The sexual health of Black women has been compromised by racial and discriminatory healthcare practices from slavery through current medical and institutional barriers to care. This paper proposes a conceptual framework that identifies the link between stigma, gendered racism, and historical underpinnings that contribute to ineffective healthcare utilization of Black women diagnosed with the chronic sexually transmitted infection (STI), genital herpes. This paper also draws attention to different social factors that act as barriers to effective healthcare utilization and influence the health outcomes of Black women beyond individual factors. Using a socio-ecological framework, this paper reviews multi-level (i.e., individual, interpersonal, community, and institutional/policy) influences of the experience of genital herpes among Black women. Recommendations are provided to improve the ability of health systems and medical providers to deliver appropriate services to diverse populations, thereby improving healthcare utilization and reducing disparities for Black women.