This retrospective study of 307 patients with advanced HIV disease residing in downtown Montreal was carried out to examine the nature and consequences of the services they received according to their degree of poverty. The findings showed that, between 1 April 1991 and 31 March 1997, patients living in extreme poverty were more likely to complain of uncontrolled pain during the final week of home visits and were more likely to die in hospital than were their more financially secure counterparts. This held true even though the poorer group had a similar clinical profile at diagnosis and were provided with practically the same services. Thus there is a need to seek better understanding of the nature of palliative care services offered to underprivileged clienteles and to see if the services now provided are adequately adapted to the specific needs of impoverished patients.