HIV Risk Attached to Using Injectable Contraceptives Studied for PhD Degree

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Centre for the AIDS Programme of Research in South Africa (CAPRISA) research associate and basic scientist, Dr Sinaye Ngcapu, received a PhD for his research on the HIV infection risk associated with the use of injectable hormonal contraceptives.

Ngcapu’s thesis was titled: “Impact of Injectable Hormonal Contraceptives on Innate Immune Environment in the Genital Tract in Women at High Risk of HIV-1 Infection”.

His studies focused on the HIV infection risk associated with using injectable hormone contraceptives (HC) in the context of a heterosexual epidemic in South Africa; and the potentially confounding effect of DMPA (also known as Depo-Provera) use in prevention research.

DMPA continues to be one of the popular hormonal contraceptive methods used by South African women aged between 15 and 49, Ngcapu said. Although access to effective methods of HC have substantially reduced maternal and infant mortality rates through giving women more control over when to have children, long acting high-dose progestin formulations (such as DMPA) have also been associated with an increased risk for HIV-1 infection.

‘The mechanisms by which DMPA might increase susceptibility to HIV-1 acquisition are important to investigate, especially in a country like South Africa where DMPA is commonly used and HIV-1 prevalence rates are high,’ said Ngcapu.

His study thus investigated the biological effect of injectable HCs on the innate environment in the genital tract of HIV-1 negative women at high risk of HIV-1 infection and the impact of injectable HC use on the genital immune environment and epithelial barrier function of HIV-1 infected women.

‘We demonstrated that injectable HC use down-modulates expression of specific chemokines, adaptive cytokines and growth factors. During acute and early HIV-1 infection, using vaginal biopsies, vaginal epithelial thickness was found to be similar in women using injectable HC compared to non-injectable HC users. Our findings suggest that modulation of cytokine and epithelial barrier factors in the genital tract rather than epithelial thinning might underlie altered HIV-1 acquisition risk in DMPA users,’ he explained.

During his student days, Ngcapu twice scooped best poster awards at the College of Health Sciences’ Annual Research Symposium.

In 2014, he was awarded the prestigious Columbia University-Southern African Fogarty AIDS Training Programme international traineeship that enabled him to spend a three-month internship at Northwestern University in Chicago, which he described as ‘an awesome opportunity to both conduct research with leading scientists in the field and immerse myself in an entirely different scientific world’.

Born in the rural village of Mdolomba near King Williams Town in the Eastern Cape, Ngcapu attributes his success to personal sacrifice. ‘I have never had the luxury of being a full-time student, having to work to support myself through my studies and, despite this, I have consistently aimed for excellence under difficult conditions,’ he said.

The ecstatic Ngcapu thanked his supervisors, Professor Quarraisha Abdool Karim and Dr JoAnn Passmore, and paid tribute to the mentoring environment at CAPRISA as well as the support of CAPRISA and UKZN colleagues in his development. He dedicates his PhD degree to his family, especially his mother for her sacrifices, faith and unconditional loving support.

CAPRISA’s Professor Quarraisha Abdool Karim said: ‘Sinaye defied many odds in obtaining his PhD and is an inspiring role model for other young people particularly from historically disadvantaged communities for what can be accomplished with hard work, discipline, dedication, commitment,  persistence and perseverance.’ 

Lunga Memela