Despite the prevailing consensus on the role that stigma and discrimination play in limiting access to HIV prevention technology, discouraging HIV testing, and impeding access to HIV care, studies that focus on structural interventions to address stigma and discrimination for gay, bisexual, and other men who have sex with men and transgender women are surprisingly uncommon. We aimed to identify the outcomes from a coordinated set of community-led advocacy initiatives targeting structural changes that might eliminate barriers to HIV care for gay and bisexual men and transgender women in five African and two Caribbean countries. We conducted a prospective evaluation that included repeated site visits and in-depth semistructured interviews with 112 people with direct knowledge of project activities, accomplishments, failures, and challenges. Using outcome harvesting and qualitative analysis methods, we observed that over the 18-month implementation period, local advocacy efforts contributed to enhanced political will on the part of duty bearers for ensuring equitable access to HIV care, increases in the availability of affirming resources, improved access to existing resources, and changes in normative institutional practices to enable access to HIV care. Evidence on Project ACT points to the vital role community-led advocacy plays in addressing stigma and discrimination as structural barriers to HIV care.

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Black women in the United States continue to be disproportionately affected by the Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) epidemic. HIV/AIDS activism among Black women for Black women may be one solution to reduce the disparate rates of HIV/AIDS among Black women. However, little is known about what processes and experiences prompt Black women to participate in HIV/AIDS activism. In this paper, I aim to identify mechanisms of empowerment for Black women to engage in HIV/AIDS activism. I draw upon empowerment theory as a theoretical framework to guide analysis of the literature and to offer a strengths‐based perspective on Black women's efforts to reduce the spread of HIV/AIDS. An extensive literature search was conducted to identify studies of Black women's participation in HIV/AIDS activism. The search yielded 11 studies that were included for review. Synthesis of the literature indicated the following analytic themes as mechanisms of empowerment for Black women to participate in HIV/AIDS activism: relationships and interactions with others, critical awareness, self‐reflection, and spirituality. Article limitations, suggestions for future research, and implications for social change are also discussed. Overall, findings from this study suggest that there are unique mechanisms that facilitate psychological empowerment and prompt Black women's entry into HIV/AIDS activism.

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