Evaluating the Camino intervention to reduce HIV risk and poor care outcomes among Latin Americans - Latin American populations in the U.S. are facing rising HIV incident rates. The Camino Study is an intervention to address the causes of increasing HIV incidence among Latin Americans, and to improve their HIV-related outcomes. We propose to assess the effects of the Camino Study, a status neutral multi-level pilot intervention combining legal services with peer navigation to improve HIV prevention and care engagement. The goal of the Camino intervention is to minimize fear of healthcare engagement, reduce stress, and improve access to HIV prevention and care services, thus enabling Latin American people to make choices that prioritize their safety and wellbeing and improve HIV care and prevention engagement. Our prior work finds this approach to be feasible and enabled us to establish strong community partnerships in two cities with significant HIV epidemics. We will recruit a stratified sample of 50 Latin American people with unmet HIV prevention and care needs. We will use a quasi-experimental wait-list control design by comparing HIV outcomes for those who receive the Camino intervention compared to those on a rolling waitlist over 18 months. Our primary outcomes include HIV prevention outcomes (HIV testing within the past 6 months and PrEP uptake) and HIV care outcomes for people living with HIV (HIV care visit attendance, ART adherence and viral load). Further, we will examine legal, social, and mental health factors’ effects on HIV prevention and care engagement. Data will come from surveys and medical record review. Finally, by collecting process evaluation data during the intervention and drawing on key informant interviews, we will assess the feasibility of testing the intervention at scale in U.S. cities with large Latin American populations. The Camino intervention proposes to fill a critical gap in HIV research by addressing legal needs as a barrier to HIV care and prevention, and by providing best practice evidence for scale up to other health care facilities and organizations on the frontlines of healthcare for Latin American populations.
