Tested." We did just that. We gained insight from the health department that people did not get tested because they didn't want to have a band-aid on afterwords, which proved they were tested. We turned that stigma into a positive by using two red band-aids as a symbol for solidarity and the act of eradicating HIV and syphilis. We also conducted red carpet photo booth events at local balls to get more people involved and invested in the campaign, while also encouraging them to get tested. Members of the ball scene took ownership of the campaign as they saw themselves in it, this helped increase word of mouth and buzz around the campaign. We also advised the Health Department on how to use social media to reach the target market.

The campaign underwent a rigorous process over three semesters that involved detailed research and discovery into the epidemic, the audience, how to reach them, and finally what to say and how to say it through visual communications. The team did extensive relationship building with the Health Department and local ball community meeting with both regularly to discuss the ideas the team was developing. The team conducted a full immersion into the Ball community attending events and getting to know local participants and hosting a screening of the Ball documentary "Paris is Burning" at a local gallery. The team also conducted site visits to Health Department clinics to understand the services available to the community. The team partnered with the Health Department's STI experts and the the youth outreach coordinator who also has strong ties to the Baltimore Ball scene. The campaign was developed in multiple iterations and proposals, and was tested extensively along the way with the Health Department and local ball scene.

The value of this campaign is that it garnered enough attention to make a difference. The campaign was well received by local LGBT community and made a big splash at the annual pride parade. The campaign also received press attention in tv and print when the Maryland Transit Authority rejected the creative. According to the Baltimore Sun, "“It took, um, guts for the city health department to sign off on a slogan that is hip enough to actually serve its intended purpose.” The Health Commissioner was committed to the right campaign, not the comfortable, easy, family-friendly approach. The entire time, the Health Department showed an unwavering support for the campaign. We worked in and with the African American MSM community to build a campaign that was authentic and de-stigmatized testing. Many of the subjects were secretive due to cultural pressures but willing to star in a photo campaign and talk to their friends about testing.