Medical-legal partnerships: An integrated approach to advance health equity and improve health outcomes for people living with HIV

Abstract

Medical Legal Partnerships (MLPs) offer a structural integrated intervention that could facilitate improvements in medical and psychosocial outcomes among people living with HIV (PLWH). Through legal aid, MLPs can ensure that patients are able to access HIV services in a culturally sensitive environment. We conducted organizational-level qualitative research rooted in grounded theory, consisting of key informant interviews with MLP providers (n = 19) and members of the Scientific Collaborative Board (SCB; n = 4), site visits to agencies with MLPs (n = 3), and meetings (n = 4) with members of the SCB. Four common themes were identified: (1) availability and accessibility of legal and social services support suggest improvements in health outcomes for PLWH; (2) observations and experiences reveal that MLPs have a positive impact on PLWH; (3) 3 intersecting continua of care exist within MLPs: HIV care continuum; legal continuum of care; and social services continuum; and (4) engagement in care through an MLP increases patient engagement and community participation. The MLP approach as a structural intervention has the potential to alleviate barriers to HIV/AIDS treatment and care and thus dramatically improve health outcomes among PLWH.

An Inquire of Cost and Benefits of Structural Interventions: The Case of Medical Legal Partnerships for People Living with HIV in Philadelphia, PA

“…Records collected during the intervention did not contain legally sensitive information pertaining to legal cases, but included indicators of legal service utilization. Limitations in the health care delivery system preclude access to care to individuals, which is important to provide timely linkage to legal support, facilitate engagement in legal services, and achieve resolution of legal issues [ 37 ]. Our approach to addressing health-harming legal needs for PLWH is based on the principles of integrated care and co-location of services to reduce redundancy, unnecessary costs and streamline services [ 38 ].…”

Medical-Legal Partnerships: a promising approach for addressing health-harming legal needs among people with HIV

“…MLPs in HIV care are an emerging approach that combines traditional medical care with legal support to address the HHLN of PWH (Martinez et al, 2017 , 2022 ; Muñoz-Laboy et al, 2019 ; Yamanis et al, 2019 ). In other settings and with other populations including veterans, immigrants, formerly incarcerated individuals, children, and patients with cancer in palliative care (Weintraub et al, 2010 ; Sege et al, 2015 ; Tsai et al, 2017 ; Benfer et al, 2018 ; Selnau and Goldberg, 2019 ; Chen et al, 2021 ; League et al, 2021 ; Griesemer et al, 2023 ; Lu et al, 2023 ; Ramos et al, 2023 ), MLPs have been beneficial for addressing complex legal needs.…”

Applying a Social Ecological Model to Medical Legal Partnerships Practice and Research

“…Medical legal partnerships (MLPs) bring together professional expertise in law, health, and other disciplines to address patients’ health harming 1 legal needs (HHLN). MLPs address social determinants of health (SDOH) through partnerships between health care providers and civil legal service providers.…”