1. 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 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