“…Previous literature has documented the relationship between stigmatization, race, healthcare access, and retention among clients who are African American, MSM and living with HIV; reasons for these consistent inequities include structural racism which propagate medical mistrust, lack of training in LGBTQ health care and diversity among providers, greater burden of barriers to care like housing insecurity, food insecurity, mental health challenges, and/or less financial resources to remain in care and virally suppressed. 16 , 18 , 22 , 38 , 41 , 42 Multi-level assessments of stigma should be prioritized to design and implement effective stigma reduction in healthcare settings for African American MSM clients 43 - 45 who have the highest rates of HIV and related negative health outcomes in the US. These poor outcomes are due to these multi-level challenges which impact their care outcomes at the individual level but require changes at the structural level.…”