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Brief on the Importance of Legal Aid in HIV Prevention and Treatment

By: Open Society Foundations

For criminalized populations such as drug users, sex workers, and men who have sex with men, difficulties with the legal system impose a substantial barrier to HIV prevention and treatment. In multiple countries, HIV prevention programs have documented police harassment at methadone and needle exchange sites, prosecution for possession of sterile injection paraphernalia, and detention or police questioning as a result of being enrolled in drug treatment. Additional legal problems include lack of necessary documents for accessing medical treatment, use of criminalized status or registries to remove child custody or drivers’ licenses, and subjecting those seeking treatment to medical or police surveillance. For example, police violence and threat of incarceration are correlated in injection drug users with hurried injection, sharing of injection equipment, and ARV treatment interruption.

The provision of legal aid to increase access to justice has resulted in increased access to health services, improved health outcomes, and increased sense of self-efficacy among criminalized groups. In a variety of low- and middle-income countries, legal aid has been integrated into harm reduction services at minimal cost.