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S. Maman 1 , D. Holness 2 , D. Moodley 3 , A.K. Groves 1 , T Ezer 4

Integrating legal services into antenatal and postnatal care for HIV positive and HIV negative women in South Africa. S. Maman 1 , D. Holness 2 , D. Moodley 3 , A.K. Groves 1 , T Ezer 4 1 University of North Carolina at Chapel Hill, Gillings School of Global Public Health

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S. Maman 1 , D. Holness 2 , D. Moodley 3 , A.K. Groves 1 , T Ezer 4

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  1. Integrating legal services into antenatal and postnatal care for HIV positive and HIV 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

  2. Background and Methods • Background • Pregnant women , particularly HIV+ women, face health & social risks • Contact with the health care system during pregnancy represents an opportunity 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 one approach that could prevent HIV and address issues faced by women • Methods • The South Africa HIV Antenatal Post-test Support Study (SAHAPS) is a randomized 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 standard PMTCT services or a model that includes enhanced post-test support • Onsite legal services is one component of post-test support for women.  

  3. Results and Conclusion • Among 611 women offered legal services, 69 (11.3%) opened a legal case, and 25 women 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 the discrimination cases were opened by HIV+ women. • This study demonstrates the feasibility of integrating legal services into a health care setting, however lengthy judicial process is a major challenge to integration • The higher uptake of services among HIV+ women suggests that their legal needs may be amplified as a result of their status

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