Health-Harming Legal Needs Identified by People with HIV: Data from a Medical-Legal Partnership Study to Improve HIV Care Continuum Outcomes.

Abstract

Introduction: People with HIV (PWH) often face health-harming legal needs that impede access to and retention in HIV care. The Organizational Partnerships for Healthy Living (OPAHL) intervention addresses these gaps by integrating legal services with health care.

Methods: This mixed-methods study was conducted at two health centers in Philadelphia, PA, from October 20, 2022 through 2024. The trial aims to: (1) refine the OPAHL intervention prototype for PWH with detectable viral loads; and (2) test the feasibility, acceptability, and preliminary effects of OPAHL, which includes (a) comprehensive partner training; (b) screening for legal concerns; and (c) access to legal services. Key legal concerns were identified from 111 participants through quantitative and qualitative analyses of patient-reported responses and attorney case summaries.

Results: Major findings from the preliminary dataset reflect distinct categories of legal concerns reported by participants, including Personal/Advanced Care Planning (n = 50), Other Legal Concerns (n = 26), Unsafe Housing/Repairs (n = 23), and Eviction or Threat of Losing Home (n = 15).

Conclusions: Findings highlight the diverse and complex legal concerns impacting PWH, particularly in relation to personal and housing-related planning. Understanding and addressing these challenges is crucial for developing targeted interventions to strengthen the HIV care continuum.