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HIV/AIDS denial (HAD)
"...the magazine Continuum, run by HIV-positive dissidents, shut down when its editors all died of AIDS-related causes."*
The denial that there is compelling evidence that HIV (human immunodeficiency virus) causes AIDS (acquired immune deficiency syndrome). The scientific consensus is that AIDS has killed more than twenty-five million people worldwide and that HIV causes AIDS. (See Viviana Simon, et al. "HIV/AIDS epidemiology, pathogenesis, prevention, and treatment." Lancet August 5, 2006: 489-504.)
Several reasons have been given for denying that the evidence is compelling that HIV causes AIDS:
AIDS is not a well-defined disease entity but rather a sociopolitical construct (Culshaw) or a single name for numerous diseases;
HIV has never been isolated in pure form, so that the existence of HIV is questionable as is validation of HIV tests;
Antiretroviral treatments have never been proven in properly controlled trials to effect clinical improvement or better health, let alone extended life;
The existence of HIV has not been proven; HIV tests are unreliable; and there is no evidence for sexual transmission of HIV (Papadopulos-Eleopulos*)
HIV exists but it's harmless (Duesberg, among others);
HIV is not sexually transmitted and does not cause AIDS (Henry Bauer, among others);
Pharmaceutical firms know that antiretroviral drugs are ineffective at treating AIDS but effective at causing AIDS (Rath and Farber);
AIDS deaths are caused by malnutrition, narcotics, and antiretroviral drugs.
Some of the more notable HAD proponents are Henry Bauer, a retired chemistry professor and writer (The Origin, Persistence, and Failings of HIV/AIDS Theory 2007); Hiram Caton, ethicist and retired professor of politics and history (The AIDS Mirage 1995); Rebecca Culshaw, a mathematical biologist (Science Sold Out: Does HIV Really Cause AIDS? 2007); Peter Duesberg, a professor of molecular and cell biology (Inventing the AIDS Virus 1997); Celia Farber, a journalist (Serious Adverse Events: An Uncensored History of AIDS 2006; "Out of Control: AIDS and the Corruption of Medical Science", Harper's, March, 37-52; 2006); Neville Hodgkinson, medical journalist (AIDS: The Failure of Contemporary Science 1996); John Lauritsen, a market research executive and analyst, and gay activist (Poison by Prescription: The AZT Story 1990; The AIDS War: Propaganda, Profiteering, and Genocide from the Medical-Industrial Complex 1993; Death Rush: Poppers & AIDS Lauritsen & Wilson 1986; The AIDS Cult: Essays on the Gay Health Crisis Lauritsen & Young 1997); Christine Maggiore, an HIV-positive person who worked in advertising and marketing, and died of pneumonia sixteen years after being diagnosed (What If Everything You Thought You Knew about AIDS War Wrong? 2000); Gary Null, a radio talk show host and promoter of "natural living" (AIDS: A Second Opinion 2001); Eleni Papadopulos-Eleopulos, a hospital worker with a bachelor of science degree in nuclear physics from the University of Bucharest (The Perth Group); David Rasnick, a biochemist, designer of protease inhibitors, and senior researcher for the Mathias Rath Health Foundation; Mathias Rath, M.D.; Rodney Richards, an organic chemist and former Amgen employee; and Joan Shenton, a medical journalist (Positively False: Exposing the Myths Around HIV and AIDS. 1998).
There are also many HAD websites like Rethinking AIDS, Alive and Well, HEAL, and the website of the San Francisco chapter of the AIDS Coalition to Unleash Power (ACT UP). The SF group used to ask the government to fund AIDS research; now it writes letters to members of Congress asking them not to fund such research.* The website proclaims that
HIV does not cause AIDS...
HIV antibody tests are flawed and dangerous...
AIDS drugs are poison...
Other chapters of ACT UP have condemned the SF chapter.*
Of course, websites exist to counter the HIV/AIDS deniers (HADers): the National Institute of Allergies and Infectious Diseases has posted The Evidence That HIV Causes AIDS; The Centers for Disease Control and Prevention has posted a Fact Sheet; the World Health Organization has posted an HIV/AIDS page; www.aids.org has posted Answering the AIDS Denialists: Is AIDS Real?; AIDSTruth.org has posted Debunking AIDS Denialist Myths; and the Southern Methodist physics department has posted AIDS Denial is Pseudoscience.
Two curious facts stand out from this list of HADers: few are highly qualified scientists with degrees from reputable universities and none of them has a background in epidemiology and has been directly involved in HIV or AIDS research. The closest we get to someone actually working in the field is Dr. Culshaw, who has done mathematical models of HIV infection, Dr. Richards who worked for the company that developed some of the first HIV antibody tests, and Dr. Rasnick, who developed protease inhibitors similar to those used in AIDS treatments. The HADers have come to their positions primarily by drawing inferences from personal experience and anecdotes, or from the published work of others. The first question we should ask is: Why do the HADers have any credibility? After answering that question, we can then ask have the HADers drawn correct inferences from the anecdotes and data they cite or have they cherry-picked the evidence?
Because of their beliefs, many HADers recommend that AIDS patients be treated with vitamins and herbs, massage, homeopathy, and a variety of unproven remedies.* Three of the most outspoken HADers in this area are Gary Null, David Rasnick, and Mathias Rath, who make a partial living selling vitamins and other supplements. A few years ago, the most significant HADers were Thabo Mbeki, the president of South Africa, Manto Tshabalala-Msimang, the health minister of South Africa, and Anthony Brink, head of the Treatment Information Group (TIG), founded to support his contention that antiretroviral drugs are a form of pharmacological genocide. Brink is self-taught in pharmacology. In recent years, Mbeki has distanced himself from Brink.* In the past, Mbeki got at least some of his advice from the Internet and novels like The Constant Gardener (Nattrass 2007) and invited the HADers to convene in his country,* but recently his party (the African National Congress) has taken the consensus position of the scientific community.Tshabalala-Msimang has some training in medicine, obstetrics, and gynecology, as well as a masters degree in public health from the University of Antwerp. None of the South African HADers have any background in HIV or AIDS research, but all at one time were convinced that antiretroviral drugs are designed to kill people and they recommended things like garlic and beetroot to build up the immune system and fight off AIDS. As far as I know, Brink continues to hold these dissident positions.
[update] In South Africa today (2013), more than 6,300,000 people are living with HIV; about 200,000 South Africans died of AIDS in 2013.* (The population of South Africa is about 53 million.) The HADers have had no impact on the scientific community but what has happened in South Africa is evidence that they are having a significant impact in non-scientific communities. Smith and Novella note: "As these challenges to mainstream theories have largely occurred outside of the scientific literature, many physicians and researchers have had the luxury of ignoring them as fringe beliefs and therefore inconsequential" (2007). This has happened before with areas like paranormal research, free energy (perpetual motion) claims, and many kinds of so-called "alternative" health treatments and psychological therapies. When you add media pseudosymmetry to the fact that the scientific community is too busy doing science to swat the flies of fringe beliefs, you have a recipe for a fringe community with no credibility in the scientific community having great impact on segments of society. Fortunately for South Africans, things are changing. South Africa now has the largest antiretroviral treatment program in the world. Life expectancy has increased by 5 years since the height of the epidemic and these efforts have been largely financed from its own domestic resources. The country now invests more than $1 billion annually to run its HIV and AIDS programs.* (Unfortunately, AIDS is now the leading cause of death for adolescents in Africa, and the second leading cause of death among adolescents globally. About 120,000 people aged between 10-19 years died of AIDS-related illnesses in 2013. In South Africa in 2013, more than 860 girls became infected with HIV every week, compared to 170 boys.*) [/update]
Why would anyone give any credence to the claims of the HADers? Almost all of the advocates come from outside of the field of HIV/AIDS research, and few of them have scientific backgrounds. Tens of thousands of health care professionals and research scientists could be wrong, but it is rather odd that not one of them in the field is joining the HADers. Is it likely that they remain silent because they are all afraid of losing income or are in the pockets of Big Pharma? Why don't the scientists among the HADers publish in medical journals like Henry Bauer has? Is it likely there is a conspiracy to stifle the insights of those who go against the consensus of the scientific community? I don't think so. It is my guess that the reason the HADers have any credibility is that they provide an appealing message to many people who are filled with fear and who don't trust science, Big Pharma, or the government. The message is appealing to those who don't want to believe that HIV is related to their lifestyle or that they should use condoms when having sex. The message is appealing to those who are HIV+ and don't want to believe that they have been handed a death sentence.
But is there compelling evidence that would give credence to the HADers? I haven't been able to find it. For example, in her book and on her website Maggiore claims that since the effects of AIDS can be caused by things other than HIV, it follows that HIV doesn't cause AIDS. This is like claiming that since things other than cigarette smoke can cause lung cancer, smoking doesn't cause lung cancer. She also claims that there are misdiagnoses of AIDS, but her arguments are specious. She claims people can test positive from flu shots, pregnancy, and other viral infections. The consensus view is not that HIV is an absolutely necessary condition for any of the AIDS-defining illnesses, such as Kaposi's sarcoma (KS), pneumocystis carinii pneumonia (PCP), diarrhea, oral leukoplakia, cervical dysplasia, and so on. Nor is the consensus view that having one of the AIDS-defining illnesses suffices for a diagnosis of AIDS. Maggiore's death from pneumonia many years after being diagnosed, but living without being given standard treatment such as AZT drugs [standard at the time; for information on the latest treatments click here], neither proves nor disproves her hypothesis. She breast fed her daughter Eliza Scovill, who died of HIV-related pneumonia in 2005 at age three, though Maggiore denies her daughter's death was AIDS-related. A year before her death in 2008, she and her husband sued Los Angeles County and others on behalf of their daughter's estate, charging that the autopsy report lacked proper medical and scientific evidence for the declared cause of death. You can read the autopsy report and decide for yourself. Whether her death from pneumonia was AIDS related will probably remain controversial. Since she was under a doctor's care at the time of her death, there will be no autopsy unless her widower requests one.
The claim that there is no clinical evidence that AZT or other antiretroviral drugs is effective in treating AIDS is simply false.* In fact, one of the first studies to document the effectiveness of AZT was done by researchers who were so intent on proving that praying for AIDS patients could increase their longevity that they didn't even mention that the reason none of the AIDS patients died during their study was probably that they were all being treated with antiretroviral drugs.* The fact that someone without AIDS might be harmed by taking AZT is irrelevant to whether it is effective in treating AIDS patients. In any case, new drugs have been developed in recent years that are more effective than AZT.
The claim that the correlations between HIV and AIDS are illusory is simply false and seems plausible only because of selective use of anecdotes and reports.*
The evidence is compelling that HIV causes AIDS* and that "heterosexual intercourse is now responsible for 70-80% of all HIV transmissions worldwide."* The claim that AIDS is primarily caused by drug use is not supported by the evidence.* The claim that the AIDS problem in Africa is caused by poverty or that there is no AIDS problem in Africa is simply false and based on distortion and omission of evidence.*
Henry Bauer begins the preface of his new book The Origin, Persistence, and Failings of HIV/AIDS Theory with the claim:
... the accepted view incessantly urges "safe sex", particularly the use of condoms, on the grounds that HIV/AIDS is sexually transmitted. In point of fact, however, studies that note different degrees of condom use find that it makes no difference; and observations of actual sexual transmission find it negligibly small: unprotected heterosexual intercourse between an HIV-positive partner and an HIV-negative one results in the latter seroconverting – becoming positive – only about 1 time in 1,000, according to studies not only in the United States, but also in Thailand, Haiti, and Africa, where, according to official pronouncements, heterosexual intercourse is the chief mode by which HIV is supposed to spread.
Bauer is correct about the rate of seroconversion. According to Nancy Padian:
The current likelihood of male to female infection after a single exposure to HIV is 0.01-0.32% and the current likelihood of female to male infection after a single exposure is 0.01-0.1%.
However, it doesn't follow from this fact that condoms make no difference. As Padian notes:
... a man or a woman can become HIV-positive after just one sexual contact. In developing countries, particularly those in sub-Saharan Africa, several factors (co-infection with other sexually transmitted diseases, circumcision practices, poor acceptance of condoms, patterns of sexual partner selection, locally circulating viral subtypes, high viral loads among those who are infected, etc.) can increase the likelihood of heterosexual transmission to 20% or even higher. Evidence that specifically documents the heterosexual transmission of HIV comes from studies of HIV-discordant couples (i.e., couples in a stable, monogamous relationship where one partner is infected and the other is not); over time, HIV transmission occurs. Other studies have traced the transmission of HIV through networks of sexual partners. Additional evidence comes from intervention studies that, for example, promote condom use or encourage reductions in the numbers of sexual partners: the documented success of these interventions is because they prevent the sexual transmission of HIV.
In short, the evidence for the sexual transmission of HIV is well documented, conclusive, and based on the standard, uncontroversial methods and practices of medical science. Individuals who cite the 1997 Padian et al. publication or data from other studies by our research group in an attempt to substantiate the myth that HIV is not transmitted sexually are ill informed, at best. Their misuse of these results is misleading, irresponsible, and potentially injurious to the public.
Bauer, the retired chemist and science writer, also claims that "HIV has never been isolated in pure form, so that the "HIV tests" have never been validated – indeed, one can question the very existence of HIV."* However, those who actually do AIDS research claim:
... modern culture techniques have allowed the isolation of HIV in virtually all AIDS patients, as well as in almost all HIV-seropositive individuals with both early- and late-stage disease. In addition, the polymerase chain (PCR) and other sophisticated molecular techniques have enabled researchers to document the presence of HIV genes in virtually all patients with AIDS, as well as in individuals in earlier stages of HIV disease.*
Bauer also asserts that "antiretroviral treatments have never been proven in properly controlled trials to effect clinical improvement or better health, let alone extended life."* In fact, the table of contents of his HAD book looks like a complete list of the HADers program. Thus, if one is interested in finding out in one place what the HADers hold and what evidence they think supports their position, one might read Bauer's book.
On the other hand, if one is more interested in what the scientists actually doing the research have to say about HIV and AIDS, I suggest the reader peruse some of their publications or at least review the websites noted above that have been created to respond to the HADers.
Finally, it should be noted that several prominent scientists once associated with HAD have changed their views and have come to accept that HIV is an important causal factor in the development of AIDS: Robert Root-Bernstein, a professor of life sciences at Michigan State University (Rethinking AIDS: The Tragic Cost of Premature Consensus 1993); Joseph Sonnabend, retired physician, scientist and AIDS researcher; and Walter Gilbert, winner of the 1980 Nobel Prize in chemistry.
further reading
by the author
Evaluating Personal Experiences by Robert T. Carroll
Mass Media Funk: Mbeki invites Duesberg to Pretoria
Mass Media Funk: Mbeki blames poverty for AIDS
Mass Media Funk: Wangari Maathai, the Kenyan assistant minister for environment and natural resources and a professor of biology at Nairobi University, claims that HIV/AIDS is a biological weapon manufactured by the developed world to wipe out the black race from developing countries
Mass Media Funk: Mbeki improves but president of Gambia picks up the baton
SD Newsletter 46: AIDS dissident and advisor to the South African Health Minister, Dr. Robert Giraldo, recently recommended that HIV+ patients take a mixture of olive oil, lemon juice, garlic, and African potato.
SD Newsletter 75: Ignorance is not bliss
SD Newsletter 83: HIV/AIDS Deniers
books and articles
Iliffe, John. 2006. The African AIDS Epidemic: A History. Ohio University Press.
Padian N. et al. 1993. Prevention of heterosexual transmission of human immunodeficiency virus through couple counseling. Journal of Acquired Immune Deficiency Syndrome. Sep;6(9):1043-8
Padian N. et al. 1997. Heterosexual transmission of human immunodeficiency virus (HIV) in Northern California: results from a ten-year study. American Journal of Epidemiology; 146:350-7.
websites and blogs
HIV/AIDS Denialism in Wikipedia
Denying AIDS and other oddities
Errors in Celia Farber's March 2006 article in Harper's Magazine (2006). Robert Gallo et al.
HIV Denial in the Internet Era. 2007. Tara C. Smith and Steven P. Novella
Answering the AIDS Denialists: Is AIDS Real? (2000). by Bruce Mirken
news stories
Killer syndrome: The Aids denialists "...denialists anywhere in the world generally share several common beliefs. They say that the "myth" that HIV causes Aids is the product of conspiracies between governments and the pharmaceutical industry; that antiretroviral medication is toxic; and that one day the orthodox medical theories on HIV will crumble." (Haven't we heard the same crackpot paranoia from the anti-vaccination crowd?)
"AIDS Denialism’s House of Cards" By Seth Kalichman
Christine Maggiore, vocal skeptic of AIDS research, dies at 52
hindsight bias