Exploring health and wellbeing in the US House/Ball Community: A systematic review

Introduction: The House Ball Community (HBC) has a longstanding, unique history and place among the LGBTQ community. HBCs provide spaces where gender and sexual minorities find support, acceptance, and freedom for self-expression. Although the HBC has been the focus of extensive HIV-related research and intervention, a more holistic view of HBC member health is important. The purpose of this systematic review is to identify health- and wellbeing-related research studies among HBC members to inform future practice. Methods: A systematic review of literature published between 2006 and 2016 was conducted utilizing keywords applied to the CINAHL, PubMed, PsycINFO, and ProQuest databases. Inclusion and exclusion criteria were applied, and articles were scored by multiple reviewers utilizing a developed scoring guide. Results: The review yielded 19 peer-reviewed full-text articles that met search criteria. A majority of studies were qualitative in nature and nearly half of the studies were based in Los Angeles. Studies of house structures and of HIV prevention were most common, followed by supportive social networks and structures, HIV interventions and new prevention approaches, and partnerships and collaborations. Three studies specifically identified stigma, resilience, and access to health care as factors contributing to the health status of HIV-positive individuals. Conclusions: The majority of HBC health research has focused on HIV prevention in urban areas. Future research should examine other health issues (e.g., mental health and substance use) to develop a more robust understanding of HBC health and foster opportunities for developing a variety of health interventions for the HBC.