DR NOMATSHILA’S GROUNDBREAKING RESEARCH REDIFINES HIV CARE

Walter Sisulu lecturer, Dr Zanele Nomatshila, has successfully defended her doctoral thesis at the University of Stirling in Scotland, marking the culmination of an outstanding academic journey that contributes a powerful perspective to human immunodeficiency virus (HIV) research.

Her work shines a spotlight on the disconnect between the objectives of HIV treatment programmes and the lived realities of people affected by the disease in underserved communities.

Titled “Beyond Viral Suppression of HIV: Quality of Life of People Living with HIV in the Eastern Cape Province, Republic of South Africa,” her research challenges conventional approaches to HIV care by arguing that treatment success should be measured not only through biomedical outcomes but also the overall well-being of individuals.

According to Nomatshila, though people living with HIV/AIDS can suppress their viral loads, their lives remain fragile as they struggle socially, economically and emotionally.

“The disconnection left a lasting impression on me and ultimately inspired my doctoral research. The global HIV/AIDS policy is obsessed with the biomedical endpoint, which is the undetectable viral load, however it is important to note that suppression is not restoration,” Nomatshila argued.

She emphasised that in a province like the Eastern Cape, where poverty, stigma, gender-based violence and food security are rife, a suppressed virus does not equate to a quality of life.

“Patients still suffer from chronic fatigue, depression, social exclusion and internalised shame. They may be clinically successful, but humanly failing,” she added.

Nomatshila’s research sought to challenge this prevailing narrative by developing a context-specific Quality of Life (QoL) framework that extended beyond physical health to include psychological well-being, social connectedness and economic resilience.

“I argued that we are currently not treating people, we are targeting numbers. The healthcare system needs to shift from pursuing viral suppression to achieving vital restoration. Eastern Cape, with its unique cultural belief systems and rural health challenges, provided the ideal context to expose this global blind spot.”

Far from viewing her PhD as the culmination of her work, Nomatshila sees it as the foundation for meaningful change, stating that it is an endpoint, rather than a blueprint.

She plans to translate her QoL framework into community-based interventions programmes, including equipping community health workers with tools to asses both clinical and psychosocial indicators that promote hope and happiness.

“In the long-term, my goal is to influence both national and World Health Organization (WHO) policies. I aspire to contribute to committees responsible for revising HIV care guidelines so that psychosocial factors are recognised as critical indicators of treatment success,” she said.

Reflecting on her research journey which strongly aligns with United Nations Sustainable Development Goal 3, she added: “My research taught me one unshakeable truth: A life saved is not the same as a life lived.”

She credits much of her success to the unwavering support received from the Faculty of Medicine and Health Sciences.

Nomatshila is one of three graduates of the South African Doctoral Training Programme for Health Sciences, a collaborative initiative between historically disadvantaged institutions in South African and the University of Stirling.

By Thandeka Mgqibi