Preventing HIV in under-served women

When diagnosed with HIV, a man will be asked about his sexual orientation. Not so, if the patient is a woman. The data discrepancy is fostering an endemic inequity in health services for HIV patients. It’s just one finding from the PLoS Medicine qualitative study that examined how marginalized HIV-positive women experience discrimination on the basis of sex, gender, race and HIV status.

“HIV experts have no real grasp of how many women with HIV belong to a sexual minority, so these women are essentially invisible,” says Dr. Carmen Logie, the study first author. “There are absolutely no programs tailored to their needs.”

Women who are in a sexual minority are not well-served by programs targeted to heterosexual women. Because these patients are excluded, they aren’t well-supported or taught how to protect their partners. It’s a growing issue, as volumes of populationbased research on HIV transmission show that infection rates in women are increasing, and are disproportionately affecting vulnerable populations.

“There is an assumption that HIV is uncommon in women who belong to sexual minorities,” says Logie. “By only collecting half the data about sexual orientation, this unfounded assumption just continues.”

This fuels other assumptions, including the belief that women who contract HIV through sexual contact are getting it through heterosexual sex.

In the same study, Logie and lead author Dr. Mona Loutfy recorded numerous accounts of patients who, based on their gender, race, HIV status or history of sex-work, were excluded from programs, harassed and stigmatized.

“Untrue assumptions about HIV, as well as stigma and discrimination, are fueling systemic failings that could contribute to increased transmission and even untreated disease,” says Loutfy.

“We brought this issue to light with the aim of improving front-end data collection,” says Loutfy. “With complete information, services can be developed that meet the needs of these women.”

In 2012, Dr. Mona Loutfy was awarded a prestigious Canadian Institutes of Health Research team grant. She is research director at the Maple Leaf Medical Clinic – the largest HIV practice in Canada with 10 physicians who manage more than 2,500 HIV-positive patients. Loutfy is a scientist at WCRI and  an associate professor in the Department of Medicine at the University of Toronto.