Through her upcoming research project on perinatal health and HIV, Angie Bengtson, PhD hopes to answer critical questions about the development and impact of cardiometabolic diseases – such as gestational diabetes, gestational hypertension, and pre-eclampsia – amongst pregnant women with HIV in South Africa. 

As an Assistant Professor of Epidemiology and a PSTC faculty associate, Dr. Bengtson has conducted preliminary research on the issue with PSTC pilot funding and funding from Brown’s School of Public Health and the Providence/Boston Center for AIDS Research. 

More recently, Bengtson and her co-investigators, Landon Myer and Hlengiwe Madlala of the University of Cape Town, received a research grant from NIH Fogarty Center. The grant will allow them to expand the pilot project into a two-year research project involving close collaboration with the University of Cape Town and the Maternity Obstetric Unit at a Cape Town clinic. 

Noting the value of these collaborations and of working with patients in South Africa, Bengtson explained, “South Africa is unique in that it has a very high burden of HIV. In the setting where we’re working, 30% of women in antenatal care are living with HIV.” With regard to the risk of cardiometabolic disease, she added, “There’s also a very high burden of obesity, so you have a population that has underlying conditions that might already increase their risk.”

By following a cohort of HIV-infected women alongside a cohort of HIV-uninfected women throughout pregnancy and monitoring development of gestational diabetes and hypertensive disorders, Bengtson and her co-investigators hope to determine how HIV-status affects the risk of developing these diseases in pregnancy. 

The research will also entail evaluation of pregnancy outcomes (such as stillbirth and preterm birth) and 6-month postpartum follow-ups to screen the women and infants for health outcomes such as obesity, hypertension, Type 2 diabetes and insulin resistance. Bengtson noted that these follow-ups can potentially improve understanding of long-term impacts on cardiometabolic health for HIV-infected women and their children.

Another important finding that the investigation may yield is an enhanced understanding of the effects of a relatively new HIV medication, dolutegravir, which has been associated with significant weight-gain, especially for women. 

Bengtson hopes that the project can fill a crucial gap in HIV research, explaining, “The reason we’re interested in this is because we’ve known for a long time that HIV infection, and its treatment with anti-retroviral therapy, impact cardiometabolic health for people long-term living with HIV– but we really don’t know a lot about the impact of these conditions in pregnancy.” Of the limited research of impacts on pregnancy, she noted, “very little of that data has come from low- and middle-income countries.” 

Along with expanding research on the subject, Bengtson hopes that this work can contribute meaningful benefits to the lives of women. When asked about the primary goal of the research, she thought for a moment, then said, “Support the long-term health of women living with HIV. That’s really the overarching goal of my research in general. We want women living with HIV to have full, happy, healthy lives and to have all the resources available to make the reproductive and life choices that they want.”