Providing legal services as part of an HIV post-test support package for pregnant women at a public clinic in Durban, South Africa

Introduction: South Africa's progressive legislation on the protection of women's sexual and reproductive rights is often cited as a model for other countries on the continent. However, there may be a gap in application, where a proportion of women are either unaware of their legal rights or unable to access legal services when needed. The purpose of this study is to describe pregnant women's unmet legal needs and to describe uptake of legal services in a public antenatal clinic.

Methods: SAHAPS is a randomized controlled trial designed to evaluate the efficacy of enhanced post-test support for HIV+ and HIV- pregnant women in Durban, South Africa. Access to onsite legal services is one component of the post-test support. Participants in the intervention arm who had access to legal services are included in this descriptive analysis (n=611).

Results: At baseline, 25.86% of women reported ever experiencing a legal problem, and 11.62% reported a current legal need. During the intervention, 69 women (11.3%) opened a legal case. Most needed assistance with child support (n=39), protection orders (n=10) or labor disputes (n=10). Significantly 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 out of 5 cases on discrimination were opened by HIV+ women.

Conclusions: A proportion of our study population had unmet legal needs. The study demonstrates the feasibility of integrating legal services into public health clinics.