**Abstract**

Structural racism is a fundamental cause of health disparities in the United States among racial/ethnic and sexual/gender minorities. Although there are well-documented disparities in the access of HIV prevention, care, and treatment services, the impact of structural racism on HIV/AIDS remains not well understood. The purpose of this chapter is to provide a detailed description of (1) the theoretical underpinnings of the link between structural racism and HIV, (2) a review of the evidence of these associations, and (3) a culturally appropriate, trauma-informed agenda that addresses intersectional, multi-level structural racism and its myriad manifestations to reduce HIV vulnerability for racial/ethnic and sexual/gender minorities, particularly Black sexual minority men.

**Keywords:** structural racism, structural discrimination, Black MSM, men who have sex with men, MSM, Black sexual minority men, pre-exposure prophylaxis (PrEP), human immunodeficiency virus (HIV), sexual and gender minorities, racial and ethnic minorities, stigma and discrimination
