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Battling HIV in Women — and Their Babies

Protection and Advocacy for Vulnerable Patients

Considering the priority they have both placed on patient advocacy in their careers, it seems natural that Julie Barton, MD, and Patricia Garcia, MD, should be married. The two met in 1991 when Dr. Barton was a resident and Dr. Garcia was a maternal-fetal medicine fellow in the Department of Obstetrics and Gynecology at Northwestern University Feinberg School of Medicine. After being among the plaintiffs in a lawsuit to legalize same-sex marriage in Illinois, the couple married in 2014.

Halting HIV Transmission to Babies

Dr. Garcia, currently a professor of obstetrics and gynecology at Feinberg School of Medicine, now advocates for vulnerable patients every day through the Northwestern Memorial Hospital Perinatal HIV Program, which she directs. Part of the hospital’s Women’s HIV Program that she co-founded in 1991, the Perinatal HIV Program provides care and support for women who are pregnant and HIV-positive, or have HIV-positive partners, to prevent HIV transmission to their newborns.

“The ability to engage women and help them achieve an undetectable viral load means that there will be no [HIV] transmission to their infants,” Dr. Garcia explains. “Equally important is empowering women to prevent HIV infection in the first place, and helping them to control when and how they get pregnant. Helping women achieve safe pregnancies in safe ways leads to healthy outcomes.”

The largest provider of OB/GYN care for women in Illinois who are HIV-positive, the Women’s HIV Program offers complete gynecologic and obstetric care, counseling services and a peer mentorship program that pairs expectant women with mothers who have previously delivered babies through the program. The initiative has achieved a 99 percent success rate in preventing HIV transmission from mothers to their newborns.

However, that reduced transmission has not been matched by reduced prejudice toward people, particularly women, who are HIV-positive. “Stigma still abounds,” Dr. Garcia says. “Respecting and valuing everyone is an essential part of addressing HIV.” She is similarly concerned about “the vulnerability of the LGBTQ community in the current political climate. It is incumbent upon all healthcare providers to improve health equity for all individuals.”

Equal Health Care for All

Both Dr. Garcia and Dr. Barton, an OB/GYN specialist at Lakeshore Obstetrics & Gynecology and clinical assistant professor at Feinberg School of Medicine, have long track records of advocating for LGBTQ patients.

Dr. Barton, who specializes in providing OB/GYN care for women who have had breast cancer, shepherded the launch of the women’s health clinic within the Howard Brown Health Center from 1993 to 1997. Now called Howard Brown Health, the 45-year-old center is one of the nation’s largest LGBTQ organizations, offering a range of medical and social services across Chicago to improve health and wellness for the LGBTQ community.

Dr. Garcia was a member of the Presidential Advisory Council on HIV/AIDS from 2009 to 2012, and she says it was “an enormous privilege” to be a member of the group that developed and implemented the first national strategy to address HIV/AIDS. At the state level, she helped found and co-directed Perinatal Rapid Testing in Illinois (PRTI), an initiative that has implemented rapid HIV testing in every Labor and Delivery unit in the state.

Additionally, Dr. Garcia is thankful for her position as associate dean for curriculum at Feinberg, as it gives her the opportunity to help shape the education of future physicians.

“I want to ensure that the next generation of healthcare providers can eliminate health inequities,” Dr. Garcia says. “I’m proud of our initiatives to provide culturally competent health care for the LGBTQ community. I think the most important impact I can have as a medical educator is to ensure that our medical students have the knowledge and skills necessary to improve the health of our LGBTQ patients.”

Women’s HIV Program