Integrating legal services into antenataland postnatal care for HIV positive andHIV negative women in South Africa
S. Maman1, D. Holness2, D. Moodley3, A.K. Groves1, T Ezer4
1 University of North Carolina at Chapel Hill, Gillings School of Global Public Health
2 University of KwaZulu-Natal, Campus Law Clinic
3 University of KwaZulu-Natal, Women’s Health and HIV Research Unit
4 Soros Foundation, Law and Health Initiative
Background and Methods
•Background
–Pregnant women , particularly HIV+ women, face health & social risks
–Contact with the health care system during pregnancy represents anopportunity to address the legal and social needs of women
– However clinics are often not equipped to address non-clinical needs
–Access to legal services for poor women has been a major challenge
–Bringing legal services into health care setting during pregnancy is oneapproach that could prevent HIV and address issues faced by women
•Methods
–The South Africa HIV Antenatal Post-test Support Study (SAHAPS) is arandomized controlled trial designed to evaluate the efficacy of enhanced post-test support for HIV+ and HIV- pregnant women in Durban.
–1,500 women have been enrolled & randomized to receive either standardPMTCT services or a model that includes enhanced post-test support
–Onsite legal services is one component of post-test support for women.
Results and Conclusion
•Among 611 women offered legal services, 69 (11.3%) opened a legal case, and 25women opened more than one case.
• 83 cases were opened, including child maintenance (n=39), protection orders(n=10), labor disputes (n=10), child related legal issues (n=7), discrimination (n=5),housing (n=5) and smaller numbers of other cases.
•More HIV + women than HIV- women opened cases (19% vs. 10%, p<.001).
•The types of legal cases did not differ by HIV status, except that 4/5 of thediscrimination cases were opened by HIV+ women.
•This study demonstrates the feasibility of integrating legal services into a healthcare setting, however lengthy judicial process is a major challenge to integration
•The higher uptake of services among HIV+ women suggests that their legal needsmay be amplified as a result of their status