Abstract
Objectives This qualitative study used the Consolidated Framework for Implementation Research (CFIR) to examine how stigma emerges in HIV prevention services for young Hispanic/Latino sexual minority men in North Carolina.Methods In-depth interviews were conducted with n = 14 community- and clinic-based providers between November 2023 and July 2024. Interviews were analyzed using a hybrid deductive-inductive approach.Results Findings identified multi-level factors shaping stigma experiences and practices. In the Outer Setting, sociocultural beliefs, discriminatory policies, and preventive care norms facilitated stigma, undermining trust and engagement in HIV prevention. Within the Inner Setting, organizational culture, physical space, accessibility, and workforce representation influenced whether services felt safe and trustworthy. Individual biases, limited awareness, stigmatizing communication, narrow biomedical framings of HIV risk, and inflexible service designs further reinforced stigma. Implementation processes that emphasized inclusive messaging, routine sexual health discussions, intentional workforce planning, and ongoing stigma-reduction training were described as opportunities to disrupt stigma across all CFIR domains.Conclusion Stigma in HIV prevention for young Hispanic/Latino sexual minority men emerges across policy, organizational, and interpersonal levels. Implementation strategies that promote inclusive messaging, routine sexual health conversations, representative staffing, and ongoing training may help reduce stigma.