Most likely it is the fuse not the ground. If you have already checked the fuse, my guess would be that if you pull the cover off the the horn or the steering wheel (after disconnecting the negative side of the battery so you don't get an airbag in your face), the ground is probably connected to the horn switch. I know this is the case with my toyota. Not positive on the Accord.
Your horn should always work, key on or off. 1999 Accord uses a horn relay. Horns themselves going bad is not uncommon.
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