This study will examine the influence of actual and perceived immigration laws on US Latino and Hispanic immigrants' willingness to utilize, and actual utilization of, services for HIV testing and two additional stigmatized conditions of public health significance that are explicitly addressed in US immigration laws - alcohol and drug use disorders (AODD) and intimate partner violence (IPV). Specifically, we will examine how US Latino and Hispanic immigrants' concerns about preserving requisite health, character, and financial standing for US residency and/or their desire to avoid government attention or detection of their own or a loved one's undocumented status, can deter those at risk for HIV infection from seeking HIV testing and seeking services for AODD and IPV, when appropriate. Study participants will be adult, Spanish-speaking, non-citizen (documented and undocumented) Latino Hispanic immigrants to the US living in one of four US metropolitan areas, Chicago and Los Angeles (more welcoming/inclusive immigration policy environments) and Phoenix and Charlotte, NC (more restrictive immigration policy environments). The sample composition in each city will reflect the demographic profile of Hispanic immigrants in each metropolitan area in terms of age, gender, national origin and documentation status. In the first phase of this 3-phase project, in-depth individual and focus group interviews with local key informants and immigrant residents will highlight actual and perceived legal barriers and facilitators for HIV testing and utilization of services for alcohol and drug use disorders and intimate partner violence in each metropolitan area. These legal barriers and facilitators will be examined during subsequent legal analysis, both for their congruence with participants' understandings of the laws and policies and for comparison of legal environments across project sites. In Phase 2, of the study, Phase 1 findings will be used to refine and expand a novel measure of immigration law concerns which will then undergo rigorous review by key informants and project advisors. In Phase 3 of the study, the resultant measure will serve as the primary independent variable in a quantitative analysis of the relationship between Latino and Hispanic immigrants' immigration law-related concerns and their willingness to utilize, and actual utilization of, when appropriate, services for HIV testing, AODD and IPV. Samples of 400 Latino and Hispanic immigrants in each metropolitan area will complete the survey via ACASI. Findings from the proposed study will provide important evidence for intervention, whether at the individual-level, through efforts to correct deleterious misconceptions of laws, at the community-level, through the development of more effective public health strategies to reach immigrant groups, and at the structural-level by shaping laws, polices, and procedures that support the goals of our National HIV Prevention Strategy.

Immigration-related laws and importantly, immigrants' perceptions of these laws, can encourage, deter, or even prevent immigrants from engaging in important public health behaviors including being tested for HIV infection and seeking services for conditions that may increase one's risk of contracting HIV. The proposed study will examine the influence of actual and perceived immigration-related laws and policies on US Hispanic and Latino immigrants' willingness to be tested for HIV and to utilize services for two additional, legally-regulated and stigmatized public health priorities: alcohol and drug use disorders and intimate partner violence. Findings from the proposed study will provide important evidence for intervention, whether at the individual-level, through efforts to correct deleterious misconceptions of laws, at the community-level, through the development of more effective public health strategies to reach immigrant groups, and at the structural-level by shaping laws, polices, and procedures that support the goals of our National HIV Prevention Strategy.