Understanding how BMSM, who represent less than 1% of the U.S. population, but account for over one-third of new HIV infections annually, practice seroadaptation can inform new interventions to improve their engagement in HIV services. To this end, we conducted a qualitative study (called the “PhotoUStudy”), which was guided by a conceptual model, the BMSM Intersectional Identity Framework Over the Life Course (BMSM Identity Framework). Thirty-six BMSM who lived in/accessed health services in Washington, D.C., aged 18-65, were recruited into a five-day photovoice activity and follow-up interview.