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There is little information about HIV among transgender women in Jamaica, who are also overrepresented in the Caribbean epidemic. HIV\u2010related stigma is a barrier to HIV testing among Jamaica's general population, yet little is known of MSM and transgender women's HIV testing experiences in Jamaica. We explored perceived barriers and facilitators to HIV testing among young MSM and transgender women in Kingston, Jamaica.<\/jats:p><jats:p><jats:bold>Methods<\/jats:bold>: We implemented a community\u2010based research project in collaboration with HIV and lesbian, gay, bisexual and transgender (LGBT) agencies in Kingston. We held two focus groups, one with young (aged 18\u201330\u00a0years) transgender women (<jats:italic>n<\/jats:italic>\u00a0=\u00a08) and one with young MSM (<jats:italic>n<\/jats:italic>\u00a0=\u00a010). We conducted 53 in\u2010depth individual semi\u2010structured interviews focused on HIV testing experiences with young MSM (<jats:italic>n<\/jats:italic>\u00a0=\u00a020), transgender women (<jats:italic>n<\/jats:italic>\u00a0=\u00a020), and community\u2010based key informants (<jats:italic>n<\/jats:italic>\u00a0=\u00a013). We conducted thematic analysis to identify, analyze, and report themes.<\/jats:p><jats:p><jats:bold>Results<\/jats:bold>: Participant narratives revealed social\u2010ecological barriers and facilitators to HIV testing. Barriers included healthcare provider mistreatment, confidentiality breaches, and HIV\u2010related stigma: these spanned interpersonal, community and structural levels. Healthcare provider discrimination and judgment in HIV testing provision presented barriers to accessing HIV services (e.g. treatment), and resulted in participants hiding their sexual orientation and\/or gender identity. Confidentiality concerns included: clinic physical arrangements that segregated HIV testing from other health services, fear that healthcare providers would publicly disclose their status, and concerns at LGBT\u2010friendly clinics that peers would discover they were getting tested. HIV\u2010related stigma contributed to fear of testing HIV\u2010positive; this intersected with the stigma of HIV as a \u201cgay\u201d disease. Participants also anticipated healthcare provider mistreatment if they tested HIV positive. Participants identified individual (belief in benefits of knowing one's HIV status), social (social support) and structural (accessible testing) factors that can increase HIV testing uptake.<\/jats:p><jats:p><jats:bold>Conclusions<\/jats:bold>: Findings suggest the need for policy and practice changes to enhance confidentiality and reduce discrimination in Jamaica. Interventions to challenge HIV\u2010related and LGBT stigma in community and healthcare settings can enhance access to the HIV prevention cascade among MSM and transgender youth in Jamaica.<\/jats:p>","DOI":"10.7448\/ias.20.1.21385","type":"journal-article","created":{"date-parts":[[2017,4,7]],"date-time":"2017-04-07T08:28:50Z","timestamp":1491553730000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":93,"title":["Barriers and facilitators to HIV testing among young men who have sex with men and transgender women in Kingston, Jamaica: a qualitative study"],"prefix":"10.1002","volume":"20","author":[{"given":"Carmen 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