Perspectives of Local Health Departments Among People Receiving HIV Services in a Southern "Ending the HIV Epidemic" Region: A Qualitative Study.

IntroductionPublic health departments (HDs) are central to HIV prevention and care, yet client perspectives remain understudied. Before implementing a social network strategy within a HD, we examined how prior experiences with HDs influence engagement.MethodsWe conducted 17 in-depth interviews with Black sexual and gender minority individuals in Charlotte, North Carolina, to explore experiences with HDs.ResultsParticipants described emotional and navigational support during critical health encounters, including compassionate linkage to care and HIV/STI testing. Identity-affirming interactions and shared cultural backgrounds fostered trust and comfort. However, stigma, concerns about privacy, and intrusive exposure notifications created barriers and, in some cases, distrust of HDs.ConclusionsFindings underscore the importance of identity-concordant care and transparent communication. Tailoring partner services to address confidentiality and affirm identity is essential for public health approaches that build trust, reduce stigma, and meet the needs of underserved communities, ultimately improving engagement in HIV prevention and care.