Clinician-researcher Dr. Mona Loutfy is using the mix of compassionate one-on-one care and nation-wide clinical trial research to improve the lives of women living with HIV.
On a Monday morning in October, 2017 Dr. Mona Loutfy welcomes a patient with a big smile and hug at her Maple Leaf Medical Clinic office in downtown Toronto.
After all, they’d been meeting for the past 18 years. The woman was Dr. Loutfy’s first HIV-positive patient, one of dozens of patients the physician has treated for more than a decade.
“I love seeing my patients,” says Dr. Loutfy, recipient of a 2017 CAHR-CANFAR Excellence in Research Award in Clinical Sciences. “Because HIV is often a stigmatized disease, when a patient comes to see you and they trust you, in my office they can be themselves. There’s something very special about that relationship.”
It’s a one-on-one warmth and caring that Dr. Loutfy has combined with clinical studies to create a world-leading program of clinical research and evidence-based care on issues of women with HIV, in particular sexual and reproductive health.
“I’ve always been one to ask questions,” says Dr. Loutfy, founder of the Women and HIV Research Program at Women’s College Hospital. “It’s great seeing what the issues are at the front line, and then being able to ask the questions that haven’t been answered, and design the study to answer them and make a difference in your patients’ lives.”
Dr. Loutfy began her medical training during the height of AIDS epidemic, and much of her learning was at Toronto’s Wellesley Hospital in the heart of the city’s gay village.
“I saw the wards filled with gay men and other people dying of AIDS,” recalls Dr. Loutfy.
Moved by this experience, and inspired by University of Toronto’s Dr. Sharon Wamsley, Dr. Loutfy trained as a clinical trials researcher and in 2005 focused on women living with HIV.
“People living with HIV wanted to have children and they weren’t being supported,” she says.
Dr. Loutfy, began a research, clinical and education program that has transformed the paradigm of care and clinical thinking, making it possible for those living with HIV to become parents.
“If a woman is on HIV antiretroviral therapy before she gets pregnant, the chance of the baby becoming infected is zero. That’s amazing!” says Dr. Loutfy, who from 2009 led the development of the Canadian HIV Pregnancy Planning Guidelines, published in 2012 with an updated version released in the fall of 2017.
Now, Dr. Loutfy’s research includes leading the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS). It’s documenting the experiences of more than 1400 women living with HIV in Ontario, Quebec, British Columbia, Saskatchewan and Manitoba.
The ongoing study has already found that about nine-in-ten of the participants are taking antiretroviral medications that effectively suppress their HIV viral load to near undetectable levels. Yet many of these women suffer from a broad range of social issues, from poverty to high levels of violence.
“There’s a dichotomy here: there HIV care is taken care of, but from a social perspective we’re potentially letting them down,” she says.
This complex intersection of politics, social, public health and medical issues affecting the care of women living with HIV has drawn Dr. Loutfy to extend her clinical practice to Saskatchewan.
She’s visiting two First Nations communities four times a year to see patients and work with communities to address the “HIV epidemic” they face, one deeply rooted in historical trauma and related addiction issues.
After a morning of seeing patients at the Maple Leaf Medical Clinic, Dr. Loutfy walks the several blocks to her Women’s College Hospital office where she’ll juggle an intensive research and education load, from advising graduate students, to lab group meetings, and CHIWOS teleconferences.
It’s a grueling pace that she says is fuelled by another love: mentoring a new generation of HIV researchers and clinicians.
“I have a lot of students and come into contact with a lot of young people who have that energy and drive to make the world a better place, and along with my patients, these young people really inspire me and give me my energy.”
Each year, the CAHR – CANFAR Excellence in Research Awards are awarded to highlight and celebrate the contributions of Canadian researchers in HIV/AIDS research. Dr. Loutfy was awarded the prize at the 2017 CAHR Conference as “a visionary, renowned leader, recognized internationally and nationally in the field of HIV clinical research.”