Exploring “House” Networks as An Intervention Vehicle for MSM Living in the South

Background: HIV/STI disparities of African-American MSM in the South continue to persist.  Networked social structures of young MSM and transgender persons of color called “Houses” are possible vehicles for intervention technologies.

Objectives: To describe the southern House network, it’s hard to reach and mobile population and participant feedback on interventions tailored for the House community. 

Methods: Semi-structure interviews and 12 focus groups were conducted with 42 African-American House leaders, members and non-members between the ages of 18-34.  Sociocultural influences of group membership and sexual risk were also explored.

Results: Most participants were 19-25yrs, House members for ≤ 2years, and HS graduates (98%). One-third were unemployed; 12% were HIV+; 23% reported self-perceived likelihood of HIV infection.  All reported sex with men, 83% identified as gay/bisexual; 25% reported attraction to males and/or females.  Partnerships included: steady (93%), non-steady (65%), and exchange (6%). Unprotected anal sex was most frequently reported with steady (33%) and non-steady (16%) partners. However, exchange partners were more often HIV+ (16.7%) or of unknown status (66.7%).  60% reported substance use 12 months prior.  Qualitative results include reported perception of high prevalence of HIV& STDs within House community, substance use, histories of abuse and coercion, and violence at social events, between Houses and in relationships.  

Conclusions: Interventions tailored for southern MSM/transgender persons of color in House networks are needed.  House networks facilitate a sense of community, and may attract persons at high risk who also reported stigma experiences and multiple challenges.  Suggestions on developing and implementing intervention strategies for House/Ball networks include internet outreach and engagement of House/Ball leaders.  

Implications for Programs, Policy, and/or Research: Use of House networks as a point intervention has potential benefits that extend to network members, MSMs and men who have sex with women.