HIV testing experiences and perceptions among Black transgender and nonbinary people in New Orleans, LA

HIV testing is a critical strategy to addressing the disproportionate impact of HIV among Black transgender and nonbinary (TNB) individuals in the Southern U.S. We conducted 12 semi-structured qualitative interviews with Black TNB young adults in New Orleans to explore factors influencing HIV testing experiences and perceptions. We used a socioecological framework to guide analysis and identified themes across intrapersonal, interpersonal, organizational, and community levels. At the intrapersonal level, HIV anxiety shaped testing experiences and perceptions. Peer influence and patient-provider interactions emerged at the interpersonal level, and clinic operations at the organizational level. Community-level factors included stigma, medical mistrust, and confidentiality concerns. Participants provided actionable recommendations, emphasizing the need for instrumental support (e.g., transportation), hiring and training Black TNB clinic staff, and creating culturally resonant HIV testing programs. Community-informed strategies centering Black TNB voices are critical for designing effective HIV prevention programs that honor their identities and lived experiences.