Black women are a diverse and dynamic group with varying experiences and social realities. Yet, many Black women navigate multiple forms of anti-Black racism at the intersections of sexism, homophobia, transphobia, immigration status, and other systems of discrimination. This reality produces and sustains social and economic inequalities such as barriers to accessing education and employment, inadequate housing, and conditions of poverty. These social determinants of health play a fundamental role in shaping Black women’s risk environments, limiting their ability to autonomously negotiate prevention and treatment practices and creating access barriers to quality HIV services.