Table 2.

Illustrative quotations that demonstrate the structural, social, and individual level deterrents of HIV testing

Level	Deterrent	Illustrative quotations from participants
Structural	Healthcare provider mistreatment (perceived and experienced intersectional stigma)	“When they see my chart, and they see what I’m in here for, it’s like ok, typical. I’m a Black man coming in here and being treated for an STD or STI. And the doctors comes in, that’s who passes judgement. She went in and looked at my past visits, and like, you’ve been here for this thing on this date, and this other thing on this date. And yea, you know I need to stop doing what I’m doing. But I’m thinking, b#### are you passing judgement on me right now? What are you doing? So I guess you can say I’m stigmatized.” (Will, age 27, HIV-negative, not using PrEP)
		“It’s just like, it’s more like the feeling you’re getting is not very friendly, so like I really wouldn’t go there anymore. I just feel bad vibes in there. It’s just kind of like…I wanna say its racist…or maybe they don’t like gay people…” (Marvin, age 29, HIV positive)
	Lack of HIV testing locations	“There is only one place to get tested in my town, and that is the hospital. I don’t want to get tested there. I shouldn’t have to drive an hour and a half just to get the services I need. I need more options close by.” (Kenny, age 24, HIV negative, using PrEP)
Social	Privacy and confidentiality concerns (anticipated intersectional stigma)	“The fear of my family finding out that, uh, cause I was very big on not having a lot of people in my business at that point in time, especially being that, hey not only am I last sleeping with women, I'm sleeping with men too. So, if somebody finds that out, then it's, oh, well, at least you're getting tested, but why are you getting tested? Who have you been sleeping with this question, that question, that third question. And so, it was that kind of, that fear that set in.” (Ricky, age 22, HIV negative, not using PrEP)
		“A lot of people, especially in my area, the health department is somewhat far off the highway and is fairly close to [redacted university]. However, when you’re looking at the deeper part of the community, a lot of people either don’t know where it is, don’t know what options are open, and are kind of nervous. I’ve been scared to go in the past because I may see somebody I know, I’d rather not.” (Ricky, age 22, HIV-negative, not using PrEP)
		“When I was probably like 16 or 17, I had like a little scare or whatever. Because someone that I was messing with, it was actually my boyfriend at the time, they didn’t have it, but we were having unprotected sex at that point. And I wanted to get tested, but I didn’t. I didn’t go to the doctor because I didn’t want my family to know what was going on because I’m pretty sure that my doctor would end up telling my family about it.” (Nathan, age 30, HIV positive)
Individual	Low perceived risk of HIV	“I was just really careful. Like really careful (laughs). Prior to my diagnosis, I had only been tested one other time. I think I was maybe 17 at that time, so I wasn’t too sexually active. I always used protection. Like always. I wish I would’ve known more information.” (Jerry, age 28, HIV-positive)
		“So when I got in the relationship I was in with my ex and it went on for a few years, I was not getting tested in the relationship, because in my mind we were mutually exclusive. I already knew that he was positive and that he was undetectable, so I was not getting tested. And after that relationship I didn’t have any others. So, um, I wasn’t getting tested regularly.” (Louis, age 28, HIV positive)
	Fear of receiving a HIV-positive diagnosis	“You have to look a certain way, you have to make a certain amount of money. They have to be a certain race. You have to be a certain height, shape, color, all of that and I don't conform to anything. I've run into a few troubles with that, like finding love or finding, sexual relations or something of that nature. Having it [HIV] would make it even harder. It's really turned me off about the gay community and I don't associate.” (Seaburn, age 30, HIV-negative, using PrEP)
		“Knowing that I guess at that time scared and didn't want to know. It's like I wasn't educated and prepared for it. I was like man I don't want to know. If I did how would I deal with it, what do I do? If I did have HIV, how would I deal with it?” (Boris, age 30, HIV-negative, using PrEP)