Men who have sex with men (MSM) in the U.S. South face a disproportionate burden of HIV yet remain underserved in traditional prevention and care pathways. Stigma, structural inequities, and limited access to culturally competent services contribute to poor engagement across the HIV care continuum. These barriers are exacerbated by resource-constrained settings such as the rural South.

Efforts to reduce HIV incidence have been bolstered by biomedical tools such as pre-exposure prophylaxis (PrEP) and increased availability of HIV self-testing kits. PrEP is highly effective at preventing HIV acquisition when taken consistently, yet uptake remains low among MSM in the South, particularly among Black and Hispanic populations. Similarly, while HIV self-testing offers privacy and convenience, its implementation raises concerns about follow-up care and emotional preparedness.

In parallel, the rise of mobile health (mHealth) platforms has introduced new opportunities to bridge gaps in HIV prevention and treatment service delivery. Yet the effectiveness of these tools depends on their cultural relevance, accessibility, and integration with the broader healthcare system. This study explores how MSM in South Carolina (SC) perceive and navigate HIV testing, self-testing, treatment, and mHealth-connected services, with attention to how these factors intersect with their lived experiences. Understanding these perspectives is critical to designing interventions that are responsible for the unique barriers and facilitators shaping HIV engagement in this population.