"I'm Anne Rancourt for AIDS.gov, and I'm here with Dr. Mike Cohen
from the University of North Carolina at Chapel Hill.
Mike, thanks for joining me." "Thank you, thank you."
"So, Mike, you ran the study that found out that being durably virally suppressed prevents HIV transmission
when, in heterosexual couples through sexual intercourse.
Tell us a little bit about your study and about your findings."
"In that study we had the opportunity to enroll 2,000, almost 2,000, couples worldwide
where one person was HIV-infected and the other person was HIV-negative.
And through that study we were able to demonstrate that in that situation
when we treated the infected person with antiretroviral drugs
that we prevented, essentially eliminated, the transmission of HIV."
"And for people who are in a serodiscordant relationship where one person is living with HIV and the other person is not,
what can they take home from these findings?"
"So because we've continued the study for a very long period of time and
showed that the benefits are durable, it seems logical that
the relationship should be such that that the person who's uninfected should come to believe,
should trust, that if the person who's infected is taking their pills reliably, is seeking medical care appropriately,
that the risk becomes negligible of HIV transmission.
In our study it was zero, essentially, in the face of suppression of viral growth by antiretroviral treatment that people now take."
"And what does it mean to be durably virally suppressed?"
"Well, people... in the old days, you know, HIV was not treatable.
Nowadays one pill a day is an appropriate treatment and that leads to what we call viral copy number that's below fifty copies or unmeasurable.
Under those conditions the person who is infected is rendered not contagious.
In addition, that can, that viral suppression leads to a fully normal lifespan, excellent health and a normal lifespan.
So, it's a huge breakthrough in medical care and public health to everyone's advantage to understand if they're infected and to take appropriate medication."
"And so if you're on treatment for HIV and you're living with HIV, do you need to be tested frequently to make sure that your viral load is undetectable?"
"Yeah, I think that's a very individualized question for the person who's infected and their doctor.
The person who's infected should certainly indicate to their doctor that they're in a relationship with somebody who is uninfected
and that they're taking medical care for themselves and for the safety of their sexual partner.
The physician providing the care needs to be aware of what's going on with the patient and their relationship
and be sure that the testing is done frequently enough to reassure the relationship.
The couple needs to communicate about this because, certainly the loving relationship, the partner who's infected doesn't want to infect the other partner.
And by taking their pills reliably that possibility is rendered very remote."
"Mike, this is an incredible finding that has meant so much to people living with HIV. What has it felt like to run this study and to arrive at these findings?"
"Well, this was a great privilege. You know, everybody, we didn't know... We started this study twenty years ago,
so we spent ten years trying to understand which drugs to use.
Then we spent another eight to ten years doing the study.
So, when we learned in 2011, that was our first finding, that we had essentially eliminated HIV transmission, it was a remarkable moment, that, that...
And we were rewarded by being recognized as the 'Science Breakthrough of the Year.'
But the study continued.
And then it was very exciting for us to have all of the results of the study and demonstrate that the results were durable.
We had a big magnitude and they were durable, and so we had a chance, a once-in-a-lifetime chance to contribute to public health and medical care for individual patients.
The study also showed immediate treatment or earlier treatment is better for personal health.
So, public health and personal health move in the same direction.
When we started the study, treatment and prevention were separate.
With the study, treatment and prevention became connected, one thing.
That was very, very exciting. And so, for me, it was a great privilege.
You know, I got to lead the study, but thousands of people worked on this study.
Thirteen sites and nine countries with 2,000 couples, almost 2,000 couples, it's a lot of people.
And at the end of the study I learned... I was doing an interview at the end of the study and I realized that couples celebrated with parties for their contribution.
These people, you know, volunteered their health and their safety and their lives to participate in something that changed medical care and public health care.
So it's very exciting, in all candor."
"Thank you, Mike." "Thanks."