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Meet & Greet with Nathalie Sohier: “Telling Someone They Were HIV+ Was Synonymous With a Death Sentence”

In this week's Meet & Greet interview, Nathalie SohierSVP Head of Infectious Diseases and Vaccine Franchise at Parexel, shares her experience working in the medical field and with HIV patients, the challenges people with HIV face, and how she thinks the treatments for HIV would progress.

Image credit: Nathalie Sohier

Can you tell us a bit about your career, and how you came to work around HIV/AIDS?


As I was finishing my medical studies, I worked in a very big prison near Paris, and part of my job was to share HIV test results with detainees. At that time, telling someone they were HIV positive was synonymous with a death sentence. That was a difficult responsibility for a very young doctor. Additionally, non-voluntary homosexual relationships were common in this type of setting – where violence is everywhere – which added to the problem and there was nothing we could do to prevent transmission. We discussed the possibility of distributing condoms with the administration, but it took us a lot of time and energy to see this approved. As a young doctor, I often felt helpless, but I also learned a lot.


For the next 10 years, I continued my career with International Medical Non-Governmental Organisations. In 1988, while I was working with Doctors of the World in South Africa, one in five adults who came to my clinic had a sexually transmitted infection (STI). I had to convince the local priest and the nuns who were helping at the clinic that condoms were part of the treatment as much as antibiotics. They finally allowed me to provide them to my patients. However, it was very clear that HIV/AIDS would become a major catastrophe in this country where STIs were so prevalent and where key leaders stayed silent on the emerging epidemic.


When I was working with Doctors Without Borders (MSF) in Southeast Asia, Africa and Latin America in the early nineties, while there was still no treatment for HIV, we focused on preventing HIV transmission in the healthcare setting through nursing and medical procedures (infusions, injections and blood transfusion). At that time, many patients were infected with HIV while receiving routine injections. I remember babies who were admitted to the hospital in Uganda because they had severe malaria and needed blood transfusions. They received blood from non-tested donors. Sadly, one blood bag from one person would infect all the babies with HIV who would each receive a small quantity from the same bag.


In addition to working in health care settings, we also supported and developed creative programs to inform populations about HIV transmission, such as theatre plays in local villages in Malawi. After my time with MSF, I went back to the hospital in Paris and worked for the French Agency on AIDS Research (ANRS). I took care of HIV/AIDS patients participating in clinical trials for HIV drug development. In parallel, I also developed a training program for healthcare professionals on Therapeutic Patient Education for patients with HIV/AIDS. Then I worked for a few years with a big pharmaceutical company, which developed HIV drugs and developed a Therapeutic Education training program in French hospitals for the benefit of patients. I finally joined Parexel, a clinical research organization (CRO) that conducts clinical studies for the pharma industry. I am the head of infectious diseases and am still involved in HIV drug development today.


What's the biggest highlight of your career to date and why? 


This is a difficult question because I have worked in very varied environments, and I was always passionate about what I was doing and learning. Working in medical humanitarian organizations, caring for HIV/AIDS patients, taking part in the development of much-needed drugs and vaccines and teaching healthcare professionals how to be more patient centred through therapeutic education programs are all big highlights in my career.


What are the main challenges facing people living with HIV?


This depends very much on where you live. In developing nations, the main challenge is to receive antiretroviral drugs (ARV) without shortages of supplies. The other challenge is having access to lab tests to make sure that the treatment is still efficacious. In case of viral failure, the next challenge is to have access to second-line treatment, which is much more expensive than the first-line treatment and thus more difficult to access. Discrimination is also a very big challenge, especially for women who are ostracized from their families and become homeless, even if it is known that their husband was the carrier of the HIV virus in the first place. In the Western World, the challenges are different, as people have better access to care and discrimination may not be as harsh, although both are still challenges. Another type of challenge is ageing with HIV, as your body ages more quickly and patients encounter more co-morbidities.


How has your work shaped your worldview?


We need activists and NGOs as much as we need the pharma industry to make a better world. I believe that some types of technical progress can improve the lives of people, but it takes much more than finding a new drug to improve people’s lives. The drugs must reach patients and the mentality of societies has to change to be more open and accepting. The latter is much more complicated, and we see that in many countries and domains we are regressing rather than progressing.


In your opinion, what does the future look like for people living with HIV?


There are several long-acting treatments in development, and these will allow people living with HIV to receive one or two injections every six months without needing to think about the complexities of receiving daily treatment or the need to hide their medication at home or when crossing borders when they travel.


I think this will help a lot in patients’ lives.  Research is also in development on treatments and vaccines that will allow the body to control the infection, but I do not see that coming on the market very soon.


What’s next for you?

When I retire, I look forward to going back to humanitarian work.

Join myGwork's World AIDS Day panel on 1st December to hear more from Nathalie and other panellists.

Check out some of myGwork's other recent Meet & Greet interviews, including:

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