Results from this study help to characterize what contributes to mistrust of the healthcare system and healthcare providers to negatively affect PrEP use among young Black MSM. We used a team-based approach to thematic content analysis to understand how racism and homonegativity affected healthcare access and experiences. Focus group transcripts were transcribed verbatim and coded using MAXQDA qualitative analysis software. Focus group topics included participants’ knowledge and perceptions of PrEP, perceptions and stereotypes about PrEP users, and general healthcare utilization patterns and behaviors. In late 2017 and early 2018, we conducted six focus groups with 44 Black MSM ages 16–25 in Milwaukee. This study aimed to uncover how young Black MSM’s perceptions of, and experiences with, health care contribute to low engagement in the healthcare system and low PrEP utilization. These disparities may be due, in part, to medical mistrust and mistreatment within the healthcare system. Young, Black, gay bisexual or other MSM are significantly less likely to use PrEP than their White counterparts.
