Patient-centered nutrition education and counseling can improve the health of HIV-positive persons. This article describes the development and implementation of a Spanish-language, community clinic-based, individually tailored, and culturally specific nutrition curriculum for HIV-positive Latinos living on the U.S.-Mexico border. Important considerations made in serving this population include low acculturation to U.S. culture, monolingual Spanish speaking, cross-border mobility, and dietary behaviors influenced by access to culturally preferred regional foods, some of which may not be nutritionally optimal. Challenges to curriculum implementation and lessons learned for replication of the curriculum in other clinical settings are discussed.