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Gay families share resources with one another, such as mentorship, financial support, and emotional support, and also facilitate new social network connections among MSM. Gay families are similar to houses in that they offer social support, and resilience that legitimizes friends as family relationships. Gay families are also important to the LGBT community but are not synonymous with the house ball community. As many as 50 houses are recognized nationally and ball events are held throughout the year in various cities across the country. House members use adopted surnames synonymous with well-known fashion designers or icons and compete at balls for awards based on talent, fashion, and performance. House ball communities have historically served as important sources of identification and a foundation of support to LGBT persons who forge new kinship ties via friendships in large cities in the USA. “Houses” refer to a familial structure and “balls” are events at which members congregate for social support and entertainment. The house and ball community is a form of constructed families composed of young black and Latino LGBT individuals. However, each of these groups is considered form of constructed families because friends refer to each other as family using traditional kinship terminology and offer social support to members. Recently, there has been increased attention within HIV prevention to house and ball communities, and to a lesser extent, other forms of constructed kinship such as gay and pageant families which are distinct from the house ball scene. Studies have noted that constructed families are social ties which may occur after LGBT experience adversity or disassociation from families of origin. David Schneider first described these relationships as forms of fictive kinship among LGBT in the 1980s. Constructed families are comprised of unrelated individuals who consider one another family and provide social support, rights, statuses, materials, and other duties for members.
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Constructed families have historically played an important role in human society, as noted in a number of anthropological studies of social groupings worldwide, wherein people manipulate social ties to form new definitions of family. Many black MSM belong to social groups that are important to the gay, lesbian, bisexual, and transgender (LGBT) community such as constructed families. In New Orleans in 2015, 75% of new diagnoses were men who reported having sex with men, 66% were black, and more than half were among individuals younger than age 35. In 2014, Louisiana ranked second and New Orleans ranked third for HIV case rates per 100,000 people, and 71% of all new diagnoses were among African Americans who only make up approximately 32% of the state’s population. The epidemic within Louisiana and New Orleans reflects national disparities by transmission mode, race/ethnicity, and age. Young black MSM represent more new infections than all other subgroups by race/ethnicity, age, and sex. The number of MSM with HIV rises every year and remains consistently high compared to other risk groups, particularly among young MSM of color. Rates of HIV remain stubbornly high among gay, bisexual, and other men who have sex with men (MSM) in the USA, most notably in southern states. These findings significantly contribute to understanding variations in HIV risk behavior among members of constructed families. Overall, younger, white MSM who did not belong to any social groups were more likely to engage in at least one risk behavior. In addition, participants who belonged to constructed families with a family name were more likely to engage in protective behaviors including wearing condoms at last sexual intercourse. Black, Latino, and other race MSM were more likely to belong to constructed families in comparison to white MSM. In 2014, 553 MSM were recruited through venue-based time-space sampling during the National HIV Behavioral Surveillance (NHBS) in New Orleans to complete a structured survey and HIV test. In some cases, however, constructed families do not identify with a collective family name. Many constructed families are associated with a family surname which is informally adopted by members. Many young black MSM belong to constructed families (i.e., the house ball community, gay families, and pageant families) which are often organized in a family structure with members referred to as parents and children. Gay, bisexual, and other men who have sex with men (MSM) represent more new HIV infections than all other at-risk populations.