Abstract / Summary
Despite the effectiveness of pre-exposure prophylaxis (PrEP) for HIV prevention, Black gay and bisexual men (GBM) have disproportionately low uptake and adherence. One major barrier is intersectional stigma—the overlapping impact of racism, heterosexism, and HIV-related stigma—which significantly hinders their engagement with HIV prevention services. Much of the literature has examined healthcare experiences such as patient-clinician communication, but less attention has been paid to the spaces that patients occupy before those encounters. Waiting rooms in particular could serve as unaddressed sites where stigma is experienced and internalized. Drawing from 45 in-depth interviews with Black GBM between the ages of 18 and 34 in Washington, DC, and Jackson, MS, this study explores how intersectional stigma manifests in the waiting rooms of HIV prevention facilities. Three key themes regarding how waiting rooms contribute to intersectional stigma were identified: (1) lack of privacy, (2) stigmatizing behaviors by staff, and (3) environmental and symbolic cues signal devaluation and poor quality care. Findings highlight the need for interventions to eliminate intersectional stigma within healthcare environments, particularly waiting rooms, to improve PrEP engagement for Black GBM.