Mona Loutfy
Dados Biográficos
| ID | 118897 |
|---|---|
| NOME | Mona Loutfy |
| PRENOMES | Mona |
| SOBRENOME | Loutfy |
| ASSINATURA | LOUTFY M |
| AFILIAÇÕES | University of Toronto |
| ORCID | 0000-0001-7887-8997 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 84 |
| TOTAL DE CITAÇÕES | 57 |
| TOTAL COMO AUTOR | 84 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2006 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 5 |
Viral suppression by residency status among men living with HIV in the context of the expanded ART policy in Shanghai, China
Access to China’s national free antiretroviral therapy (ART) program was historically restricted to the home province or province of birth (“Hukou”). During the COVID-19 pandemic, Shanghai facilitated access to free ART and supportive services for all Shanghai residents regardless of residency status. Our aim was to study differences in viral suppression according to residency status in Shanghai, China. We conducted a cross-sectional survey with …
Delivery of the women-centred HIV care model in Canadian HIV clinics
The Women-Centred HIV Care (WCHC) Model addresses women living with HIV's multifaceted healthcare needs, but its delivery remains unclear. This environmental scan examines the delivery of the WCHC Model in Canadian HIV clinics. Clinics were surveyed on health service delivery, then scored out of 10 in the six domains of the WCHC Model using a service-based score system. Generally, on-site services were assigned more value than off-site referrals.…
Stakeholder mapping
Introduction: In the initial steps towards the development of an implementation project aimed to support sexual and reproductive health (SRH) policies and income protection for cisgender and transgender sex workers in the Ciudad Autónoma de Buenos Aires (CABA), we employed stakeholder mapping. This is a crucial tool in health policy and systems and research to identify, categorize, and characterize key stakeholders involved in policy planning and…
Comparing fertility clinic care for individuals and couples living with and affected by HIV and in Canada from 2014 to 2023
Access to fertility care, particularly medically assisted conception (MAC), is a reproductive justice concern for individuals with HIV. This longitudinal study investigates MAC access for people with HIV in Canada. Surveys were distributed to medical and laboratory directors from 58 fertility clinics across nine provinces. Responses were initiated by 24/89 (27.0%) participants, representing 19/58 (32.8%) clinics in 7 provinces. Complete responses…
The need to change the narrative, to change the context
Indigenous women have varying degrees of control over their life stressors. • A lack of control over built and neighborhood environments was experienced. • Their environments impacted how they managed their mental and physical health. • Drugs and alcohol, shutting down and cutting ties were common survival responses. • Gaining control included engaging in culture, relationship building and advocacy. In Canada, Indigenous women have a range of lif…
A prospective multi-site study to evaluate the performance and usability of an oral fluid-based HIV self-test in Canada
Overall, 951 participants were recruited and consented with 911 available for all analyses. With respect to sociodemographics: 84% of participants were between 18-45 years of age, 73% had at least a college education, 48% were Cis-male, 45% were employed; and 26% identified as White, 23% as African, Caribbean or Black, 5% as Indigenous [First Nations, Métis or Inuit], 33% as Asian, and 6% as LatinX. Primary efficacy analysis on the 911 who comple…
Sexual Activity, Pleasure, and Testosterone
Sexual health research comparing women with and without human immunodeficiency virus (HIV) often pathologizes women living with HIV, overlooking biopsychosocial factors that may drive differences between groups. Low testosterone levels have been reported among women living with HIV; however, how this may impact sexual health outcomes remains unclear. We compared the prevalence of sexual activity and sexual pleasure between women with and without …
Post-arrival HIV acquisition patterns
The evolving HIV epidemic in Ontario, Canada
These data show that HIV testing and prevention strategies should be targeted to (1) MSM with a history of syphilis, gonorrhea, or chlamydia; (2) heterosexual men and women with a history of hepatitis C; and (3) immigrants within the first 5 years of migration. To address the evolving epidemic, it will be necessary to employ targeted HIV screening and prevention measures
Between worlds
Youth Sexual Health and HIV/STI Prevention in Middle Eastern and North African Communities (YSMENA) is the first community-based research study in Canada to explore key determinants of sexual health among diaspora Middle Eastern and North African (MENA) women living in Canada. Our objectives were to identify the factors influencing sexual health for MENA youth and grow an evidence base to strengthen the sexual health response for MENA communities…
Medical chart-reported alcohol consumption, substance use, and mental health issues in association with HIV pre-exposure prophylaxis (PrEP) nonadherence among gay, bisexual, and other men-who-have-sex…
Chart-indicated suboptimal adherence was present among a small subgroup of PrEP-prescribed gbMSM. Adherence-related interventions should target gbMSM who use club drugs, are younger, experience challenges attending PrEP care, and are prescribed non-daily regimens. Offering long-acting injectable PrEP when available and feasible may also improve PrEP's HIV-preventive impact among this population
Correlates of Using Medically-Authorized Cannabis in a Large Cohort of People Living with HIV Who Use Cannabis
Disclosure of HIV-serodiscordant relationships and association with viral suppression
BACKGROUND: Little is known about the effects of disclosure of HIV-serodiscordant relationships on clinical outcomes. We aimed to evaluate the effect of relationship disclosure on HIV viral suppression, and hypothesized that disclosure by HIV-positive and HIV-negative partners would be associated with viral suppression in the HIV-positive partner. METHODS: We conducted a Canadian national online and telephone-administered survey of HIV-positive a…
Practices, support and stigma related to infant feeding and postpartum engagement in care among women living with HIV in Canada
Background: Breastfeeding is not recommended for women living with HIV (WLWH) in Canada. We described the prevalence of breastfeeding and explored experiences of care, support, and stigma related to infant feeding. Setting: Quebec, Ontario, and British Columbia (Canada). Methods: Data were obtained from the HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS) surveys, conducted between 2013 and 2018. Results: Breastfeeding was reporte…
Women-centred HIV care
Women living with HIV (WLWH) face unique barriers and require specialized, integrated care that focuses on women's specific needs. We conducted a scoping review to examine factors important for a women-centred HIV care (WCHC) approach. We included published peer-reviewed articles which featured WCHC services as their central focus; included study populations of girls and WLWH aged 14 years of age or older; and contributed to the understanding of …
Perceived influence of alcohol consumption, substance use, and mental health on PrEP adherence and condom use among PrEP-prescribed gay, bisexual, and other men-who-have-sex-with-men
Overall, findings suggest that PrEP adherence can often be successfully achieved in the presence of alcohol-, substance use-, and mental health-related issues. Augmenting self-care, and addressing pronounced addictions- and mental health-related concerns, may enhance PrEP treatment among GBMSM
An exploration of the fertility desires and intentions of men living with HIV in Ontario, Canada
Planning families is an important issue within the HIV community. The primary objective of this study was to explore the fertility desires and intentions of men living with HIV (MLWH). A cross-sectional survey containing 77 questions in 10 domains was developed, validated and administered to MLWH. The sample was stratified by sexual orientation, ethnicity, and city of residence. Logistic regression analyses were conducted to determine sociodemogr…
Mental health among transgender women living with HIV in Canada
Antiretroviral therapy adherence among transgender (trans) women living with HIV (WLWH) is negatively impacted by depression and post-traumatic stress disorder (PTSD). Yet, little is known about factors associated with depression or PTSD among trans WLWH. Using cross-sectional data from a national community-based study of 1422 WLWH (n = 53 trans women), we characterized the prevalence of depressive and PTSD symptoms among trans WLWH and examined …
Help-Seeking to Cope With Experiences of Violence Among Women Living With HIV in Canada
Using baseline data from a community-collaborative cohort of women living with HIV in Canada, we assessed the prevalence and correlates of help-seeking among 1,057 women who reported experiencing violence in adulthood (≥16 years). After violence, 447 (42%) sought help, while 610 (58%) did not. Frequently accessed supports included health care providers ( n = 313, 70%), family/friends ( n = 244, 55%), and non-HIV community organizations ( n = 235,…
Prevalence of Sars-CoV-2 infection among people experiencing homelessness in Toronto during the first wave of the Covid-19 pandemic
During the first wave of the pandemic, rates of SARS-CoV-2 infection at sites for people experiencing homelessness in Toronto varied significantly over time. The observation of lower rates at certain sites may be attributable to overall time trends, expansion of outreach-based testing to include sites without known outbreaks, and/or individual site characteristics
Employing Indigenous Methodologies to Understand Women’s Perceptions of HIV, Health, and Well-being in Quebec, Canada
Guided by an Indigenous Methodology and a participatory research approach, we explored the experiences and priorities of Indigenous women living in Quebec regarding HIV prevention and care, overall health, and well-being. We drew from our research process to identify recommendations for conducting research with Indigenous women. These lessons include: (1) incorporating culturally adapted methods (e.g., sharing circles, arts, ceremony) facilitated…
A Journey of Doing Research “In a Good Way”
The relationship between the First Peoples of Canada and researchers is changing as processes of self-determination and reconciliation are increasingly implemented. We used storytelling and ceremony to describe a historic event, the Indigenous Women’s Data Transfer Ceremony, where quantitative data of 318 Indigenous women living with HIV were transferred to Indigenous academic and community leaders. Relationship building, working together with a …
“I Just didn’t Think they Would Because of My Status…”
There is limited research exploring the experiences of people living with HIV (PLWH) who have pursued/successfully adopted children. We aimed to gain a deeper understanding of such experiences by analyzing six interviews with PLWH using thematic analysis. In this paper, we highlight three themes: Understanding the Adoption Process, Desire for Caseworker-Client Transparency, and Framing Health and Wellbeing. While most of the findings are relevant…
Alcohol consumption, substance use, and depression in relation to HIV Pre-Exposure Prophylaxis (PrEP) nonadherence among gay, bisexual, and other men-who-have-sex-with-men
Findings highlight the need to integrate alcohol- and substance-focused initiatives into PrEP care for gbMSM. Such initiatives, in turn, may help improve PrEP adherence and reduce the potential for HIV acquisition among this group
Building Bridges
Building Bridges' success hinged on ongoing co-learning and engagement of Indigenous peoples, service providers and researchers
Opportunities, Ethical Challenges, and Lessons Learned from Working with Peer Research Assistants in a Multi-Method HIV Community-Based Research Study in Ontario, Canada
We discuss ethical challenges and opportunities experienced by peer research assistants (PRAs) in a multi-method HIV community-based research study in Ontario, Canada. We review lessons learned and best practices based on our experience conducting a qualitative investigation of research priorities with diverse women living with HIV (WLWH) and implementation of a cross-sectional survey with African, Caribbean, and Black WLWH. While some opportunit…
Adapting stigma mechanism frameworks to explore complex pathways between intersectional stigma and HIV-related health outcomes among women living with HIV in Canada
Intersectional stigma research examining pathways to HIV outcomes is limited. • Adapted conceptual frameworks to examine intersectional stigma and health outcomes. • Stigma interacted with social/institutional support to increase depression. • Depression led to maladaptive coping, lowering adherence and CD4 count. • Argues for multi-level strategies, including women-centred HIV care
It’s a very isolating world’
HIV health services research conventionally defines place in terms of proximity to care. However, understandings of place must also include the social spaces that women living with HIV (WLWH) occupy which shape their experience of health and access to care. Drawing on focus group data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study, we explored how 28 WLWH navigate geographic place and social space in attempting to acces…
Retrospective Reports of Developmental Stressors, Syndemics, and Their Association with Sexual Risk Outcomes Among Gay Men
Gay and bisexual men (GBM) continue to have a disproportionately higher HIV incidence than any other group in Canada and the United States. This study examined how multiple co-occurring psychosocial problems, also known as a syndemic, contribute to high-risk sexual behavior among GBM. It also examined the impact of early life adversity on high-risk sexual behavior as mediated by syndemic severity. A sample of 239 GBM completed self-report questio…
Surviving Surveillance
Pregnant women and mothers living with HIV are under surveillance of service providers, family members, and the community at large. Surveillance occurs throughout the medical management of their HIV during pregnancy, preventing HIV transmission to their baby, infant feeding practices, and as part of assessments related to their ability to mother. Enacted and anticipatory HIV-related stigma can exacerbate the negative impact that being under surve…
Supporting the Sexual Rights of Women Living With HIV
In the context of human immunodeficiency virus (HIV), a focus on protecting others has overridden concern about women's own sexual well-being. Drawing on feminist theories, we measured sexual satisfaction and pleasure across five relationship types among women living with HIV in Canada. Of the 1,230 women surveyed, 38.1% were completely or very satisfied with their sexual lives, while 31.0% and 30.9% were reasonably or not very/not at all satisfi…
The Problematization of Sexuality among Women Living with HIV and a New Feminist Approach for Understanding and Enhancing Women’s Sexual Lives
Love with HIV
Hear(ing) New Voices”
Peers discussed the strengths and weaknesses of participatory methodologies in survey development
Access to conception planning information and services for people living with HIV in Ontario, Canada
Decreased mortality, decreased risk of vertical HIV transmission, and many people living with HIV (PLWHIV) being of reproductive age have led many PLWHIV to consider pregnancy. However, scarce data exist regarding the conception planning resources required and available for PLWHIV to have safe and healthy pregnancies. This study aimed to identify gaps between the need for, knowledge of, and access to conception planning information and services a…
Prevalence of Sars-CoV-2 infection among people experiencing homelessness in Toronto during the first wave of the Covid-19 pandemic
During the first wave of the pandemic, rates of SARS-CoV-2 infection at sites for people experiencing homelessness in Toronto varied significantly over time. The observation of lower rates at certain sites may be attributable to overall time trends, expansion of outreach-based testing to include sites without known outbreaks, and/or individual site characteristics
Building Bridges
Building Bridges' success hinged on ongoing co-learning and engagement of Indigenous peoples, service providers and researchers
A qualitative exploration of barriers to HIV prevention, treatment and support
Transgender (trans) women experience barriers to access to HIV care, which result in their lower engagement in HIV prevention, treatment and support relative to cisgender people living with HIV. Studies of trans women's barriers to HIV care have predominantly focused on perspectives of trans women, while barriers are most often described at provider, organisation and/or systems levels. Comparing perspectives of trans women and service providers m…
Strategies for Recruiting Women Living with Human Immunodeficiency Virus in Community-Based Research
Having multiple approaches, engaging a diverse team of PRAs, ensuring flexibility, and cultivating reciprocal relationships with community stakeholders were key to recruiting a diverse and representative sample of WLWH
Changing the Rules in Times of Crisis
A physician discusses the ethical issues surrounding the use of experimental treatments during an epidemic and suggests guidelines that should govern such usage. Virtual Mentor is a monthly bioethics journal published by the American Medical Association
Long-term efficacy and safety of polyalkylimide gel for the treatment of HIV-associated lipoatrophy
The long-term safety and efficacy of products used in the correction of HIV-associated facial lipoatrophy (FLA) are largely unknown. The purpose of this study was to describe the long-term efficacy and safety of polyalkylimide gel (PAIG) in the treatment of HIV-associated FLA. In this open-label, randomized, single-center study, 31 HIV-positive individuals (median age 48 years (interquartile ranges (IQR) 45, 55, 97% male) with FLA were randomized…
Cost consequences of HIV-associated lipoatrophy
HIV-associated lipoatrophy may affect up to 35% of patients who have received antiretroviral (ARV) regimens for more than one year, and may result in depression, social isolation, and career barriers. Interventions including the injection of dermal fillers for restoration of facial fat loss are being used for treating HIV-associated lipoatrophy. Since reimbursement is often lacking, patients must consider the pros and cons of such interventions, …
Once Daily Dosing Improves Adherence to Antiretroviral Therapy
HIV, Gender, Race, Sexual Orientation, and Sex Work
BACKGROUND: HIV infection rates are increasing among marginalized women in Ontario, Canada. HIV-related stigma, a principal factor contributing to the global HIV epidemic, interacts with structural inequities such as racism, sexism, and homophobia. The study objective was to explore experiences of stigma and coping strategies among HIV-positive women in Ontario, Canada. METHODS AND FINDINGS: We conducted a community-based qualitative investigatio…
“We don't exist”
BACKGROUND: Lesbian, bisexual, queer and transgender (LBQT) women living with HIV have been described as invisible and understudied. Yet, social and structural contexts of violence and discrimination exacerbate the risk of HIV infection among LBQT women. The study objective was to explore challenges in daily life and experiences of accessing HIV services among HIV-positive LBQT women in Toronto, Canada. METHODS: We used a community-based qualitat…
Correlates of Anxiety in Women Living with HIV of Reproductive Age
Access to conception planning information and services for people living with HIV in Ontario, Canada
Decreased mortality, decreased risk of vertical HIV transmission, and many people living with HIV (PLWHIV) being of reproductive age have led many PLWHIV to consider pregnancy. However, scarce data exist regarding the conception planning resources required and available for PLWHIV to have safe and healthy pregnancies. This study aimed to identify gaps between the need for, knowledge of, and access to conception planning information and services a…
Opportunities, Ethical Challenges, and Lessons Learned from Working with Peer Research Assistants in a Multi-Method HIV Community-Based Research Study in Ontario, Canada
We discuss ethical challenges and opportunities experienced by peer research assistants (PRAs) in a multi-method HIV community-based research study in Ontario, Canada. We review lessons learned and best practices based on our experience conducting a qualitative investigation of research priorities with diverse women living with HIV (WLWH) and implementation of a cross-sectional survey with African, Caribbean, and Black WLWH. While some opportunit…
Associations Between HIV-Related Stigma, Racial Discrimination, Gender Discrimination, and Depression Among HIV-Positive African, Caribbean, and Black Women in Ontario, Canada
African, Caribbean, and Black (ACB) women are greatly overrepresented in new HIV infections in comparison with Canada's general population. Social and structural factors such as HIV-related stigma, gender discrimination, and racial discrimination converge to increase vulnerability to HIV infection among ACB women by reducing access to HIV prevention services. Stigma and discrimination also present barriers to treatment, care, and support and may …
A review of reproductive health research, guidelines and related gaps for women living with HIV
The study of pregnancy and motherhood in women living with HIV (WLWH) has concentrated on the health of the unborn baby and the prevention of mother-to-child transmission, whereas consideration of the broader aspects of women's reproductive health has been largely overlooked. The rights of WLWH with respect to their reproductive health should be exactly the same as non-HIV-positive women, however, inequalities exist due to discrimination and also…
Socio-Demographic Determinants of Familial and Partner Pressures to Conceive in Hiv-Positive Women in Ontario, Canada
Introduction Access to antiretroviral therapy has improved quality of life, minimized vertical transmission, and reduced mortality and morbidity in HIV-infected women. With these advances, many HIV-infected women and their partners are deciding to have children or carry unplanned pregnancies to term. Objective To examine the relationship between socio-demographic factors and family and partner pressures to conceive in HIV-positive women in Ontari…
Demographic and clinical factors correlating with high levels of psychological distress in HIV-positive women living in Ontario, Canada
The concept of psychological distress includes a range of emotional states with symptoms of depression and anxiety and has yet to be reported in HIV-positive women living in Ontario, Canada, who are known to live with contributing factors. This study aimed to determine the prevalence, severity, and correlates of psychological distress among women accessing HIV care participating in the Ontario HIV Treatment Network Cohort Study using the Kessler …
The importance of motherhood in HIV-positive women of reproductive age in Ontario, Canada
Motherhood is personally, culturally, and historically rooted. Recent publications have focused on medical issues related to pregnancy and HIV, with attention on fetal well-being. There is limited literature on the importance of motherhood for HIV-positive women. Our study's purpose was to investigate the importance of motherhood among HIV-positive women of reproductive age in Ontario, Canada and to analyze the correlates thereof. We present our …
Breaking the Glass Ceiling
The meaningful involvement of women living with HIV/AIDS (MIWA) is a key feature of women-centred HIV care, yet little is known about transforming MIWA from principle to practice. Drawing on focus group data from the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS), we explored HIV-positive women's meaningful involvement in the design and delivery of HIV/AIDS services in British Columbia, Canada. In this article, we highl…
Why Aren't You Breastfeeding?”
Infant feeding raises unique concerns for mothers living with HIV in Canada, where they are recommended to avoid breastfeeding yet live in a social context of "breast is best." In narrative interviews with HIV-positive mothers from Ontario, Canada, a range of feelings regarding not breastfeeding was expressed, balancing feelings of loss and self-blame with the view of responsibility and "good mothering" under the current Canadian guidelines. Ackn…
Barriers to access to care reported by women living with HIV across 27 countries
Increased access to successful antiretroviral therapy (ART) is necessary in order to achieve an AIDS-free generation. Importantly, slightly over half of the people living with HIV are women. Small studies have described many barriers to accessing treatment and care among women living with HIV. This cross-sectional, non-interventional, epidemiological study assessed the prevalence of barriers to accessing care for women living with HIV across 27 c…
Adequacy of prenatal care among women living with human immunodeficiency virus
Despite universal health care, disparities exist in the receipt of adequate prenatal care between women living with and without HIV. Interventions are required to ensure that women with HIV receive timely and adequate prenatal care
Hear(ing) New Voices”
Peers discussed the strengths and weaknesses of participatory methodologies in survey development
It’s a very isolating world’
HIV health services research conventionally defines place in terms of proximity to care. However, understandings of place must also include the social spaces that women living with HIV (WLWH) occupy which shape their experience of health and access to care. Drawing on focus group data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study, we explored how 28 WLWH navigate geographic place and social space in attempting to acces…
Retrospective Reports of Developmental Stressors, Syndemics, and Their Association with Sexual Risk Outcomes Among Gay Men
Gay and bisexual men (GBM) continue to have a disproportionately higher HIV incidence than any other group in Canada and the United States. This study examined how multiple co-occurring psychosocial problems, also known as a syndemic, contribute to high-risk sexual behavior among GBM. It also examined the impact of early life adversity on high-risk sexual behavior as mediated by syndemic severity. A sample of 239 GBM completed self-report questio…
Perceived HIV risk, actual sexual HIV risk and willingness to take pre-exposure prophylaxis among men who have sex with men in Toronto, Canada
Pre-exposure prophylaxis (PrEP) reduces HIV acquisition. Our goal was to determine the willingness of men who have sex with men (MSM) to take PrEP given perceived and actual HIV risk. HIV-negative MSM were recruited from September 2010 to June 2012 and asked about PrEP willingness and perceived HIV risk. Actual sexual HIV risk was measured by three condom-use components generated through principal components analysis. General HIV risk was measure…
Differential predictors of ART adherence among HIV-monoinfected versus HIV/HCV-coinfected individuals
Although adherence is an important key to the efficacy of antiretroviral therapy (ART), many people living with HIV (PLWH) fail to maintain optimal levels of ART adherence over time. PLWH with the added burden of Hepatitis C virus (HCV) coinfection possess unique challenges that potentially impact their motivation and ability to adhere to ART. The present investigation sought to (1) compare ART adherence levels among a sample of HIV/HCV-coinfecte…
Assessing access for prospective adoptive parents living with HIV
Work has been underway to increase the availability of parenting options for people living with and affected by HIV. One option, adoption, has not yet been explored in the literature. The study aimed to gain a better understanding of the potential of adoption for individuals/couples living with HIV in Ontario, and to assess potential structural barriers or facilitators that may impact their experience navigating the adoption system by conducting …
Comparison of coping strategies and supports between aboriginal and non-aboriginal people living with HIV in Ontario
Complex historical and cultural factors have contributed to the HIV epidemic among Aboriginal populations in Canada. This study assesses social supports, adaptive and maladaptive coping mechanisms, stress, and mastery of Canadian-born Aboriginal and Canadian-born Caucasian people living with HIV in Ontario and posits that coping and social support are important micro- and meso-level factors associated with the epidemic. This cross-sectional analy…
HIV/AIDS Research and Interventions (73 obras) · Medicine (73 obras) · Family medicine (42 obras) · Psychology (36 obras) · Sociology (33 obras) · Demography (32 obras) · HIV, Drug Use, Sexual Risk (32 obras) · Environmental health (29 obras) · Adolescent Sexual and Reproductive Health (28 obras) · Human immunodeficiency virus (HIV (27 obras)