Epidemiologic research methods are generally not designed to capture the cognitive, social, and structural realities that influence health behaviors and related outcomes, especially for Black sexual minority men (SMM). For this population, health decisions and outcomes are influenced not only by health knowledge, but also by accumulated experiences of stigma, homophobia, and trauma. These emotional, psychological, and behavioral effects are not entirely visible from statistical results. Moreover, Black SMM generally distrust researchers and clinicians partly because they believe researchers do not fully understand their experiences. Autoethnography can help address this gap by positioning researchers to engage with or reflect shared experiences and vulnerabilities of target populations to generate insider insights into how target groups navigate their social ecology across the life course. This chapter draws on my published autoethnography in which I servedas both principal investigator and peer change agent in an NIH-funded HIV prevention intervention, and shows how autoethnography can strengthen intervention design, deepen participant engagement, and generate new insights into the lives of Black SMM. The chapter discusses how the roles of researcher, participant, and interventionist can collapse when one occupies multiple identities within the research context, producing both tension and healing. Rather than positioning autoethnography as a departure from health scientific rigor, I suggest that this research method functions as a significant complement to epidemiologic methods by generating insider perspectives that illuminate how stigma, agency, and “structural factors” influence health behaviors. Drawing on reflection, community engagement, and teamwork, this chapter demonstrates how autoethnography can extend the methodological toolkit of public health research. This positions autoethnography as a scientifically grounded, culturally responsive, and ethical approach to advance health equity for Black SMM.