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Self-reported legal needs of women with or at risk for HIV infection

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Abstract

Women at risk for human immunodeficiency virus (HIV) infection are often poor and members of racial or ethnic minorities. In addition to legal concerns that might be common among persons with similar sociodemographic characteristics, HIV infection adds the potential of possible stigma and discrimination, as well as the prospect of illness and increased mortality. To determine women's perceptions of need for and access to legal services and whether such perceptions are affected by HIV infection, from November 1993 through September 1995 we interviewed 509 women with or at risk for HIV infection by virtue of injection drug use or high-risk sexual behaviors in New York and Baltimore, Maryland. A majority of women, regardless of HIV serostatus, reported current or future needs for legal assistance with government benefits. More than 25% reported needing current or future legal help with housing, debts, arrangements for care of children, a will, and advance directives. Substantial minorities of women reported other legal needs. HIV-positive women were significantly more likely to report anticipated future need for help with paternal custody or visitation, current need in making a will, and anticipated future assistance with advance directives. For most items, a majority of women thought they knew where to receive help. However, among women reporting a current need, only a minority actually were receiving legal assistance. This study suggests that the extent of legal needs among women with or at risk for HIV infection is substantial, and that few receive legal assistance. With few exceptions, at least for women early in the course of illness, HIV infection does not appear to alter the pattern or extent of legal needs. There are dramatic differences, regardless of HIV status, between expectation and reality in women's access to legal services.

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Author information

Authors and Affiliations

  1. Department of Epidemiology and Social Medicine, Montefiore Medical Center, 111 East 210th Street, 10467, Bronx, New York

    Paula Distabile MSN, JD,  Nancy N. Dubler LLB &  Robert S. Klein MD (Professor of Medicine)

  2. Department of Medicine, Montefiore Medical Center, 111 East 210th Street, 10467, Bronx, New York

    Robert S. Klein MD (Professor of Medicine)

  3. Albert Einstein College of Medicine, Bronx, New York

    Robert S. Klein MD (Professor of Medicine)

  4. School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland

    Liza Solomon DrPH

Authors
  1. Paula Distabile MSN, JD
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  2. Nancy N. Dubler LLB
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  3. Liza Solomon DrPH
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  4. Robert S. Klein MD
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Corresponding author

Correspondence to Robert S. Klein MD.

Additional information

Members of the HER Study group are listed in the Appendix.

Supported by cooperative agreements U64/CCU206798 and U64/CCU306802 with the Centers for Disease Control and Prevention. During the study, Paula DiStabile was supported by the Skadden Fellowship Foundation and sponsored by New York Lawyers for the Public Interest, New York, New York.

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Distabile, P., Dubler, N.N., Solomon, L. et al. Self-reported legal needs of women with or at risk for HIV infection. J Urban Health 76, 435–447 (1999). https://doi.org/10.1007/BF02351501

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