PhD focuses on cardiovascular disease among women living with HIV

‘Women of child-bearing age who are living with HIV face an added burden of obesity and hypertension, which heightens their risk of developing cardiovascular disease (CVD), particularly in resource-limited settings.’

This concern led Dr Sherika Hanley, a specialist family physician and lecturer in Family Medicine at UKZN to pursue a quasi-experimental PhD study at two clinics in eThekwini’s Umlazi Township. The research assessed the effectiveness of regular screening and lifestyle modification interventions in limiting CVD risk factors among South African women with HIV.

Hanley was the principal site investigator for the US PEPFAR-funded PROMOTE prospective observational study conducted across four African countries, which assessed long-term outcomes in women with HIV. The vast majority of the participants had controlled HIV; however, obesity levels were high at the study site. ‘During this time, studies that were mainly conducted in high-income countries suggested a link between HIV and CVD. The lack of data from low- and middle-income countries inspired my PhD project,’ she said.

Co-supervised by Professors Daya Moodley and Mergan Naidoo, her study found a high prevalence of metabolic syndrome, obesity, and abnormal HDL levels combined with unhealthy lifestyle practices amongst the study cohort aged 18 to 49. The intervention she developed improved dietary choices, physical activity, and blood glucose and high-density lipoprotein (HDL) levels, demonstrating the potential benefits of lifestyle modification and regular screening for CVD risk factors in women with HIV.

Hanley said: ‘The study’s intervention failed to improve obesity that remains a challenge in under-resourced settings such as South Africa, particularly among women. Interventions need to be person-centred and sustainable, with robust monitoring of CVD risk in the era of dolutegravir (antiretroviral medication).

‘I am relieved and grateful to have reached this academic milestone,’ said Hanley who was awarded the National Research Foundation Thuthuka grant towards her PhD. She said she received tremendous support from the UKZN-DRILL Fellowship and thoroughly enjoyed her journey as a student at the University.

‘I am privileged to share my graduation day with my youngest sibling, my brother Dr Shaheev Parthab, who graduated with his Master of Medicine in Surgery.

‘I am presenting my PhD findings as an oral presentation at the International AIDS Conference in Brisbane, Australia in July this year. My goal is to leverage my prior research, training and experience to establish myself as a leader and resource in the field of chronic multi-morbidity, in particular HIV and non-communicable diseases in resource-limited settings. I hope to expand my clinical research expertise to include implementation science to bridge the policy and research implementation gaps, and to address important research questions regarding person-centred health service delivery for people living with chronic multi-morbidity.’

She said she gains her strength from the support of her husband, son, parents and siblings. ‘Good music and dancing feed my soul. I also enjoy playing tennis and travelling.’