HIV is a chronic yet manageable disease, however women living with HIV face unique medical, social, and political obstacles, including intersecting stigmas, such as racism, transphobia and those related to sex work and drug use. Issues such as trauma and violence, as well, are still prevalent. With 80 percent of HIV positive women reporting having experienced violence and 20 percent having experienced it in the past three months. “I want people to know that women with HIV are strong, proud and resilient – they should be acknowledged and celebrated,” says Women’s College Hospital (WCH) scientist Dr. Mona Loutfy.
Dr. Loutfy founded The Women and HIV Research Program (WHRP) in 2006 and partners with women living with HIV to address their unique clinical needs. WHRP is guided by principles of feminism, equity, anti-oppression, anti-racism and social justice, as well as Meaningful Engagement of Women Living with HIV/AIDS (MEWA).
Pregnancy planning has become an important issue for people living with HIV of child-bearing age with a growing number wanting to start families. Dr. Loutfy’s work on normalizing pregnancy and parenting in the realm of HIV involves breaking down stigmas and discrimination, which includes having published Canadian HIV Pregnancy Planning Guidelines in 2012 and updated in 2018. With the success of current treatments, the risk of HIV transmission to a baby when the pregnant woman is on effective combination antiretroviral therapy before pregnancy is zero.
Women-Centred HIV Care Model
The comprehensive care needs of women living with HIV in Canada have not been thoroughly addressed due to the historic focus of the HIV response on men who have sex with men and the underrepresentation of women in decision-making roles. The novel Women-Centred HIV Care (WCHC) model was developed using data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS). The goal of the model is to provide healthcare personnel, both HIV specialists and primary practitioners, with a framework that will allow them to provide the best and most informed care to female HIV patients. WCHC is defined as care that supports women living with HIV to achieve the best health and wellbeing as defined by them. The WCHC model integrates five care components as determined by community members and CHIWOS participants and places an emphasis on flexibility of implementation to meet the needs of all women. The five care components include:
- Person-centred care
- Trauma- and violence-aware care
- Integrated HIV care
- Women’s healthcare (including sexual and reproductive health and rights
- Mental and emotional healthcare (including substance use health)
- Peer support, leadership and capacity building
WCHC Toolkits for Clinician’s and Community Members – https://cep.health/clinical-products/hiv/
A foundation grant from the Canadian Institutes of Health Research (CIHR) in 2017 allows Dr. Loutfy and team to work with key populations affected by HIV, including supporting three organizations. They’ve partnered with the Communities, Alliances, and Networks (CAAN) which supports Indigenous people with HIV, as well as the Trans Women HIV Research Initiative and Women’s Health in Women’s Hands, a community health centre specializing in healthcare for Black and racialized women and supporting Black women living with HIV. “Our support for these organizations is at the community level, allowing for greater self-determination,” says Dr. Loutfy.
For more information on Dr. Loutfy’s work with women and HIV, visit the research page.