Author ORCID Identifier


Date of Award

Fall 1-5-2024

Degree Type


Degree Name

Doctor of Public Health (DrPH)


Public Health

First Advisor

Dr. Carlos A.O. Pavão

Second Advisor

Dr. Sheryl Strasser

Third Advisor

Dr. Stacy W. Smallwood

Fourth Advisor

Ms. Nicole Roebuck, MSW


Black Sexual Minority Men (Black SMM), whose sexual orientation or expression differs from the presumed majority heterosexual, cisgender society, account for 37% of 36,126 new HIV diagnoses nationwide while representing two percent of the US population. Black SMM exists at this unique intersection of stigmas associated with race, sexuality, gender expression, and HIV acquisition risk. These varied experiences have drawn certain Black SMM to the HIV workforce, thus delivering health-related and social services aimed at preventing new HIV diagnoses and reducing comorbidities associated with HIV.

Considerable research exists in the inquiry to prevent HIV seroconversions or when the body produces antibodies to HIV among general Black SMM. The same cannot be said for Black SMM in the HIV workforce.

Persistent gaps remain unaccounted for as we understand how being diagnosed with HIV as a Black SMM employed in the HIV treatment and prevention service delivery may affect their practice and perspective with navigating HIV services both as a patient and as a provider. The mixed-method descriptive phenomenological study explored the following questions: 1) What are Black SMM experiences within the HIV workforce who experience HIV seroconversions [individual interviews], and 2) What is the organizational culture among the workforce providing HIV treatment and prevention services for Black SMM [survey instrument]?

Ten Black SMM discussed experiencing an HIV seroconversion while in the HIV workforce. Seven themes and nine subthemes emerged, including navigating the world [coming of age, dating, sex, and mobile applications], family [biological and chosen families], shame, mental health, health care providers [client comfortability, cultural competency, and provider identity], HIV Viral Caste System, and pleasure. The HIV Workforce Intersectional Stigma survey solicited 285 participants to assess the culture across HIV prevention and treatment services. Overwhelmingly, Black, and non-Black SMM reported HIV stigma, and shame remains present across service delivery despite advances in preventing and treating HIV among Black SMM.

Recommendations can be made with novel funding structures to Black SMM peer networks and Black queer-led organizations. These networks can prioritize pleasure-based and wide adoption of people-centered communication toward reducing seroconversions. Additional recommendations for improving confidentiality policies among service delivery organizations are encouraged.


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