UCL Institute of Clinical Trials and Methodology


Marthe Le Prevost

Senior Research Nurse - MRC CTU at UCL

When did you first become interested in medicine/science?

I guess it was when I decided to become a nurse, and that was very much through an interest in working with children. I had quite good skills across the board. I liked science and social science. I just thought nursing allowed you to have both.  
That would have been in school, in the classic, ‘deciding what you wanted to do your A-levels for’ moment. I was trying to look at a way of merging different skills and interests: the academic and the social aspects. For me, that never equalled medicine. I always thought the patient contact was better in nursing, and that was my main interest. 

Could you describe your current role?

I coordinate AALPHI, which stands for ‘Adolescents and Adults Living with Perinatal HIV’. It’s an adolescent cohort study. There are very few adolescent HIV cohorts in the world so it’s a really exciting study. We’re following up over 300 HIV-infected young people and just over 100 HIV-negative affected young people in the UK. This is the first group of young people to survive into adolescence so it’s crucial to find out how they’re doing. It’s really unusual to have such a big HIV-negative control group in a study like this.  
It merges lots of my interests. It has got a very scientific base, as we’re looking at neurocognitive, cardiac and metabolic outcomes. But we are also looking at the psycho-social component. You can’t look at the other outcomes – particularly neurocognitive outcomes – in isolation from where these kids have come from, and what their social environment is like.
I was really interested in this study for exactly the same reasons I was interested in nursing: it’s a mix of science and social-science. And it’s a brilliant, brilliant study. And everyone thinks it’s great, so everyone wants to be involved in it: all the clinics like it and the young people like it.  
I think I’m doing all sorts of things that I never knew that I’d be doing - lots of data stuff - and I’m starting to make much more sense of the science with those new skills. It’s a really unique project to be working on. It was quite a big tear coming away from clinical work, and it was only because it was such a brilliant project that I even considered it. 

And you’re also taking a PhD part-time?

Yes. It’s one of the great things about working here, that I’ve been really encouraged to push myself. My PhD is comparing children with HIV in paediatric care and those who’ve transitioned into adult care, and seeing how their outcomes differ. I’ve only been doing it for 3 months so it’s quite new!
But it feels like an exciting opportunity. I’m working with the teams here at MRC CTU at UCL and the qualitative team at the London School of Hygiene and Tropical Medicine, so it’s an innovative, mixed-methods model. 

Can you tell us a bit about how your career developed?

It’s funny how these things work… I trained outside London, and although I’m from London I didn’t know very much about the hospitals in London from a work perspective. I’m the first person in my family to do anything vaguely scientific (I’ve got a creative family and they all think I’m a bit odd!).
So I didn’t really know where to apply. I applied for several hospitals and took the first job that I got offered and – amazingly – it was on a paediatric infectious diseases ward. And that’s how I’ve ended up doing HIV.  
I instantly liked HIV, just because of the complexity of the patients. They have very sick families with lots of social problems and loads of exciting stuff happening in the treatment field. It was the late 1990s/early 2000s when I started working in this area, so there were drugs around but they were unlicensed. But very quickly, new drugs and information started to come out.   It felt like a very exciting – and daunting – time to join as a junior nurse. I was at St Mary’s, which was really central in paediatric HIV care in the UK, so it was a pretty great unit to be working in.
I love working in this field. I like the families, the children, and now I’ve been working with colleagues in this field for 20 years.

And how did you join MRC CTU at UCL?

MRC CTU at UCL and the HIV world work quite closely together, so I’ve been partially involved in the PENTA trials for a long time and had worked with people here before.
AALPHI just came at the perfect time. I’d been working clinically for quite a long time, and wanted a change.  Because it had patient contact (interviews) it felt a unique project to be working on. And it’s all really new stuff. There are only a couple of other cohorts like this, in America and France.
People have had real difficulty recruiting the HIV-negative groups and so the fact that we have a good control group is really important. Using standardised norms (levels taken from the whole population) for our group is very problematic because they are rarely comparable, so having an internal control group for the study is really crucial and gives the results a lot more meaning.

Have you experienced barriers in your career, or have there been any times when you have needed extra support?

No, I haven’t, I think I’ve been very lucky. I don’t know whether it’s just HIV, but I’ve always been really supported at every level and encouraged to go for positions that I wasn’t sure I was ready for.
I’ve always had the experience that if you work hard and give it a go then it’s been fine, but I don’t know if paediatrics is different or if I’ve been lucky with hospitals…

What plans do you have for future research?

I feel like I’m at quite a big crossroads of my career. I miss the clinical work in lots of ways, but I have really enjoyed all the new aspects of doing AALPHI.
A large reason I’m doing a PhD is to try and open new doors. I’m hoping that the experience will clarify things and show me different areas of research.
I really like cohort studies and would definitely want to keep working in some form of cohort studies. I also really like being involved in mixed-methods research as I can see the benefit of both and the combination together.  
Studies like CHIPS have been crucial to paediatric HIV in this country. Having that knowledge of the bigger cohort is key when you’re looking at relatively small clinics dotted around the country. I think it’s really exciting, crucial work to be involved with in providing that overall picture. Sometimes when you’re in the clinical world it’s really hard to have the time to think about that and it’s been a great opportunity to step outside and look at it from a very different angle.