Progress and purpose:

a conversation with Merck scientists and
HIV care providers

Dr. Peter Sklar, director, clinical research, Merck Research Laboratories and Dr. Kathleen Squires, global director for scientific affairs, infectious diseases/HIV, Merck Research Laboratories, work together as scientists on Merck's HIV drug discovery team. They're also practicing physicians who treat people living with HIV. Recently, they sat down for a conversation about what inspires them and their hopes for their patients.

Kathleen: Peter, I'm excited to be talking with you about our perspectives and experiences as HIV researchers and physicians caring for people living with HIV. I've been with Merck for about two years, but you've been here longer.

Peter: Eleven years.

Kathleen: I have my own motivations for working at Merck while continuing to treat patients - what are yours?

Peter: For me, working with people living with HIV is a privilege. You have the chance to help them lead healthier lives, which is tremendously rewarding. I'm fortunate that the things I'm deeply passionate about align with an area in which Merck remains committed, which is advancing HIV science. And by continuing to provide care, I'm able to stay true to myself.

Kathleen: Yes! That rings true for me. When I put on my white coat, I know who I am.

Peter: How does your work with patients influence your work as a scientific leader at Merck?

Kathleen: At Merck, we spend a lot of time talking about the voice of the patient. We try to consider the patient perspective and their unmet medical needs in every drug development decision we make. You and I are subject matter experts who can provide meaningful insights about what people living with HIV need to live more satisfying lives.

Peter: You were just a few years out of medical school when the AIDS epidemic began. What was it like?

Kathleen: I did my fellowship in New York City in the 1980s. New York was one of the hotbeds of the AIDS crisis. The stigma was horrifying. AIDS patients were abandoned by society. I chose to do clinical investigation because it allowed me to use my experience with patients while also making a difference for the greater community.

Peter: When I was deciding where to specialize earlier in my career, the opportunity to serve as a physician who could also advocate for people living with HIV appealed to me.

Kathleen: What about stigma today? How do you help people who are newly diagnosed with HIV?

Peter: The most important thing I say to people who are newly diagnosed is that you're the same person you were yesterday before you had this diagnosis. You are you. You may have this diagnosis, but together we're going to find a way to treat and manage it.

HIV-related stigma has evolved with better understanding of the condition, but it's still a significant issue. For example, because of stigma, a person may be afraid to go to an HIV clinic. They're worried someone might see them. If a person living with HIV defers their care, they may develop more advanced stages of untreated infection.

Kathleen: You and I have also talked about the Undetectable = Untransmittable campaign as an important tool against stigma.

Peter: U= U is the most powerful message I've been able to tell my patients in many years.

Kathleen: Undetectable= Untransmittable means that if you're on effective HIV treatment and the viral load in your blood reaches and stays at undetectable levels for at least six months, you effectively have no risk of transmitting the virus to others.

Peter: I think another way to reduce stigma is to normalize HIV testing and make it a routine part of care.

Kathleen: For people living with HIV, what do you think is key for them to successfully manage their condition?

Peter: The key to doing well is for patients to be engaged in their care. I feel we've been successful when we can broaden the focus of their health care beyond HIV. That's leaps and bounds beyond where we were when I got started.

Kathleen: One of the most interesting aspects of this field is that there's been constant learning and new discovery. At Merck, we believe more meaningful medical advances in HIV are still to come. We've been committed to HIV research and invention for more than 30 years, but we're not done yet.

Peter: Not even close.

Kathleen: Thanks for the conversation, Peter!

Peter: Thank you, Kathleen.