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Background <p>Young Black sexually minoritized men (YBSMM) are a key population for Ending the HIV Epidemic though their care engagement is limited due to inequities shaped by social determinants of health. This study explores clinic experiences and preferences among YBSMM in Chicago to inform implementation of equitable care delivery interventions for this key population.</p> Methods <p>In-depth-interviews were conducted with <i>N =</i> 24 cisgender YBSMM aged 18–29, across HIV serostatus, who were part of the Neighborhoods &amp; Networks (N2) cohort in Chicago, Illinois, USA. The interview protocol examined barriers and facilitators to clinic engagement as well as ideal clinic experiences among YBSMM, with questions informed by the Health Equity Implementation Framework (HEIF). Four coders independently analyzed interview transcripts using rapid qualitative analysis (RQA), applying a deductive approach to identify care delivery practices to promote health equity for YBSMM across HEIF domains.</p> Results <p>Equal proportions of YBSMM were living with and without HIV (mean<i> =</i> 24.9&#xa0;years, SD = 2.5). Barriers and facilitators to clinic engagement and experiences included clinic location and internal clinic environment. Participants’ clinic experiences and perceived quality of health were shaped by person-level factors such as provider demeanor as well as patient and provider identities (i.e., sexual orientation and gender identity). YBSMM reported divergent experiences of stigmatization within clinic settings, involving both LGBTQ stigma and HIV stigma. Resources such as financial and transportation assistance as well as sexual health materials and snacks facilitated positive clinic engagement and were desired as part of an ideal clinical environment for YBSMM.</p> Conclusions <p>YBSMM cited comprehensive, non-judgmental healthcare and resources as crucial to improving their clinic experiences and engagement. Participants emphasized that differentiated and person-centered care approaches were key for facilitating YBSMM’s continued engagement along the status-neutral care continuum. Offering basic needs resources, financial assistance, and other incentives as part of a low threshold model may enable clinics to better engage and retain YBSMM in care. This study identifies multi-level factors within the HEIF that can guide future research as well as implementation of low threshold clinics that center lived experiences of YBSMM.</p> Trial registration <p>Clinical trial number: not applicable.</p>

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Health equity for young Black sexually minoritized men through their eyes: a qualitative study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年4月20日

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  • Jordan Victorian,
  • Mayra Malagon,
  • Alicia Dawdani,
  • Marie Grace Giramahoro,
  • John A. Schneider,
  • Alida Bouris,
  • Jade Pagkas-Bather

摘要

Background

Young Black sexually minoritized men (YBSMM) are a key population for Ending the HIV Epidemic though their care engagement is limited due to inequities shaped by social determinants of health. This study explores clinic experiences and preferences among YBSMM in Chicago to inform implementation of equitable care delivery interventions for this key population.

Methods

In-depth-interviews were conducted with N = 24 cisgender YBSMM aged 18–29, across HIV serostatus, who were part of the Neighborhoods & Networks (N2) cohort in Chicago, Illinois, USA. The interview protocol examined barriers and facilitators to clinic engagement as well as ideal clinic experiences among YBSMM, with questions informed by the Health Equity Implementation Framework (HEIF). Four coders independently analyzed interview transcripts using rapid qualitative analysis (RQA), applying a deductive approach to identify care delivery practices to promote health equity for YBSMM across HEIF domains.

Results

Equal proportions of YBSMM were living with and without HIV (mean = 24.9 years, SD = 2.5). Barriers and facilitators to clinic engagement and experiences included clinic location and internal clinic environment. Participants’ clinic experiences and perceived quality of health were shaped by person-level factors such as provider demeanor as well as patient and provider identities (i.e., sexual orientation and gender identity). YBSMM reported divergent experiences of stigmatization within clinic settings, involving both LGBTQ stigma and HIV stigma. Resources such as financial and transportation assistance as well as sexual health materials and snacks facilitated positive clinic engagement and were desired as part of an ideal clinical environment for YBSMM.

Conclusions

YBSMM cited comprehensive, non-judgmental healthcare and resources as crucial to improving their clinic experiences and engagement. Participants emphasized that differentiated and person-centered care approaches were key for facilitating YBSMM’s continued engagement along the status-neutral care continuum. Offering basic needs resources, financial assistance, and other incentives as part of a low threshold model may enable clinics to better engage and retain YBSMM in care. This study identifies multi-level factors within the HEIF that can guide future research as well as implementation of low threshold clinics that center lived experiences of YBSMM.

Trial registration

Clinical trial number: not applicable.