UKZN PhD Graduate Breaks Ground in HIV Research

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Balancing the demands of clinical medicine, motherhood, and academic research, Dr Gaysheen Kistan has achieved a remarkable milestone, graduating with a PhD in Obstetrics and Gynaecology from the University of KwaZulu-Natal (UKZN).

Her pioneering study sheds critical light on the safety of HIV prevention medication for pregnant and breastfeeding women in Africa.

Supervised by Professor Daya Moodley, Kistan’s research, ‘Effect of Tenofovir Disoproxil Fumarate/Emtricitabine on Maternal Bone Mineral Loss in African Breastfeeding Women’, addresses an urgent gap in understanding the impact of pre-exposure prophylaxis (PrEP) on maternal health.

Reflecting on her journey, Kistan described the experience as both demanding and deeply rewarding. “I feel relieved and grateful to finally complete my PhD, which took seven years. It was a chaotic but gratifying experience as I had my two children during this time and also juggled my clinical responsibilities with my research,” she said.

Her study focused on the effects of Tenofovir-based PrEP - widely used in HIV prevention - on bone mineral density, renal function, and metabolic health in HIV-negative pregnant and breastfeeding women. Importantly, her findings provide reassurance that there were no harmful effects associated with the use of Tenofovir-containing PrEP during pregnancy.

While previous studies on Tenofovir disoproxil fumarate (TDF) and bone mineral density have produced inconsistent results, Kistan’s research stands out for its focus on African women, particularly those who are pregnant or lactating - a group often underrepresented in clinical studies.

Her work also explored additional factors influencing bone health, including vitamin D status and serum mineral levels, contributing to a more comprehensive understanding of maternal health in this context.

“This study adds to a very limited body of evidence on bone mineral density in young, healthy African women,” Kistan noted. “I aimed to examine antiretroviral drugs in HIV-negative pregnant and lactating women to discover any adverse effects and ultimately improve clinical care.”

Kistan’s passion for women’s health and HIV research was shaped early in her career. As a junior doctor during the height of the HIV and AIDS epidemic in South Africa, she witnessed firsthand the devastating toll of the disease.

Over time, she also saw the transformation brought about by antiretroviral therapy, turning HIV into a manageable chronic condition.

However, the persistently high rates of HIV among pregnant women remain a concern. “We are now entering the era of preventative medicine with the rollout of PrEP to pregnant women,” Kisten explained. “Yet there is still a paucity of data on HIV-negative individuals. My research aims to address that gap.”

Her academic journey was not without obstacles.

The onset of the COVID-19 pandemic significantly disrupted her research timeline, forcing delays and adaptations in patient follow-ups to ensure safety. Despite these challenges, she credits the strong support system at UKZN for helping her persevere.

Born and raised in Durban, Kistan matriculated from Durban Girls’ College before pursuing her undergraduate Medical degree at the University of Cape Town. She returned to Durban to complete her internship and later specialised in Obstetrics and Gynaecology at UKZN, where she also earned her Master of Medicine (MMed).

Since 2016, she has served as a specialist at Addington Hospital and now holds the position of Acting Head of the Clinical Unit in Obstetrics and Gynaecology. She began her PhD in 2019 while continuing her demanding clinical duties.

Kistan emphasised that her success was made possible by the unwavering support of her family and supervisors. Outside of her professional life, she finds joy in being a mother to her two young children. “They never fail to bring a smile to my face,” she shared. “I cherish our time together, especially outdoor play and swimming.”

Words: MaryAnn Francis

Photograph: Sethu Dlamini