This chapter builds upon Chapter 1 and discusses integrative approaches to improve research and interventions with Black sexual minority men (SMM). It critiques the overreliance on loosely applied or ill-fitting frameworks in public health studies and calls for more appropriate theoretical models that can provide meaningful solutions globally. Life Course provides the foundation and complementary social and behavioral science frameworks including the Health Belief Model, the Socioecological Model, and W.E.B. Du Bois’ Double Consciousness theory offer interdisciplinary lenses to help explain both vulnerability and resilience among this group, particularly in societies where Black SMM are racially marginalized. These theories and frameworks situate individual behavior within broader psychological, social, and structural systems that shape health trajectories over time. Positive Deviance is also discussed as an underutilized strengths-based framework in public health research. This chapter provides conceptual roadmaps for researchers and practitioners to design health promotion strategies that are attuned to the realities and needs of Black SMM in the past, present, and future and calls for a paradigm shift: from risk to context, from pathology to promise, and from individual blame to collective accountability.