BACKGROUND: Among individuals with an alcohol use disorder (AUD), little is known about why Latino adults are less likely to use formal alcohol treatment than their non-Hispanic White counterparts. OBJECTIVE: To investigate Latino-White differences in barriers to specialty alcohol treatment, including sex differences by race/ethnicity. METHODS: In 2021, a national sample of 1200 Latino and White adults with AUD were recruited to complete a structured online questionnaire. Alcohol treatment barriers were assessed using the 36-item Barriers to Specialty Alcohol Treatment (BSAT) scale. Differences in barriers to specialty alcohol treatment between Latino and White participants were examined using multivariable regression models. RESULTS: Latino (vs. White) adults had greater odds of reporting that specialty alcohol treatment was not culturally accepted (AOR): 1.43
95 % CI: 1.29-1.59), concerns that providers might not understand their cultural background (AOR: 1.45
95 % CI: 1.32-1.61), and that providers would not be of the same racial/ethnic or cultural background as them (AOR: 1.58
95 % CI: 1.42-1.76) as reasons for not using treatment. Further, Latino (vs. White) adults were more likely to endorse immigration-related barriers to treatment, including concerns about disclosing sensitive information, such as their immigration status (AOR: 1.34
95 % CI: 1.21-1.48) or that using treatment would negatively affect their own immigration status (AOR: 1.35
95 % CI: 1.21-1.48) or the immigration status of someone in their family (AOR: 1.36
95 % CI: 1.23-1.50). No sex differences by race/ethnicity were documented. CONCLUSION: Culturally tailoring existing alcohol treatment services that incorporate immigration-related concerns may be key for encouraging Latino adults to use formal alcohol treatment services.