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Podcast 2 - transcript

Podcast theme - Transfer

On episode two, we talk about things that transfer from one place to another.

  1. Discover how traces of DNA can transfer onto things you’ve never touched, leading to wrongful convictions - with Professor Ruth Morgan, Professor of Crime and Forensic Sciences in the Faculty of Engineering Sciences
  2. Hear about future technology that will send information on light waves rather than radio waves - with Dr Paul Haigh, a visiting lecturer and a former senior research associate within the Communications and Information Systems Group
  3. and learn how antiretroviral drugs prevent the transmission of HIV between partners with Professor Alison Rodger, Professor of Infectious Diseases and consultant at the Royal Free London NHS Foundation Trust, and Simon Collins, HIV positive treatment advocate at i-Base, an organisation that provides information about HIV treatment to HIV positive people and healthcare professionals.

TRANSCRIPT

Suzie McCarthy: This is made at UCL: the podcast. Bringing you closer to the UCL research answering life's big questions. From engineering to art, healthcare to space exploration, ancient artifacts to the technology of the future. Episode 2: Transfer.

Hello! I'm Suzie and welcome to our second episode. This month, I have stories for you about things that transfer from one place to another. We'll be talking disease transfer, transfer of information and, for our first story, the transfer of forensic evidence. Last episode, we stepped into the office of Professor Ruth Morgan.

***

Ruth Morgan: So I'm a professor of forensic science...

Suzie McCarthy: Head of UCL's Centre for Forensic Science.

Ruth Morgan: So we have two major themes there, one of them...

Suzie McCarthy: We talked about how human bias can sometimes lead people to wrongly interpret forensic evidence.

Ruth Morgan: How can we understand what it means and then we're also looking at how do we...

Suzie McCarthy: This time we're heading back to further explore the complexities of forensic science and technology.

In 2000, a young woman went clubbing with her boyfriend. During the night out, the two had an argument and parted ways. Two days later, she was found dead on a golf course. The case went to court and the boyfriend and one of his friends were convicted of murder. Forensic evidence was crucial in charging the two men.

Ruth Morgan: In the judges summing up, he presented to the court that the critical point on which the verdict was rest was on what they made of the forensic science evidence. They'd found these particles that were on the victim and in the suspects vehicle, and the prosecution's case was that these particles are very rare, and that the fact that they were on the suspects vehicle and on the victim meant that the victim must have sat in the vehicle very shortly before death.

Suzie McCarthy: The particles examiners found on the woman's clothing were called cerium and lanthanum.

Ruth Morgan: They're tiny little spheres. And you can get about three of them within one hair’s width.

Suzie McCarthy: These tiny spheres were also found on the seat of the van the two men had been driving.

Ruth Morgan: They were seen as proof of their involvement in the murder. And that was for very reasonable reasons. One was that they were made of rare earth elements so considered to be rare...

Suzie McCarthy: Which makes sense. If something is called rare, you would assume it to be well, rare!

Ruth Morgan: The second assumption was that they were incredibly small particles, very, very rounded. And so if they would go onto clothing, it was reasonable to think that they might fall off quite quickly.

Suzie McCarthy: In other words, the men must have been with the victim much sooner before her death than they claimed. Three years after the guilty verdict sent two men to prison, Ruth started investigating the transfer of various types of particles. And she found something really quite important.

Ruth Morgan: We found that these particles are actually quite common. That they're all over the place.

Suzie McCarthy: It turns out that the reason that cerium and lanthanum are called rare earth elements is not because they are in fact rare, but because they are found within rocks which are spread quite evenly across the earth, and therefore not found in high quantities in any one place. In fact, they can be found in lots of everyday objects, such as cigarette lighters. [sounds of lighters clicking]

Ruth Morgan: When you flick a disposable lighter, you're getting 4 or 5,000 particles every time.

Suzie McCarthy: At the time of the case, there was no public smoking ban. The victim had been in a club the night of the murder, so many lighters would have been flicked that night, releasing cerium and lanthanum all over the place. [lighter sounds continue]

Ruth Morgan: And we then did some experiments looking at those particles on clothing and how long they last. And we found that after 18 hours, there was still a very significant proportion of those particles still on the clothing. So that increased the time window when those particles could have been transferred on to the clothing. So on that basis, it was shown that the particles weren't as significant as had been originally thought in the original trial.

Suzie McCarthy: Essentially, the case had rested on forensic evidence have been totally misunderstood. Research findings on lighter particles led to the two men's sentences being quashed, and they were released from prison. This might seem like a special case, but in a study published last year, Ruth's team has found that forensic evidence is being misunderstood in an alarming number of investigations.

Ruth Morgan: Yeah, so we looked at cases at the Court of Appeal between 2010 and 2016. And we found just under 1000 cases where criminal evidence had been critical in the original trial, and that would have included forensic science evidence. And when we looked into those cases, we found that in 22% of them, there was a misinterpretation of evidence.

Suzie McCarthy: This misinterpretation includes a lack of understanding about how evidence is transferred from one place to another. This doesn't just apply to weirdly named rare earth particles, but also to the evidence we most commonly associate with forensics: DNA.

Ruth Morgan: A woman was found murdered and they found male DNA on her cardigan buttons.

Suzie McCarthy: In this second murder case, investigators traced this DNA from her buttons. as well as from skin cells found under her fingernails, to a taxi driver. The man was arrested and spent 8 months in prison as he awaited trial. This time, however, the defense was able to call into question the evidence have been used to charge the man.

Ruth Morgan: The scenario that the defence presented as to how this man's DNA was on the victim’s cardigan buttons when he denied having killed her, centered around the fact that he was a taxi driver. And she had been in the taxi and in giving her change at the end of the journey, she had received the change that he'd handled, put that in her purse, and somehow there’d been his DNA on those coins, which then transferred onto her hands, which she then transferred onto her cardigan.

Suzie McCarthy: The defence also explained that as the taxi driver had a skin condition, he shed more cells than the average person. And so his skin could easily have ended up under her fingernails. The taxi driver was exonerated (found not guilty) but he'd already spent time in prison for a crime he didn't commit.

There are many reasons that forensic evidence might be misinterpreted in this way. Often, it's because detectives barristers, judges, and jurors view forensics as the kind of evidence that can't be argued with. Modern forensic technology is so sensitive now that it can give us all kinds of information about the crime scene. And more information seems to offer a better chance of solving a case.

Ruth Morgan: You only have to be speaking in a room for about just under a minute and it's possible to detect your DNA.

Suzie McCarthy (in room with Ruth): How would your DNA transfer?

Ruth Morgan: So I mean, so when you when you're speaking, there is saliva, but there's also other ways that our DNA can be transferred. Each of us loses between 30 and 40,000 skin cells every single hour. So the quantity of biological material that it is possible to recover, in a room where you've been sitting or where you've been speaking, is quite significant.

Suzie McCarthy: And as the technology develops, it gets more sensitive and can pick up more of that biological information like skin cells.

Ruth Morgan: I often say forensic science is a technological success story, because what we can now detect, the accuracy with which we can detect it, the speed that we can do that is just increasing all the time. As that sensitivity has increased, it's actually raised a number of new challenges that we need to be able to address. So it's now not enough for us to find, say, gunshot residue on your jacket to know that you find a gun. It's not enough to know that it's your DNA on a weapon. It could be that there are other ways that that DNA got there.

Suzie McCarthy: Ruth and her colleagues are conducting all kinds of experiments to help us understand what happens when DNA or other particles transfer. For example, they've been firing guns in the lab and looking at how the tiny particles that make up gun residue (things like barium, antimony and previously lead) move once the gun has been shot.

[gun shot sounds]

Ruth Morgan: If you fire a gun, you will get gunshot residue on you. What we're seeing is that it is possible for you to transfer that gunshot residue you onto somebody who hasn't fired a gun, if you make a direct contact with them, say shake their hand. And we've also seen that it's possible that if you touch a door handle, having fired a gun, and then somebody else who hasn't fired a gun and touches that door handle, there can be a transfer through that intermediary object.

Suzie McCarthy: So if you happen to be listening to this podcast while waiting for your train to work... [train sounds]

Ruth Morgan: You know, you're waiting at the station, the train pulls up. You press the button to open the doors, you get on, you maybe to touch a grab rail. You then get off the other end…

[train announcement: “Would all passengers please take care”]

…grab onto the escalator. There are various things that you will be touching that lots of other people have touched. Our experiments are indicating that it is possible, if somebody else has fired a gun and touched that grab rail that you then go to touch, that there could be a secondary transfer taking place. It's very complex picture. But there are definitely ways that you could have residues on you, that don't necessarily mean you fight on this morning.

Suzie McCarthy: I think I'll be looking at people on train platforms a bit more closely from now on. Clearly, that's not the answer. So what is?

Ruth Morgan: I think, a number of different things. I think one of the things is that we see a lot of forensic science in the media. And that's really great because it's really good at showcasing the capabilities that science can have. You know, so that's a real positive of the way that forensic science is portrayed in the media. But I think what it has also done is it's given an impression of the kinds of answers that science can give, which in the real world, it can't always do. So I think one of the things we need to be much better at is knowing what kind of questions can science give us answers to? And what kind of questions can it not at the moment?

Suzie McCarthy: Okay, so what can it tell us?

Ruth Morgan: We're very good at what. What is something? You know, what is it made of? Is it barium? Is it antimony? And we're very good at who. Is it this person's finger mark or is it this person's DNA? What we need to know is how did that DNA get there? And when did it get there? Because if we can answer those two questions as well, then we can start telling you what the evidence means in a particular case.

Suzie McCarthy: So those experiments firing guns in a lab, for example, are helping to inform the how and the when.

Ruth Morgan: And then there's also the understanding of the human decision making part and understanding expertise and understanding better how external factors might be influencing what we're seeing and what we're understanding and so on. I'm a real believer that we need to understand the physical trace, but also the human investigators and the human scientists who are engaging with it. Because both of those two things are absolutely critical to getting the answers.

Suzie McCarthy: So shows like CSI might suggest that forensic science is clear cut. But in order to prevent wrongful convictions, we need to be more realistic than that.

Ruth Morgan: There is a perception that science can give you a very clear black and white answer. And actually, it's very rare that we can give black and white answers. There's always some uncertainty because we're dealing with a very complex world. And so how we communicate what we do know, and what we don't know, is really important.

Suzie McCarthy (in room with Ruth): It doesn't mean forensic science is no good at all?! It's just that science...

Ruth Morgan: No!  And I think that's really important. I think sometimes people are saying, ‘oh,’ ‘you know, ‘you're sweeping the credibility of forensic science away’, and it's absolutely not. It's, it's showcasing the absolutely incredible things that the science can do and the kinds of questions that can answer but it's also being very clear about where there are things that we still don't know. And where we need to be investing in finding answers to those things so that we can know. And that we can continue to grow the capabilities that forensic science can offer.

***

Suzie McCarthy: Understanding how science works is really crucial, especially in an age where there is a growing awareness of scientific uncertainty and where experts are often dismissed. And, as Ruth says, that includes being honest about what forensic science can and can't tell us.

Our next story takes us from the transfer of gun residue to the transfer of information. And it starts with a light.

Paul Haig: So, imagine that you have a light, like an LED, and you switch it on and off, but you switch it on and off really, really quickly, much faster than you can notice with your eyes. So it looks like the lights on all the time but in actual fact, it's switching on and off. And then suppose that we switch it on and off in a pattern that corresponds to some information that we want to send. So, for example, if we want to stream a video on YouTube, in essence, that dilutes to a binary sequence of ones and zeros data. So you can impress that series of ones and zeros onto the LED, onto the light. So it flickers with that pattern. And then on your laptop, or phone or computer or whatever, you can sense that series of information, the ones and zeros, which translates to a video that you might want to watch or internet or a game that you might want to play or or so on.

Suzie McCarthy (in room with Paul): So you turn the light on and off.

Paul Haig: Yeah

Suzie McCarthy  (in room with Paul): Really fast? And that can send a video to a computer?

Paul Haig: Exactly. That's right.

Suzie McCarthy: This is Dr. Paul Haigh, an expert and visible light communications. Which is basically Wi Fi but on light. It's a new technology in development and UCL is one of the places that Paul and his colleagues have been working to make it a reality. What it means is that in the near future, the light bulbs in our ceilings won't just be lighting up our rooms, but sending signals to computers and other devices. We will be getting the internet not through broadband routers, but through LED light bulbs.

Paul Haig: If that makes any sense whatsoever.

Suzie McCarthy (in room with Paul): I mean, it doesn't make any sense.

Suzie McCarthy: Whether it makes sense to you, or whether like me, it only half makes sense and the rest seems like magic, Lifi technology is going to make big changes within the next 5 to 10 years. Firstly, it can send a lot of data much faster than traditional Wi Fi. Because light cycles at a frequency which is much faster than radio waves. Each little LED lamp will each be turning on and off really fast and sending loads of information out into the world. And let's be honest, we all appreciate fast internet.

Paul Haig: The current speed record in VLC (in visible light communications) is about 17 gigabits per second, which is... or maybe more, I'm not sure... I think it's about 17 gigabits per second, which is 17 billion pieces of information every second. Which is something like three Blu-ray discs every one second. Which is rapid. It's really fast. And if anybody can watch three Blu-ray discs in one second, it’s even more impressive. [laughs]

Suzie McCarthy: It's true. I've never watched three movies at the same time before, let alone in one second! But more than just fast internet, Paul told me about some applications that could even be life saving.

Paul Haig: One really important and interesting aspect for me is not data communications inside your house or your office or anywhere you want to stream videos because Wi Fi does quite a good job of that. But it's actually in cars and transport systems, where you might use the brake lights of the car in front of you as an early warning system for your car. So you could put a small set of photo detectors that sense the light and convert it into electricity on your bonnet. And then if the car in front of you suddenly breaks, the red lights come on, and instead of you having to react to that car suddenly breaking, and potentially having an accident, actually, the photo detector will read that warning sign and, and slowly automatically break your car to avoid kind of traffic collisions and so on. So I think that's one super cool application of the technology. I think that's really exciting and has a big future.

And the other one is cancer research. So we have this new thread of development where we're looking at how the light signals can measure oxygen inside tissue. And that translates to tumour growth. And I'm completely ignorant in this area, so I can't tell you any more than that! That's what I've understood. So what we're doing what we're starting to do now is develop plastic foils with lights and detectors on that you can actually place on the tissue and pulse light through it. So that's light with the signal on top of it. And then at the receiver, measure the signal and see how it's changed from what we transmitted. And that corresponds to, somehow by some magic, the oxygen level inside the tumour. And therefore we can gain a lot of information about whether or not somebody does or doesn't have cancer and what stage is and how it's, you know, kind of developing and so on

Suzie McCarthy (in room with Paul): It does seem a bit like magic

Paul Haig: It is a little bit like magic. But there's a lot of clever people that do a lot of clever things. And I'm not one of them, I'm afraid.

Suzie McCarthy (in room with Paul): Well you must be a little bit,

Paul Haig: It's a massive team, you'd be surprised, you'd be surprised.

Suzie McCarthy: So here's the thing. Paul's own expertise is in something called digital signal processing, which essentially boils down to finding ways to filter out interference in the signals that these devices send, to make them as fast as possible.

Paul Haig: That's where my expertise lie. And that's what I like to kind of mess around doing.

Suzie McCarthy: Now, he's got to be pretty clever to be able to do this, but he couldn't do it alone. And more than that, he couldn't come up with the idea of how to apply this technology to cancer diagnosis without a whole team of experts, each with their own specialisms.

Paul Haig: So there's a big collaboration there's a collaboration that includes UCL engineering - Ioannis Papakonstantinou and Manish Tiwari -  the Great Ormond Street Hospital - which is Paolo De Coppi -  and also myself in Newcastle. And this is a collaboration that includes proper doctors, if you want, the people that do the surgeries and so on and save people's lives, and us who like to play engineering games. And these we have kind of complementary skills together. So we're mechanical engineers, electrical engineers, a little bit of biomedical engineering in the middle. And all of those skills together make a solution that we can then give to the doctors, and maybe they can apply to their patients down the line somewhere.

Suzie McCarthy: Now, forgive me for this analogy, because it's very much on the nose. But I can't help thinking of all those experts, as though they were all the little lights turning on and off, sending and receiving information themselves. I've sometimes heard people being critical of academics and of the amount of money that goes into research funding. I've heard people say that researchers ought to 'get a real job'. Paul's own dad doesn't really understand what he does...

Paul Haig: Five years working in a university and [I've] told him a million times that I'm working . But he still always tells me when you're gonna finish school. So...

Suzie McCarthy: And sure, a lot of what goes on at universities is about learning and experimenting. And sometimes it hits dead ends. Or it might find something that is only useful in a very, very small way. But sometimes, when a number of people come together and swap ideas and share information, they can find solutions to much, much bigger problem. A lot of this is based on chance. But that sort of chance can only come about when funding allows open cooperative environments to be created. And transfers of information can take place from one human to another. It's for this reason that research councils are keen to fund something called interdisciplinary research.

Paul Haig: So that means that you organize a group with people who have completely different expertise than you, you have an idea and you say: "This might work. This might be really cool." So you get together with some people in a different department that might know about those things. And you say:

"Well, what can we do together? How can we solve these problems?"

And then, you know, over a coffee or a beer or whatever, you might have a conversation where somebody has a piece of expertise, for example, in healthcare, ( [in] which I have no experience, I have experience in signal processing and optics) and say:

"Well, actually, we have this problem in connected health. And I can see a solution to that based on my expertise."

And I can say to my colleague: "Well, actually, why don't we try this?" And because of the fact that we've had a conversation, because we've had the funding and the opportunity, that might lead to a thread of research that significantly improves society and maybe solves one specific problem.

The cancer detection came about kind of in the same way. So it's really cool when those type of things happen and it's so natural. And also then when you start doing those projects, you're really excited about it and, you know, you know the potential of what you're doing and you can see that there could be an outcome and it's all very exciting.

Suzie McCarthy: When we decided to cover this story, I was really determined to pin down exactly how this magical light communication works. But I realised that what's more important is how this technology came to be, and how it continues to be developed: through specialists working collectively, transferring their knowledge from one person to another.

Suzie McCarthy (in room with Paul): And you know, when you like, think about the universe as a whole?

Paul Haig: Yeah.

Suzie McCarthy (in room with Paul): And you get like a bit teary, because it's just like, woah?

Paul Haig: Okay, yeah,

Suzie McCarthy (in room with Paul): Does that... do you... is that just me or?

Paul Haig: I can't relate personally. But go ahead.

Suzie McCarthy (in room with Paul): Okay. [laughs] Well, that's how I get. And then I used to get like that about computers, because it just seems, and the same with internet like, it does seem like magic. And it does seem like, you know, how did humans make that happen?

Paul Haig: It's just clever people doing stuff.

Suzie McCarthy (in room with Paul): Yeah.

Paul Haig: When people have some interest in what they do, and they really like, you know, like spending their time on that and they're given the opportunity and the resources, people can do magic.

***

Suzie McCarthy: Our final story is also pretty magic. But this time it's about preventing a transfer from taking place. HIV is no doubt a disease that you've heard of before. But when I found out about this UCL research, I was amazed that its findings are not known by every single one of us.

Alison Rodger: So I'm Allison Roger.

Simon Collins: So I'm Simon Collins

Alison Rodger: I'm a Professor of infectious diseases at University College London

Simon Collins: I'm an HIV positive treatment activist at an organization called HIV i-base

Alison Rodger: I also work at the Royal Free [Hospital] as an infectious diseases consultant.

Simon Collins: We produce lots of information for HIV positive people about treatment, and there's some resources there about prevention and the way HIV is transmitted.

Suzie McCarthy: Alison and Simon worked together on a study called the PARTNER2 study. Alison led the research and Simon was a community representative who helped to make it possible. It had been suspected for some time that if you had HIV and were taking the right antiretroviral treatment, you could have unprotected sex without passing on the virus.

Simon Collins: Lots of people were already pretty convinced that within their partnership, it was safe. And lots of doctors were also saying this. There was data going back to 2000, so that's almost 20 years ago. Some doctors had little bits of evidence, saying that transmissions didn't occur if viral load  was dramatically lower from being on treatment.

Suzie McCarthy: But there was not enough data to prove this was definitely the case. Which is where the PARTNER2 study came in.

Alison Rodger: We recruited about 1,000 couples over the time, one positive one negative.

Simon Collins: Not asking anyone to change what they were doing, just to record, tell us how it went for the last few months. How often did you have sex, roughly what you did so we can work out what the risks were if there were different risks, and then slowly compile that data over what turned out to be 10 years.

Suzie McCarthy: And in those 10 years, they got a lot of data.

Alison Rodger: They had sex without condoms 77,000 times. And that's a lot of sex. But despite that there were no transmissions from the positive partner on suppressive treatment to the negative partner. We're all very clear now that if you are on suppressive treatment and you have HIV you’re actually non-infectious,

Suzie McCarthy: If your viral load is undetectable, you cannot transmit HIV to your partner.

Alison Rodger: It's basically as if you don't have a virus.

Suzie McCarthy: And in order to get this vital message across, the team needed it to be heard.

Simon Collins: The press coverage was remarkable. Overnight, you suddenly had Channel Four, BBC One, BBC Two, Sky News were pulling people in. It was so dramatically powerful.

Alison Rodger: And we did that deliberately. It wasn't just because you know, the study had ended and we wanted a bit of a splash, we thought it was a really important message to get out. And something that became clear (I did a lot of the interviews) was how different our thinking was and our knowledge was compared to the wider population.

Suzie McCarthy: Researchers were surprised by the gap in knowledge between themselves and the general public. But this was also true for people with HIV and doctors too. People struggled to accept the finding, even though the evidence was so clear.

Simon Collins: On one level, doctors who are often quite conservative people may need a little bit of reassuring and persuading with the data to actually make the jump from saying, “we think it's a very low risk” to actually say, “it's a zero risk”.

That's a big jump for a doctor. And so that involves getting doctors to a point where they would realise that they're not suddenly going to be sued because someone's coming through the door, saying, "Actually, look what happened when we stopped using condoms."

It's not going to happen. And so in the same way that medical professionals need support and need results highlighted and explained, this the same for HIV organisations.

Within HIV positive networks and support groups, lots of HIV positive people are very surprised when they hear these results. They don't quite believe them. Most HIV positive people are incredibly worried about their partners.

You know, even if their partners say, '”Oh, it's fine, I'm not really worried about it”

The HIV positive person is always worried about, “well, you know, what happens if we're a bit more save or a bit less safe?”

If that was new, and if you had spend all that time worrying about your partners, you'd need a little bit of time for this news to settle. Might take three months, six months or a year for that news to settle for them. They still might say, "I appreciate the results of the study but just in case I'm going to carry on using condoms for a while."

And then slowly acceptance gives them the option to change that aspect of their life if they want to. So it's not like we're running out to have condom-less parties as soon as the news breaks! Actually, this is news that people found challenging and difficult to accept. If it takes time for HIV positive people to do that, and, and it takes time for HIV doctors to do that, who understand all the science, you can see the gap that there might be between the general public and our study results, which means that we need much more of a widespread campaign. We need something on TV that explains this.

Alison Rodger: So we talk a lot about U=U and people who have access to treatment, and people who are on treatment. So I think the remaining issue that we are very aware of is actually trying to test people early so that they can work out their status, and trying to get people on treatment. And we're also very aware about stigma and discrimination. I mean, globally, you know, a lot of people, the key populations affected by HIV, are stigmatized for other reasons. So we know in some countries still, same sex relationships are criminalised. We know in many countries being HIV positive is criminalised. And we know that a lot of the criminalisation laws based on HIV were actually rushed through in the 1980s. And they haven't evolved to keep up to date with the science. So, I mean, again, Simon can talk about it much better than I can, but there are people imprisoned on the basis of risks that our data set disproves. And so I do hope that a lot of this will also combat [these laws/this discrimination]. Especially in the US, Russia, [who are] particularly bad in terms of criminalizing HIV and actually imprisoning people, not based on the kind of legal principles of you know, intent or causation or any of them [but] just because they are HIV positive.

Simon Collins: So but the laws are being changed state by state in the US in order to recognize that the laws were established at a time, you know, 30 or 40 years ago when there was very little knowledge and a lot of fear. And actually, the success of medicine has completely changed that.

Alison Rodger: I listened to a really interesting talk at the AIDS conference in Amsterdam last summer. And it was Robert Suttle. I don't know if you heard him Simon? He was basically imprisoned in, I think, Louisiana. He was a gay man who had a bad relationship breakup. He was on treatment he was suppressed and his partner went to the police and he was imprisoned. He could have a 10 years, he did a plea bargain for six months in a penitentiary. There was no risk to his partner at all. His partner remained negative, but he was imprisoned for that. And there are people who are worse than him. The whole thing about people being in prison and there was absolutely no risk to their partners.

Suzie McCarthy: The PARTNER2 study has been an important funding for a campaign called U=U, which stands for undetectable equals un-transmittable. The U=U campaign aims to inform patients and healthcare providers about the amazing effect of proper treatment.

Alison Rodger: One of the key things I think partner has done is really underpin that campaign and given that campaign the confidence, which has now been rolled out globally. I mean, it's something like 900 organisations, last time I looked, have signed up to it, including all the major health organisations.

Simon Collins: It's fantastic to be included in a study with positive results. You know, where the outcome is very simple to explain: [if] you are on effective treatment then, whether you use condoms or not, HIV isn't something you need to be worried about.

Alison Rodger: The impact I'm telling people in clinic about U=U. I mean, it's a hugely emotional thing for a lot of people, isn't it? You know, they just didn't know.

Simon Collins: So give us some examples of how, of the reactions you've had?

Alison Rodger: Well I've had people, you know, people cry, because this is just liberating for them that, you know, their deepest fear is that they're infectious and actually, to know that they're not infectious… And we know even from studies a couple years ago, if you ask HIV positive people on treatment, how infectious they think they are, then a lot of them think that they're still infectious and we know that they're not. So it's just trying to get the word out. Just to normalise this.

Suzie McCarthy: The study has been so beneficial to the community, and so certain in its findings, that Alison received an unexpected reaction when she presented it at conference in Amsterdam.

Alison Rodger: And I was presenting it and I gave the results and a lot of people in the audience started clapping, which is unheard of for scientific presentation! And you suddenly realised how much the results meant to people. Because you get into the scientific mode, and it was actually quite emotional doing it. I made it through to the end...

Simon Collins: You got a standing ovation.

Alison Rodger: Well… Thank you. But it was just then you realised how much these results meant to people living with HIV, their partners, just liberating, I think. But yeah, it was it was a big study. I mean, you know, Simon was involved, I was involved, Andrew Phillips, Ian Sogun? It was a big study group. And actually a lot of people put a lot of effort, time and effort, because we believed in the study and wanted the answer.

Simon Collins: And a thousand couples.

Alison Rodger: And a thousand couples! So yeah, I always say thank you to the couples who give their time and energy and without them we wouldn't have got the answer.

Simon Collins: All that energy going into those 77,000 times that people had sex, we really appreciate you did this! [laughs]

Alison Rodger: I did say that conference once and a guy came up to me and said, "I took part in this study and I'm more than happy to have sex for any study any time!”

But no, the result meant, that aside, the result is such a positive outcome.

Simon Collins: Yeah, great outcome.

Alison Rodger: It's great news.

***

Suzie McCarthy: So spread the word! Tell your friends, family, your neighbors, the bus driver that takes you to work. Also, if you or somebody you know is affected by HIV, do check out the U=U campaign and Simon's organization, HIV i-base, (that's i hyphen base) which will provide you with all the information and links you might want to know more.

That brings us to the end of this episode. If you've enjoyed what you've heard so far, do tell people about it. We're on all the usual social media and you can talk about the podcast with the hashtag #MadeAtUCL.

MadeAtUCL: the podcast is made by me, Suzie McCarthy. The executive producer is Nina Garthwaite, additional reporting this episode from Isis Thompson. Mixing support from Mike Woolley. We'd like to thank all our researchers for welcoming us into their labs and offices. #MadeAtUCL is a campaign that brings to life disruptive thinking from UCL. Research presented in this episode was nominated and selected because of the impact is made on everyday life and society. This episode is brought to you from UCL minds: events, lectures and podcasts, open to everyone.

Transcribed by https://otter.ai Transcript edited by Suzie McCarthy.