Tom Bethell on AIDS--the breakdown

Chris has been excoriating Tom Bethell (author of "The Politically Incorrect Guide to Science") over on The Intersection and elsewhere (see, for example, here, here, and several posts here). However, since he's not yet done a takedown on Bethell's chaper on AIDS (titled "African AIDS: a Political Epidemic"), he suggested I have a go at it. Man, I knew the book would be bad, but it reaches a whole new level of terrible.

Bethell's central thesis will be familiar to anyone who's read the anti-HIV arguments by Peter Duesberg and others. As the chapter title suggests, Bethell claims that AIDS in Africa is a made-up epidemic; AIDS is really due to simple malnutrition and dirty water supplies, rather than a virus. Government officials, scientists, and journalists are either too brainwashed or too scared to speak against the "AIDS orthodoxy." The evil liberals aren't concerned about AIDS because the real concern of the left, according to Bethell, is overpopulation in Africa (and hence the emphasis on condom use to prevent AIDS). Public health officials aren't actually concerned about disease in Africa--just overpopulation. Little did I know.

However, Bethell's story is long on emotion and hyperbole, and short on facts. His references read like a report I wrote in my 9th grade English class: newspapers, a few books, magazines (heavy-hitters like Rolling Stone and SPIN), and a grand total of 2 references from science journals. Really, he should leave off the "Politically" portion of the title--the Incorrect Guide to Science is much more apt.

Okay, okay. Enough snark. (C'mon, reading this was 20 minutes of my life I'll never get back--I think I'm entitled to some seething). So, on to address Bethell's claims.

The "invention" of the AIDS epidemic in Africa

First, his suggestion that HIV was "invented." Bethell claims that, following a 1985 meeting in the Central African Republic, "overnight there were millions of Africans who had AIDS," and that HIV was not required for this diagnosis. Well, kind of. As Bethell notes but then subsequently ignores, well-equipped laboratories in Africa are few and far between. That was the whole point of the 1985 meeting: to try and figure out a clinical spectrum of AIDS that could be used to diagnose patients when viral confirmatory tests were lacking. By both necessity and practicality, then, the clinical definition did not include a positive HIV test--what use would that be when there was no clinical laboratory to carry out the testing, and no money to pay for it? Doctors basing their diagnosis on symptoms rather than a positive identification of a particular pathogen is nothing new, and it happens here in the U.S. every day as well. But as you'll see, Bethell (and other AIDS-deniers) hold that illness to a much more rigorous standard than they do the rest of infectious disease agents.

So instead, AIDS was defined according to four major symptoms: weight loss of 10% or more; pronounced weakness or lack of energy; diarrhea lasting for more than a month; and fever. Other symptoms commonly found included a persistent cough, chronic herpes infection, and swollen glands. There was a bit more to it than this, however: indeed, Bethell includes a diagnostic matrix which assigned a number of points to a variety of symptoms (for example, cough was worth 2 points, while generalized Kaposi's sarcoma was worth 12). Bethell quotes a journalist named Rian Malan (author of the aforementioned article in Rolling Stone) that "almost anyone in any African hospital could be said [to have AIDS]." What they neglect to mention, however, is that any physician is also going to take an extensive medical history. Simply coming in with a cough, diarrhea and weakness in an otherwise healthy individual isn)t going to trigger a diagnosis of AIDS, any more than someone entering a hospital with a headache and weakness won't automatically be diagnosed with a brain tumor, even though the symptoms may be consistent.

Bethell also tries to insinuate that HIV was somehow "removed" from the definition of AIDS in Africa, saying that following the African meeting, "HIV was no longer necessary for an AIDS diagnosis." However, the meeting he keeps harping on took place in 1985. The HIV virus was only identified a year prior, in 1984--so it's absurd and disingenuous to assert a newly-discovered virus was "removed" from the case definition of AIDS. Heaven forbid he let a little thing like honesty stop him, though, even while he chastises other reporters for ignoring the "real" AIDS story in Africa.

Sexual discrimination in AIDS cases

Next, Bethell says that

...infectious epidemics normally break out evenly between the sexes; viruses are not supposed to discriminate by sex. (In the U.S. today, however, over half of the new HIV infections are diagnosed among black men, so this virus apparently discriminates both by sex and by race).

Bethell claims that, by insisting on an African AIDS epidemic, officials at the CDC could claim that AIDS was an urgent plague, no one was immune, and everyone was at risk. These numbers also, he claimed, created an equal division between the sexes, a phenomenon not seen in the U.S. So, apparently, the idea of AIDS in Africa was just a ploy to get people in the U.S. to accept AIDS as a viral disease, instead of the "lifestyle" disease that many HIV-deniers had claimed (and continue to claim--more on that later).

Additionally, once again he's being misleading about the data. AIDS is found in all races. Yes, it is diagnosed more commonly in black men, especially when you take into account that they're in the minority numerically in this country. But again, this isn't unique to AIDS, something Bethell again ignores. Rates of all STDs are higher in minority populations. It's not a matter of the virus "discriminating by race;" it's that in the U.S., minorities are more likely to live in poverty and not receive as much education about STD prevention as their white counterparts. (But that's probably too "politically correct" for Bethell). You can find the latest AIDS stats here, showing that about half the new infections in 2004 were in blacks, ~30% in whites, and ~20% in hispanics. If you scroll down further, you can also see the data that show it's increasing among heterosexual women, though Bethell claims the "everyone is at risk" idea was just implemented as a scare and fund-raising tactic.

The HIV test

Bethell cites a 1999 WHO report, claiming that from 1982-1999, only 12,825 AIDS cases had been reported in South Africa. Bethell fails to note, or perhaps (giving him the benefit of the doubt--I'm feeling generous) he is simply unaware, that reported cases are only the tip of the iceberg. Additionally, while he uses those statistics to support his case that AIDS is a made-up disease in Africa, on the very next page he decries the "same old unreliable WHO estimates of HIV/AIDS." Can't have it both ways. He claims that the WHO numbers were then inflated when surveillance was undertaken in an effort to determine the actual seroprevalence of HIV. Though he only mentions surveillance undertaken at prenatal clinics in South Africa, those are far from the only surveys undertaken. Here, for instance, they discuss

The survey's fieldworkers visited 12,581 households across South Africa, of which 10,584 (84%) took part in the survey. Of the 24,236 people within these households who were eligible to take part, 23,275 (96%) agreed to be interviewed and 15,851 (65%) agreed to take an HIV test.

These were men and women, young and old. What did they find?

Based on this survey, the researchers estimate that 10.8% of all South Africans over the age of 2 years were living with HIV in 2005. Among those between 15 and 49 years old, the estimated HIV prevalence was 16.2% in 2005.

Funny, that. Matches up pretty nicely with other estimates made (including those done when testing pregnant women), and matches up with the death statistics. Ain't it nice when multiple lines of evidence converge to the same result?

Additionally, while Bethell shrugs off HIV tests taken during pregnancy and attributes the high prevalence found to false-positives, this page shows that even among pregnant women, the number of HIV+ women has been steadily increasing over the years. If they were simple false positives, there's no reason for the prevalence to increase.

He also describes more reporting by Rian Malan on deaths in South Africa, where Malan reportedly talked to coffin makers. Accoridng to Malan, business was so bad that coffin makers were closing their doors--certainly evidence that the AIDS epidemic was manufactured, right? I can't speak to South Africa's coffin economy, but statistics found here show a different story.

In February 2005, the South African government and Statistics South Africa published the report "Mortality and causes of death in South Africa, 1997-2003". This large document contains lists of how many people died from each cause over a six year period, according to death notification forms.

The government's report reveals that the annual number of registered deaths rose by a massive 57% between 1997 and 2002. Among those aged 25-49 years, the rise was 116% in the same six year period. Part of the overall increase is due to population growth and more complete reporting of deaths. However, this does not explain the substantial rise in the proportion of deaths occurring among persons aged 25 to 49 years. In 1997, people in this age group accounted for 23% of all deaths, but in 2003 they made up 34%

Additionally,

The MRC (Medical Research Council of South Africa) analysed a 12% sample of death certificate data from the year 2000-2001, and compared it to all the data from 1996. When they looked at deaths for which HIV was a reported cause, they saw that rates (deaths per thousand) had increased according to a distinctive age-specific pattern. The greatest increases were in the age groups 0-4 and 25-49 years, while death rates among teenagers and older people remained more or less unchanged.

The researchers observed that nine other causes of death had increased substantially according to the same distinct age pattern as HIV. They then estimated how much of the increases were likely to be caused by HIV, and concluded that 61% of deaths related to HIV had been wrongly attributed to other causes in 2000-2001. In adults, tuberculosis accounted for 43% of misclassified deaths, and lower respiratory infections for another 32%. Among infants, most of the excess deaths had been misclassified as lower respiratory diseases or diarrhoeal diseases. According to the MRC results, HIV caused the deaths of 53,185 men aged 15-59 years, 59,445 women aged 15-59 years, and 40,727 children under 5 years old in the year 2000-2001.

Much higher than the "cumulative total of only 12,815 AIDS cases in South Africa since 1982" he cites in his book.

One word on this--his reference for that number is this WHO document from 1999. Note on page 403 of that document:

Nearly all countries have AIDS case-reporting systems in place, but the proportion of AIDS cases reported varies significantly. Caution should therefore be exercised in considering this information.

Guess Bethell should have read a bit further than the first page.

What *really* caused "AIDS"

How does Bethell end his diatribe? By harkening back to the good ol' days of colonial rule.

Sadly, I'm dead serious.

In tropical Africa, a deterioration of the physical infrastructure swiftly followed the end of colonial rule. Sewage and sanitation crumbled. The issue was too awkward to mention because it would strongly suggest that Africans were better off--or at least in better health--under colonial rule.

***

It has been comforting to Western intellectuals to attribute the bad health of Africans not to the hazards and difficulties of self-government but to bad luck. The culprit was the human immunodeficiency virus--the "savage virus"...

Bethell suggests that "clean water and rebuilt sanitation systems will work wonders for the health of Africans." Well, gee, no kidding. Additionally, he suggests that this is a new focus for scientists and health workers. Sadly, again, I'm dead serious. Where he's been over the past decades, while the "politically correct" group has discussed the issue of African poverty and lack of even basic sanitation, is a mystery to me.

The rest of the story

Finally, it's interesting that Bethell only discussed AIDS in Africa. Bethell just happens to sit on the Board of Directors of the Group for the Scientific Reappraisal of the HIV-AIDS Hypothesis. [Edited to add: thanks to commenters, I'll note that he is not currently on the board; see here for the current board, and here for the current homepage]. This group denies that HIV causes AIDS, period, and runs the virusmyth website. They are also aligned with other AIDS-denial groups such as Christine Maggiore's "Alive and Well" group. Why, I wonder, didn't Bethell choose to discuss this in his book? Wouldn't a discussion of the idea that HIV simply doesn't cause AIDS be a more straightforward exposition than this roundabout discussion of the over-diagnosis of African AIDS? Could it be that Bethell--he who chides reporters for being too cowardly to stand up for the truth and dig deep for the facts--realizes that some of his own ideas are too "politically incorrect" to try to sell even to his core audience of science deniers?

As I've mentioned before, the central gist of AIDS denial is a fundamental misunderstanding of the germ theory of disease. Deniers point out, for example, that immunodeficiency is possible without HIV, and use this as a "blow" against the idea of HIV causation of the disease. This is, of course, patently ridiculous. Just because Streptococcus pneumoniae causes pneumonia doesn't rule out Staphylococcus causing it too. This also explains why there are conditions such as so-called "HIV-negative AIDS." Immunosuppression in the absence of HIV could be due to a number of other things, including, potentially, other viruses. Conversely, the fact that not everyone who is HIV-positive develops AIDS is also to be expected. There are very few, if any, pathogens that cause disease in every single person who is infected. Every other disease has people who are infected, but healthy--we call this the "carrier state." There's no reason this couldn't happen with HIV as well. It's already been shown that people carrying a certain mutation appear to be resistant to AIDS. There are likely other factors that contribute to this as well. For instance, it's been suggested that other viruses may play a role in progression of AIDS, either speeding it up or slowing it down. Additionally, differences in viral strains may make some more virulent and the progress to AIDS quicker. There certainly can be other factors we just don't know about yet either--disease is a complicated process, and is never as simple as Koch's postulates suggest.

One thing that is notably absent from Bethell's essay is a statement that scientists' knowledge is incomplete. No one suggests that we know everything about HIV. Indeed, as with every subject, there are gaps in our knowledge. In typical creationist fashion (Bethell has 2 full chapters denying evolution in his book), Bethell exploits these gaps in an attempt to discredit the entire HIV-AIDS connection--suggesting thousands of scientists, doctors, and public health officials are either mistaken, incompetent, or lying about HIV as the cause of AIDS--and therefore, we should just throw our hands up in the air and discard the whole theory, rather than working to fill these gaps in with additional knowledge. How terribly typical of his ilk, and how dismally unsurprising.

,

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Wouldn't a discussion of the idea that HIV simply doesn't cause AIDS be a more straightforward exposition than this roundabout discussion of the over-diagnosis of African AIDS?

Indeed it would be more straightforward. But its so much more effective just implying you have a case than showing you do. And a whole lot easier too. And when you also paint yourself as the brave underdog, fighting against 'The Man', then surely you must be right!

Nice post Tara.

Nicely written! I love a good debunking. I haven't read this book yet, though I hear he discusses some physics and astronomy. I'm loathe to buy it, so I'll see if the local library has it. Maybe some margin notes will be in order...

Many thank-you's Tara! Have you had a shot yet at Michael Fumento's The Myth of Heterosexual AIDS? The book is off the best-sellers list now, I'm sure. But I think it still gets a lot of attention in Right-Wing circles (Bethell probably drew heavily from it). If not, it could use a few of your well-aimed arrows too. Thanks again, and all the best.

I will not even try to correct your numerous mistakes, and hope that some email network will shortly call your post to Mr. Bethell's attention, and he will find the time and patience to give you a proper spanking.

Here I would only correct one.

Mr. Bethell is not presently on the board of The Group for the Scientific Reappraisal of the HIV-AIDS hypothesis, whose very recently reactivated and reinvigorated website is located at the following url: www.rethinkingaids.com

Tara unfortunately distorts the WHO's 1985 'Bangui' definition.
To quote from: WHO/CDC case definition for AIDS. Wkly Epidemiol Rec. 1986 Mar 7; 61(10): 69-76.
AIDS in an adult is defined by the existence of at least 2 of the major signs associated with at least 1 minor sign, in the absence of known causes of immunosuppression such as cancer or severe malnutrition or other recognized etiologies. 1) Major signs (a) weight loss >= 10% of body weight, (b) chronic diarrhoea > 1 month; (c) prolonged fever > 1 month (intermittent or constant). 2. Minor signs (a) persistent cough for >1 month; (b) generalized pruritic dermatitis; (c) recurrent herpes zoster; (d) oro-pharyngeal candidiasis; (e) chronic progressive and disseminated herpes simplex infection, (f) generalized lyphadenopathy. The presence of generalized Kaposi's sarcoma or cryptococcal meningitis are sufficient by themselves for the diagnosis of AIDS.
So, Tom Bethell is quite correct. Weight Loss (>=10%) plus prolonged fever (not necessarily continuous) plus persistent cough ... is AIDS according to the Bangui definition.
In 1999 I wrote to WHO asking whether this definition was still in effect, and was assured that it was (I can email a scan of the letter I received to anyone who's interested).
So, it is true, in Africa, HIV is not part of the definition of AIDS.
(oh, and by the way, Tom Bethell is not on the Board of Rethinking AIDS as far as I know, and I am on the board, fwiw).

Hi Dr. Bialy,

I suppose I'm flattered you dropped by (I assume I know who alerted you to the page). I'd be happy to discuss my "numerous mistakes" with either yourself or Mr. Bethell. I'll make the correction regarding his position on the board.

Tara unfortunately distorts the WHO's 1985 'Bangui' definition.
To quote from: WHO/CDC case definition for AIDS. Wkly Epidemiol Rec. 1986 Mar 7; 61(10): 69-76.
AIDS in an adult is defined by the existence of at least 2 of the major signs associated with at least 1 minor sign, in the absence of known causes of immunosuppression such as cancer or severe malnutrition or other recognized etiologies

Hi Mr. Crowe--

That's very interesting. First, I used the definition given by Bethell in his book, which certainly doesn't include the portion I put in bold, above. Whyever would he leave that out, I wonder...? That makes my case even stronger that it's not just a catch-all diagnosis, since doctors must take into account "other recognized etiologies" of immunosuppression before calling it AIDS.

Tara

Assumptions as you must know are dangerous, and in your case, like most of what you write, a rhetorical gimmick since you have not the temerity to state it. Should you wish to hazard your guess here, I will let you know with all honesty (and by copy of the email i received as proof) if you are correct or not in this assumption.

And if you really want to talk about these issues, my email is h.bialy@natureny.com, and you cvan send me a telephone number. I would be happy to talk to you for as long as you can stand (I have a big telephone budget).

Will you also kindly correct the website address.

Thanks.

Harvey

BTW is your name from Gone with the Wind or India?

By harvey Bialy (not verified) on 10 Feb 2006 #permalink

Now that you have mentioned it.

http://www.rethinkaids.info/body.cfm?id=61

is the URL for the AFRICA page of the Group for the Scientific Reappraisal of the HIV-AIDS Hypothesis' website.

It contains primary data documents available nowhere else that shed a great deal of clear light on the mess called AIDS in Africa´´ that you know so little about.

By Harvey Bialy (not verified) on 10 Feb 2006 #permalink

Harvey Bialy said:

And if you really want to talk about these issues, my email is h.bialy@natureny.com, and you cvan send me a telephone number. I would be happy to talk to you for as long as you can stand (I have a big telephone budget).

Why do you insist on talking about all these "numerous mistakes" in private?

I'm sure we'd all like to see your input.

Tara

You managed to introduce yet another error in your attempt to correct Mr. Bethell's relationship to "The Group".

I am not a member of the board either.

Thanks for correcting this as well.

Harvey

By Harvey Bialy (not verified) on 10 Feb 2006 #permalink

Dave S.

You can easily go to the URL I just posted. What you will read there will not be glib internet back and forth however.

By Harvey Bialy (not verified) on 10 Feb 2006 #permalink

Harvey Bialy said:

You can easily go to the URL I just posted. What you will read there will not be glib internet back and forth however.

Yes, I'm sure I will not find two sides represented there.

Thanks for your input.

Dr. Bialy,

I don't know what mistake I "introduced." That link was in the original post--the part in brackets I added, noting he's no longer a member and pointing readers to the current board makeup. I don't say that you're a member of the board, and no, I will not remove the old link because it shows Bethell's prior involvement with the group, even if he is no longer a member of the board.

And the name's from GWTW. (Was supposed to be Melanie, but a cousin born a few weeks before me apparently stole that name...so Tara it became).

I'll drop you an email. Not much of a phone person, though.

Dave S.

Exactly. But you will find:

"...primary data documents available nowhere else that shed a great deal of clear light on the mess called AIDS in Africa´´ that you know so little about."

By Harvey Bialy (not verified) on 10 Feb 2006 #permalink

Tara,

Thank you for replying so quickly so that I can leave this internet forum and return to sketching out some pieces for my own "bLLog", bialy/s at http://bialystocker.net should anyone care to see what I do when not involved in HIV/AIDS battles.

I am only asking you to note in your post that the current website of the "Group for the Scientific Reappraisal of the HIV-AIDS Hypothesis is http://rethinkingaids.com, and remove the error that Mr. Bethell is currently a member of its board. Na mas

With regard to the inadvertant introduction (via assumption, I guess) that I am a board member: You did write:

-------------------
Hi Dr. Bialy,

I suppose I'm flattered you dropped by (I assume I know who alerted you to the page). I'd be happy to discuss my "numerous mistakes" with either yourself or Mr. Bethell. I'll make the correction regarding his position on your board.

Posted by: Tara | February 10, 2006 01:51 PM
---------------------

I am looking forward to your email.

Harvey

By Harvey Bialy (not verified) on 10 Feb 2006 #permalink

Tara said:

Dr. Bialy,

I don't know what mistake I "introduced."

I think he's referring to this sentence:

I'll make the correction regarding his position on your board.

Ah, okay. I'll switch that to "the" and add the current homepage to the post. It's too bad you won't comment further publically, though--I'm sure people are interested in hearing your rebuttal to the post, beside just a protest that it contains numerous mistakes and I'm in need of a spanking.

Tara said:

It's too bad you won't comment further publically, though--I'm sure people are interested in hearing your rebuttal to the post, beside just a protest that it contains numerous mistakes and I'm in need of a spanking.

I asked, and would be very intested. But all I saw in return was directions to a URL and the rude comment you mention.

That, and trivial corrections about who is on what board.

Thank you for that, Tara. I would suggest that, if you don't want more minutes of your life wasted, you continue this dialogue with Bialy in email under the condition that you have the option of making all communcations public so that the rest of us don't miss out on the fun.

Tara,

Thank you for making the corrections to your article so quickly and so nicely.

Dave S.

I erred when i so glibly agreed with your sarcastic comment about not finding the best arguments of the HIV-AIDS orthodoxy on the Africa page. I just looked myself, and I see that the very first document on the beautiful page is as complete a refutation of the most authoriataive todate exposition of the establishment position in a letter published in Nature in July 2000 under the rubric "The Durban Declaration". I suggest you read it.

By Harvey Bialy (not verified) on 10 Feb 2006 #permalink

I also erred in neglecting to proof the comment above before posting it. Sorry.

The long sentence above should read:

"I erred when I so glibly agreed with your sarcastic comment about not finding the best arguments of the HIV-AIDS orthodoxy on the Africa page. I just looked myself, and I see that the very first document on the beautiful page is a complete refutation of the most authoritative todate exposition of the establishment position as set forth in a letter published in Nature in July 2000 under the rubric "The Durban Declaration". I suggest you read it.

Let me take the opporunity of making this correction to also add the url here so that you don't have to exert yourself and make 2 clicks to read it.

http://www.rethinkaids.info/durbandeclarationrebuttal.htm

By Harvey Bialy (not verified) on 10 Feb 2006 #permalink

Harvey Bialy said:

Dave S.

I erred when i so glibly agreed with your sarcastic comment about not finding the best arguments of the HIV-AIDS orthodoxy on the Africa page.

And those best arguments are ...?

Good post, Tara. I read the 'rebuttal' that Bialy linked to, as well. It brought to mind this snippet from Tara's post:

>>One thing that is notably absent from Bethell's essay is a statement that scientists' knowledge is incomplete. No one suggests that we know everything about HIV. Indeed, as with every subject, there are gaps in our knowledge.<<

I agree with Dave and Neuro, I'm very interested in the resulting discussion.

By ChristieJ (not verified) on 10 Feb 2006 #permalink

>>Immunosuppression in the absence of HIV could be due to a number of other things, including, potentially, other viruses. Conversely,
....
>>AIDS quicker. There certainly can be other factors we just don't know about yet either--disease is a complicated process, and is never as simple as Koch's postulates suggest.

Isn't this what at least the non-fanatical "AIDS deniers" are saying? This seems to be a debate over policy more than science.

>>What they neglect to mention, however, is that any physician is also going to take an extensive medical history.

With shortages of staff, time and equpment this is likely to be unreliable. I don't see how anyone can have a strong opinion at least based on the info presented.

Must we still use this term "AIDS deniers," even in quotes?

The argument, as we all know, revolves around what CAUSES (what gets called) AIDS. Who is "denying" AIDS itself? The question is what causes the collapse, and whether the word has become so broad as to lose meaningful, precise meaning. There is one robust debate in the industrialized world and different one in Africa. Both are essential. The "A" stands for "acquired." It is not called "infectious immune deficiency syndrome," which is noteworthy.

Language is very key, and ours has become debased and politicized.
Terms such as "AIDS deniers," or "AIDS denialists," carries a built in shadow of shame and wrongness, and even Holocaust connotations. Must this continue, like a kind of flogging, every time the word is used?

If we cleared up our language we would clear up our thoughts.

Further, it has not been made clear here what point, or points, are being dissected exactly.

Is it Tom Bethell's arguments, per se, or the sum total of any and all critiques of the orthodox AIDS in Africa model? Are we discussing whether the WB test is required in Africa, or whether it is proof of HIV infection, or whether it "causes" AIDS is all or most cases, or whether "it" is transmitted sexually in Africa in ways that do it fails to do in Western countries, even where sex abounds (prostitutes, porn stars, etc?)

Are we arguing over who is on the RA board? Whether Harvey Bialy is rude? Whether Bethell ever lent his name to RA?

You would expect those who take the critique seriously to have perhaps been involved with RA at some point because RA was formed as the body of measurable dissent against the theory and policies of the orthodox model. If somebody made a moral argument against Communism in the 1970s/80s, for example, you would not dismiss them on the grounds that they were "members" of Charter 77 or Solidarity.

It's formalized dissent, that's all. You can't deploy this eternal tautological accusation--oh-but-he-or-she-is-one-of-those-aids-denialists-from-RA-or-used-to-be-associated-with-RA.

So what? Where's the surprise?

Is there a space left in which to lend gravity, or one's voice, or vote, to the idea of Rethinking AIDS, without being dismissed as being one of those people who wants to Rethink AIDS?

By Celia Farber (not verified) on 10 Feb 2006 #permalink

Celia Farber writes:

Must we still use this term "AIDS deniers," even in quotes?

The argument, as we all know, revolves around what CAUSES (what gets called) AIDS. Who is "denying" AIDS itself? The question is what causes the collapse, and whether the word has become so broad as to lose meaningful, precise meaning.

As you say, we all know the argument revolves around what causes AIDS, so the term is apparently precise enough and not causing any undo confusion. One could say "people who deny HIV causes a condition called AIDS", which might be more fully descriptive, but more cumbersome too.

What term would you use?

The "A" stands for "acquired." It is not called "infectious immune deficiency syndrome," which is noteworthy.

But are not infections acquired? The two terms are not in direct opposition. Acquired is a more general term, to be sure, but one could acquire an infection, among other things.

Oh...and I would still like to see Tara's point addressed about why the exclusionary criteria (malnutrition, cancer, immuno-suppressive treatments) were ignored in the posts about the 1985 'Bangui' definition. I haven't seen anyone really explain that one yet.

If you have a problem with them that's one thing, but don't just ignore them people.

By Anonymous (not verified) on 10 Feb 2006 #permalink

Although I only perused the site a bit, I found it interesting that you noted "2,300" scientists supposedly in dissent of the hypothesis HIV causes AIDS. I thought, my that's quite a few and decided to look at the list for myself.

Stated on the original home page:

the small group of public scientific dissenters (that includes Nobelists in Chemistry and Medicine, and members of the US National Academy of Sciences) has increased to more than 2,300 as can be seen here,

Scientific dissenters indeed.

The 'scientific' dissent on HIV for those curious evidentally involes:

Economists (The first name on the list, ironically isn't even a scientist)

"Ono A. Abada. MSc (Economics). Country Director, Pan African Educational Services (PANAFES), Cape Town, South Africa."

Carrying on as well we find:

Medical students

Engineers (Fernando Alameda. Engineer, Bogotá, Colombia)

A number of lay-people or those without any formal scientific qualifications.

And such forth.

While there are indeed those with proper medical degrees on the list and the odd microbiologist, I get more than an impression of artificially inflating the numbers rather than being a truly honest list. How someone with a degree in journalism or economics 'qualifies' as a scientist is a bit baffling.

Reminds me of certain other lists that certain other groups produce...

Celia:

The "A" stands for "acquired." It is not called "infectious immune deficiency syndrome," which is noteworthy.

I fail to see whatever point you are trying to make here. The "aquired" part is indicating that it is a disease caused by a transmissable agent (in this particular scenario a virus). I'm pretty certain that you seem rather confused about that point.

Language is very key, and ours has become debased and politicized.

Unfortunately, I can't think of a better term than to describe the anti-HIV movement as "AIDS deniers" myself.

Harvey:

I will not even try to correct your numerous mistakes, and hope that some email network will shortly call your post to Mr. Bethell's attention, and he will find the time and patience to give you a proper spanking.

As a microbiologist and immunologist myself, I think it would be rather good to have a public discussion on the issue. After all, you've come here throwing around baseless assertations and then declaring that Tara should "get a proper spanking", you could at the very least directly and publically address her points.

The "statement" does not say "dissenting scientists", It reads "scientific dissenters", i.e, those who are questioning the hypothesis on scientific grounds. Further, there is a link that enables people to sign, and those signatures are vetted for authenticity. Medical students, writers, economists, therapists, etc are certainly entitled to hold "scientific opinions" even though they do not hold advanced degrees in some biological or medical science.

Don't you agree?

And if you wish to see the very best and most spirited discussion ever on the internet between Dr. Bialy and many indivduals with many degrees (on paper at least) go to

http://www.rethinkaids.info/documents/Popular%20Media/Eleven%20Days%20o… and enjoy.

By Anonymous (not verified) on 10 Feb 2006 #permalink

The "statement" does not say "dissenting scientists", It reads "scientific dissenters", i.e, those who are questioning the hypothesis on scientific grounds.

And again, a journalist, engineers and laypeople are qualified scientists when they speak on these issues suddenly?

Medical students, writers, economists, therapists, etc are certainly entitled to hold "scientific opinions" even though they do not hold advanced degrees in some biological or medical science.

Only to a degree, as I would question the worth of such 'scientific opinions' from individuals that are not familar with the fields of immunology, microbiology and epidemiology. I have a scientific background but I would not, for example, think just because of that my opinion would be worth anything on a debate on string theory (for example). It seems more like a tactic to just artifically extend the number of names on the list.

Don't you agree?

No. Anything further?

Joe,

I am just in receipt of a gmail asking me to look here.

Something further:

The signatories to the "statement" you are unsuccessfully attempting to malign does not contain any "opinions" by the indivduals who sign. It is merely a statement that says "we" (collectively) are unsatisfied with the evidence that we have seen (all in our own ways obviously)that purports to "establish beyond any shadow of even doubting" that the HIV-AIDS hypothesis is anything except scientiic stuff and nonsense. Please read the very enjoyable disscussion hyperlinked above.

Goodnight.

The only point about "acquired," is that it was the early term (after 'GRID' and 'Gay Cancer,' I think)and reflected the concensus at the time that this was an acquired (as opposed to infectious) syndrome. I speak here of the earliest years, 1980-1983/4, when the dominant theory, or one of them, was that amyl and butyl nitrites caused the disease. It's not very important.
Language is very key, and ours has become debased and politicized.

"Unfortunately, I can't think of a better term than to describe the anti-HIV movement as "AIDS deniers" myself."

It is sir, neither "anti-HIV," nor a "movement." "It" sees no pathogenicity in HIV, due to the familiar arguments that this is an "ordinary" (non-pathogenic) retrovirus. It is does not get exercized about HIV, but it is not "anti," pers se. Certainly it's not a movement.

Why can't you think of a better term that "AIDS deniers?"

Nobody is denying AIDS.

Does the word "deny," mean that something IS and (yet) is being denied, like in religious terminology, or can it mean the same as "repudiated?"

Is it the same in essence, to say:

Jane denies HIV causes AIDS

or

Jane is unconvinced HIV causes AIDS

or

Jane does not think HIV causes AIDS

By Celia Farber (not verified) on 10 Feb 2006 #permalink

I really must learn to proof these blog notes better. But I am in the middle, as usual, of ten things, so if there are any remaining typos,live with them.
------------------

The "statement" you are unsuccessfully attempting to malign does not contain any "opinions" by the indivduals who sign. It is merely a statement that says "we" (collectively) are unsatisfied with the evidence that we have seen (all in our own ways obviously)that purports to "establish beyond any shadow of even doubting" that the HIV-AIDS hypothesis is anything except scientific stuff and nonsense. Please read the very enjoyable disscussion hyperlinked above.

Goodnight.

Harvey

The signatories to the "statement" you are unsuccessfully attempting to malign does not contain any "opinions" by the indivduals who sign.

This was never in contention Harvey in my post, I merely pointed out the irony of your tactics in comparison to this list:

For example. Here we see a collection of engineers and such forth but few researchers from the actual field in question.

I just wanted to bring up the comparison in these lists usually provided by certain organisations.

It is merely a statement that says "we" (collectively) are unsatisfied with the evidence that we have seen (all in our own ways obviously)that purports to "establish beyond any shadow of even doubting" that the HIV-AIDS hypothesis is anything except scientiic stuff and nonsense.

Yes, and the Intelligent Design movement say the same thing about evolution now I think about it. Unfortunately, it doesn't really mean a lot when you say 'we' in many respects. A large number of Americans dispute that evolution is a process that occurs and instead believe in a literal 6 day creation, but the numbers of individuals do not make that particular assertion valid. The overwhelming scientific consensus on evolution is more important than the various lists that creationists can put out for example.

A list of people, many non-scientists is about as valid when it comes to HIV.

Please read the very enjoyable disscussion hyperlinked above.

I already have, in fact I've been following the HIV denial movement for a while and already read the Dean Esmay discussion. I've also read some of the other discussions on HIV/AIDS on other forums other than ones that are on 'friendly ground' for you as well.

The only point about "acquired," is that it was the early term (after 'GRID' and 'Gay Cancer,' I think)and reflected the concensus at the time that this was an acquired (as opposed to infectious) syndrome. I speak here of the earliest years, 1980-1983/4, when the dominant theory, or one of them, was that amyl and butyl nitrites caused the disease. It's not very important.

This doesn't particularly affect my point.

It is sir, neither "anti-HIV," nor a "movement." "It" sees no pathogenicity in HIV, due to the familiar arguments that this is an "ordinary" (non-pathogenic) retrovirus.

Would you agree to be injected with HIV? After all, if it's just a harmless retrovirus surely you wouldn't have anything to be scared of?

It is does not get exercized about HIV, but it is not "anti," pers se. Certainly it's not a movement.

I would disagree with that, because I for one do see the "anti-HIV" movement as a political as opposed to scientific movement. Just because someone thinks (as Harvey seems to believe) evidence is not convincing does not make their position suddenly 'scientific'. I can think the evidence the earth revolves around the sun isn't convincing, it doesn't make that opinion scientific.

Nobody is denying AIDS.

I should possibly phrase it as HIV/AIDS denial as opposed to simply using "AIDS denier" to be more specific.

Does the word "deny," mean that something IS and (yet) is being denied

I would think that is quite a reasonable statement of what I mean.

Incidentally, for those who want to view the Deanesmay HIV discussion that is linked above in the original context (without the 'editing' that the document on rethinkaids has had), you can read the discussion here:

Not sure why you didn't just link the original discussion so people can just read it for themselves in its entire context.

Joe

Jeez just when I thought I was done with this for today.

The "statement" that you continue, even more unsuccesssfully, to malign is only intended to refute constant media assertions that scientific dissent from the prevailing HIV-AIDS hypothesis is restricted to a small band of nut-jobs (a band in which I am often included, as written in really simple English in the homepage text.

Your other point(s) are more interesting since you apaprently take the position that scientific proof is indeed a matter of consensus of professional opinion.

Not so. So, so so not so, as to be scary.

I am convinced that evolution based on selective pressures and genetic change accounts for all the organic diversity on the planet not because 10,000 smart guys with PhDs say so but because the evidence is (unlike that for the HIV-AIDS hypothesis) quite substantial.

Glad you found the discussions fun. Why didn't you contribute?

The "statement" that you continue, even more unsuccesssfully, to malign is only intended to refute constant media assertions that scientific dissent from the prevailing HIV-AIDS hypothesis is restricted to a small band of nut-jobs (a band in which I am often included, as written in really simple English in the homepage text.

Thanks for missing my point Harvey. Maybe you should compare the purpose of your 'list' with the list published by the discovery institute about evolution/intelligent design. I would vastly appreciate you to comment on the similarity of tactic employed and why your 'list' is valid compared to the 'ID list'. For that matter are they both valid?

Just out of curiosity, if this list is designed to convince the media that it's about scientific dissent, shouldn't it therefore include those with relevant scientific degrees primarily?

Your other point(s) are more interesting since you apaprently take the position that scientific proof is indeed a matter of consensus of professional opinion.

No I don't, obviously you've missed the point here. I take the position that scientific consensus is extremely important and where that consensus is determined is through experiments published in peer review. Not in the media or anywhere else.

I am convinced that evolution based on selective pressures and genetic change accounts for all the organic diversity on the planet not because 10,000 smart guys with PhDs say so but because the evidence is (unlike that for the HIV-AIDS hypothesis) quite substantial.

Funny, the ID movement would disagree with you and they have lists just like you do! Maybe you might be figuring out why I find a list with a large group of individuals without relevant scientific credentials rather unconvincing and more than a little familiar...

Glad you found the discussions fun. Why didn't you contribute?

I got to the party too late :(

PS

I see your posted url for the full Esmay blog discussion didn't show up.

But to answer your question while you figure how how to make it appear, the edited version is *quite* long. The original 11 days is, as you know, unreadable by anybody but me, and Dr. Stein (the editor). What Stein did at some pain was exactly to present the contexct in a way that it only takes *some* stamina to read it all.

¿Claro?

But to answer your question while you figure how how to make it appear

I left out a / :p

, the edited version is *quite* long. The original 11 days is, as you know, unreadable by anybody but me, and Dr. Stein (the editor). What Stein did at some pain was exactly to present the contexct in a way that it only takes *some* stamina to read it all.

This isn't the point, the point of the matter is to present the original discussion as is so that interested individuals can read it for themselves. You underestimate many of the readers of blogs such as these when you think they won't read a discussion they are interested in. Although I have no particular reason to think anything dishonest happened with the edited version presented, the full discussion should still be linked so as to provide proper context.

This also allows the individual to make up their mind for themselves if what was removed was really just 'ad hominems' and irrelevant information. Then nobody has anything to hide anymore, isn't that right Harvey?

Joe

The list isn't meant to convince you of anything about the merits of the debate. It is, *I repeat*, merely to refute the media contention that those who publically dissent from the prevailing dogma are not simply a small band of nuts. The same is true of the ID people. And the minions of Aids, Inc.

None of the lists such groups could and have compiled (like the Durban Declaration) prove anything about the substantive issue under debate.

Mr. O'Donnell,

It is not a "movement;" it is a discussion. It is not trying to grow, in the Canetti sense of crowd formation, but rather to dissolve once the matter has been resolved.

To say it is political as opposed to scientific...I don't understand what you mean, really. Did you read Peter Duesberg's 1987 paper in Cancer Research on retroviruses, cancer, and aids? This was not the first critique of the official theory, but it was the one that formalized the anti-thesis and got the ball rolling.

A scientist. In a scintific paper.

It is a scientific debate at its core.

By Anonymous (not verified) on 10 Feb 2006 #permalink

The list isn't meant to convince you of anything about the merits of the debate. It is, *I repeat*, merely to refute the media contention that those who publically dissent from the prevailing dogma are not simply a small band of nuts. The same is true of the ID people. And the minions of Aids, Inc.

2,300 'dissenters' many of which aren't any scientists is still a relatively 'small band'. If they are nuts or not can be left to the individual to decide, but out of the many thousands of scientists world wide, the names on the list with scientific credentials in the relevant fields are the important ones. The DI list is 200-1 (as one left, but he hasn't actually been officially removed yet, IIRC) and I think an Answers in Genesis list is around 500.

Just because they can accumulate a bunch of signatures changes nothing about their claims or anything else. I don't care for the numbers supporting a claim only what that the individual claims are. Publishing 'lists' filled with mostly individuals in irrelevant fields does more harm to you than to what you're opposing.

None of the lists such groups could and have compiled (like the Durban Declaration) prove anything about the substantive issue under debate.

I agree and mimicking the tactics used by other psuedoscientific organisations is certainly a poor idea. When I see such a list I automatically think "Snap, crackle and crank!".

Incidentally, just out of curiosity Harvey, shouldn't you be trying to convince the scientific community of your claims validity and not the media?

Joe,

Your nasty style is going to get you burned very badly one day.

I am not interested in convincing the massive *mass media* of anything. I am, and always have been 100% concerned and actively involved in changing the scientific consensus. Read my book you fool.

To say it is political as opposed to scientific...I don't understand what you mean, really. Did you read Peter Duesberg's 1987 paper in Cancer Research on retroviruses, cancer, and aids? This was not the first critique of the official theory, but it was the one that formalized the anti-thesis and got the ball rolling.

A scientist. In a scintific paper.

From 1987. It may occur to you that since 1987 there has been 19 years and science happens to keep moving along. A cursory look over pubmed and other journal sites indicates that his ideas have recieved no traction in the scientific community. Additionally, he has not found the empiracle support to actually solidly base his claims and convince the scientific community (or he would be more widely cited in HIV literature).

He does demonstrate the wonderful principal that even those with 'minority' scientific opinions can indeed still be published. The problem is unless the data one produces is of good quality it is unlikely to perform well with other scientists. Unfortunately for Deusberg, it appears that he has been even less convincing to other scientists than apparently those proposing HIV causes AIDS are to the remaining community.

I'll leave that for the individual to determine if that is about the quality of Deusbergs data or a 'HIV orthodoxy'. Incidentally, here is one of his latest papers (which was published in 2003):

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&do…

Your nasty style is going to get you burned very badly one day.

I fail to see how I was anything but polite to you in our discussion Harvey. I most certainly didn't imply that I or any of my associates was going to spank you for one thing.

I am not interested in convincing the massive *mass media* of anything. I am, and always have been 100% concerned and actively involved in changing the scientific consensus. Read my book you fool.

Ahhh I see, you're wanting to change scientific consensus so buy your book! Is that how one gets royalties or how one advances a scientific argument?

While waiting for the blog-owner, Tara, I suppose to clear my last comment, which was held I imagine because I scolded Joe:

If you had actually read EVEN the edited version of the Esmay blog discussions you would have discovered that I stand to receive NO royalties at all should my book ever become profitable, and if you had spent 5 minutes reading my very recent interview with Lee Evans, you would have seen where all such revenues will go.

I think I have really had enough of you.

Mr. O'Donnell,

You've slipped away again. The matter was whether the HIV needs rethinking 'movement' as you call it was (as I said) rooted in scientific arguments or (as you said) primarily a "political" movement. Then you shifted to talking about whether in your opinion Duesberg gained any "traction," in the literature, ie your view that he must be wrong.

All Duesberg really did was to stay put on a bridge that others crossed. He said: "I do not agree."

You would not be likely to find citations of this (traction)in the HIV/AIDS "literature," would you?

Why hasn't anybody begun to deal with the facts about AIDS in Africa? Don't we care anymore?

By Celia Farber (not verified) on 10 Feb 2006 #permalink

While waiting for the blog-owner, Tara, I suppose to clear my last comment, which was held I imagine because I scolded Joe:

Not in particular. Your rude demeanor throughout this whole discussion hasn't caused your posts to be widthheld or similar.

If you had actually read EVEN the edited version of the Esmay blog discussions you would have discovered that I stand to receive NO royalties at all should my book ever become profitable, and if you had spent 5 minutes reading my very recent interview with Lee Evans, you would have seen where all such revenues will go.

That doesn't actually change the point I was making Harvey, which was in reference to what an ID advocate, Michael Behe was asked in the recent trial in Dover:

Q. Okay. But scientists, as they do with many subjects on which there's disagreement, may continue to be making arguments and writing papers and submitting them to peer review journals and doing experiments to see if they can come up with a consensus answer on the subject?

A. Sure. And they may write books to try to come up with an answer, too, as well.

Q. That's how you get the royalties, right?

A. (No response.)

From:

http://www.talkorigins.org/faqs/dover/day12am2.html

I think I have really had enough of you.

That's a shame because until you degenerated into merely throwing insults as me, I thought we were having a polite and productive discussion.

Celia

You would not be likely to find citations of this (traction)in the HIV/AIDS "literature," would you?

That is the point Celia, that Deusbergs work is not widely cited by researchers working in the fields in understanding AIDS. The lack of ability to find citations referencing back to work performed by Deusberg is the point I am making.

Joe

You "think" a lot of things, and sometimes all at once and sometimes you try to make an omlette.

You *wrote* plain as vanilla

"Ahhh I see, you're wanting to change scientific consensus so buy your book! Is that how one gets royalties or how one advances a scientific argument?"

I informed you of the gross error you were making and you suddenly invent some bs ID analogy and CLAIM that is what you were referring to. But in case you slip away (or try to) again: No unkind (but typographically polite sir. one writes "scientific biographies" to advance scientific arguments. My own is data full and quite readable, as many have said online at Amazon and Barnes & Noble, and most of them have the most impressive academic credentials imaginable.

Even an immunologist can do better than that surely.

And that's really it.

You "think" a lot of things, and sometimes all at once and sometimes you try to make an omlette.

Not really.

You *wrote* plain as vanilla

"Ahhh I see, you're wanting to change scientific consensus so buy your book! Is that how one gets royalties or how one advances a scientific argument?"

I informed you of the gross error you were making and you suddenly invent some bs ID analogy and CLAIM that is what you were referring to.

Actually, I am not particularly worried that you are not collecting the royalties personally, just that the comment that "Is that how one gets royalties" still stands. You can't get royalties without selling a book and I viewed what you wrote as a sales pitch. Although you've decided to focus on this point again, it's interesting that you haven't decided to focus on the actual question posed:

Is writing books how you convince the scientific community or do you do so by publishing papers in journals? I thought that was pretty clear.

But in case you slip away (or try to) again: No unkind (but typographically polite sir. one writes "scientific biographies" to advance scientific arguments.

This isn't really very clear what you're trying to say here. Could you rephrase this good sir? I was under the impression that if you're making an argument, you typically advance it with experimentation in scientific journals.

My own is data full and quite readable, as many have said online at Amazon and Barnes & Noble, and most of them have the most impressive academic credentials imaginable.

But it's not posted in a scientific journal under peer review by experts in the relevant field in question. Since when did reviewers at Amazon become the equivalent of peer review in a journal such as Nature (for example) Harvey? Sounds like what Behe said about the reviews about Darwins Black Box.

But then again, there's that comparison with the ID movement. Isn't it funny how similar you and they are?

Incidentally Harvey, just to show that I'm not a poor sport after all, I'll make sure that I have a read of your book (Oncogenes, Aneuploidy, and AIDS: A Scientific Life and Times of Peter H. Duesberg, for the curious) at some point. It turns out that I can order it through the local library.

Folks ...

Rather than use italics (which are automatically lost at paragraph breaks) to quote a previous poster, please use the blockquote function. Just type {blockquote} before and {/blockquote} after the quote, substituting angled brackets for the curley ones. Makes it so much easier to read. You might even add Joe Smith said:, or some such indicator, before the quote.

Thanks.

Tara, having stumbled across this review, I was appalled at your wilful denial of serious and substantive unanswered flaws (not just 'things we don't know yet') about the dominant model of HIV and AIDS. You seem to be willing to believe that HIV has in some way been demonstrated to be the cause of AIDS according to rigorous science. Have you, for example, remained unaware that investigation into Robert Gallo's original work revealed he had neither proved he had found HIV nor proved it caused AIDS?

You bandy mention of HIV diagnoses about as if you believe that they really do correlate with HIV infections. Do you know absolutely nothing about HIV tests? Have you never read the instructions that come with them? Are you not aware of the multitude of other factors published in established medical literature shown to provoke false positives in many people?

Science only makes robust advances by trying and failing to prove theories to be unreliable. Quite clearly, traditional theories about HIV and AIDS have proved completely incapable at making substantiated predictions at every level, from microbiological to epidemiological, when data is examined closely and not just glibly. This does rather undermine the credibility of the currently dominant paradigm of HIV and AIDS, don't you think?

By Mike Herse (not verified) on 11 Feb 2006 #permalink

Joe

Will wonders never cease? I suppose I should pretend to be "grateful" for your begrudging acceptance of the fact that you don't know anything about these matters, never have studied them with any attention and probably are actually professionally unqualified to read the literature you go on about but most obviously have neither carefully read nor understood.

And as an old professor (From where is *your* degree? When? Do you have publications?) who loves nothing more than opening the eyes of students, I might hope that your future "read at" OAA will prove as profitable to you as to many who began it in your ignorant position and finished with a decent insight into the science and scientific politics involved in the Duesberg saga.

But I think not on both counts. I began assuming that your posing as a scientist was at least a little real. But like a few I have encountereed over the past year in these blog discussions, you are a cardboard clown like Nick Bennett and "Daffy Dale" and all the other comical characters in the "11 days of cyberspace" discussions referred to above.

Lest you take umbrage at this. Let me point out that you *volunteered* that you had followed those discussions in real time. But when I asked you why you didn't join, you wrote it was "too late" with a smiley thingy (or is it a frown). And then proceeded to demonstrate that you had not even read the "edited" version with any care. (No surprise since you obviously have not read much written here with any attention either, eg, you thought I had asked you to "buy" my book, when I quite deliberately said for you to "read" it, etc. I also know from long experience that you will have some "explanation" for your less than honest blog behavior. I won't read it, so don't bother inventing some lame excuse). I could go on at greater length in a complete analysis of every contradiction you have been caught in over the past hours, but readers who actually follow this are quite aware of them already.

I am going on about this because it really infuriates me that people like you come on in these low level science blog discussions as though you know a great deal and hold a strong hand. You leave them (at least the ones with me) having shown the world that you know actually a very little and the best you might have is a jack high busted straight.

Oh Harvey, I could almost swear I've struck a nerve with you.

Will wonders never cease? I suppose I should pretend to be "grateful" for your begrudging acceptance of the fact that you don't know anything about these matters, never have studied them with any attention and probably are actually professionally unqualified to read the literature you go on about but most obviously have neither carefully read nor understood.

I never admitted that, I just have said I haven't read your particular book as of yet. At the same time, I'm going to have a read of it in any event, despite your rude demeanor.

A large collection of ad hominems doesn't intimidate me incidentally :)

And as an old professor (From where is *your* degree? When? Do you have publications?) who loves nothing more than opening the eyes of students, I might hope that your future "read at" OAA will prove as profitable to you as to many who began it in your ignorant position and finished with a decent insight into the science and scientific politics involved in the Duesberg saga.

You certainly do have quite the high sense of self-importance, but none the less if your book reflects your demeanor you've demonstrated here it isn't looking good.

But I think not on both counts. I began assuming that your posing as a scientist was at least a little real. But like a few I have encountereed over the past year in these blog discussions, you are a cardboard clown like Nick Bennett and "Daffy Dale" and all the other comical characters in the "11 days of cyberspace" discussions referred to above.

I see you've chosen to attack me and not the arguments or points I have bought up. Quite telling Harvey.

Lest you take umbrage at this. Let me point out that you *volunteered* that you had followed those discussions in real time. But when I asked you why you didn't join, you wrote it was "too late" with a smiley thingy (or is it a frown). And then proceeded to demonstrate that you had not even read the "edited" version with any care.

Not in particular, firstly, the 'smiley' thingy is a little unhappy face (indeed a frown). I had missed out on the discussion the first time, because I didn't really start reading blogs until about the middle of last year. I did however read through the "drama" that occured at deans blog, albeit after the date.

Your baseless assertions from here on amount to nothing more than an attempt to avoid answering the question I posed:

Is writing books how you convince the scientific community or do you do so by publishing papers in journals?

It's a pretty clear and direct question, which has continued on my tangent that I've argued from the start.

(No surprise since you obviously have not read much written here with any attention either, eg, you thought I had asked you to "buy" my book, when I quite deliberately said for you to "read" it, etc.

:) That was certainly my impression from reading it and the images of Rothschild and Behe just sprang up immediately.

I also know from long experience that you will have some "explanation" for your less than honest blog behavior. I won't read it, so don't bother inventing some lame excuse).

That's alright, your devolution into name calling and ad hominems says everything I require for me.

I could go on at greater length in a complete analysis of every contradiction you have been caught in over the past hours, but readers who actually follow this are quite aware of them already.

I'm sure, but the rude demeanor you expressed both to the owner of this blog from your first post, then (over time) to me as we carried on discussing comes out loud and clear.

Harvey, before you complain about spinters in my eyes you should remove the log from your own.

I am going on about this because it really infuriates me that people like you come on in these low level science blog discussions as though you know a great deal and hold a strong hand.

I never claim to know everything actually, I've kept my points focused and on specific comparisons. You on the other hand have usually simply avoided the points in question or simply answered with ad hominems.

You leave them (at least the ones with me) having shown the world that you know actually a very little and the best you might have is a jack high busted straight.

I know how you've left this discussion with your ad hominems and avoidance of the points I bought up. Thats ok Harvey, all I know is that eventually someone will be proven right and I'll be certain to congradulate you (and Deusberg especially) if it turns out he was right.

I'd not bet on that being the case however :)

I've noticed that wherever criticisms of the African-AIDS denialists show up, so do the legions of denialists with their "facts" and one-liners. So much of your criticism is rooted in a fundamental misunderstanding of the facts.

I posted a review very similar to Tara's as part of my chapter-by-chapter review of Bethell's work last December. I was disgusted by the AIDS chapter, as was one of my commenters whos job is to research African AIDS and its impact on children there. See the post and the comments for some more clear-headed thinking than have showed up after Tara's critical review.

Harvey Bialy: As you have pointed out, those who have spent considerable time worrying about the veracity of the HIV/AIDS paradigm and its Octopus of Fear, have little or nothing in common, politically or in other ways. But to the extent that I am associated with you because some of our brain waves concur about HIV/AIDS, I want now to spank YOU, ideally with a wide paddle, for calling Joe a "cardboard clown."

Condescension is a SIN.

It should be reserved for those who need it, because they have lost their "traction" with something real.

By Celia Farber (not verified) on 11 Feb 2006 #permalink

Hi all--

Weekends are time with my kids for me, so as I mentioned to Harvey yesterday, I'm rarely online. So I'm goint to answer just one post that was directed at me and then call it quits for the day. Mike wrote:

Tara, having stumbled across this review, I was appalled at your wilful denial of serious and substantive unanswered flaws (not just 'things we don't know yet') about the dominant model of HIV and AIDS. You seem to be willing to believe that HIV has in some way been demonstrated to be the cause of AIDS according to rigorous science. Have you, for example, remained unaware that investigation into Robert Gallo's original work revealed he had neither proved he had found HIV nor proved it caused AIDS?

I'm aware of all the controversy. Are you aware that there's similar controversy over some of Pasteur's experiments as well? Does that rule out the germ theory of disease? The point is, thousands of subsequent experiments have shown the role that HIV plays in the causation of AIDS. That's not a matter of contention in the mainstream scientific sphere.

You bandy mention of HIV diagnoses about as if you believe that they really do correlate with HIV infections. Do you know absolutely nothing about HIV tests? Have you never read the instructions that come with them? Are you not aware of the multitude of other factors published in established medical literature shown to provoke false positives in many people?

I'm aware of them--in fact, molecular epidemiology (which includes a lot of work in examining diagnostic tests) is what I do. The biggest beef many seem to have with the HIV tests is the pregnancy angle, which is why I pointed out that even in population-based studies, similar levels of HIV+ individuals are found.

No molecular test is perfect--and again, HIV seems to be oddly singled out for this level of criticism. I don't see anyone arguing how unreliable the rapid Strep test is, for example, though it's subject to a lot of the same criticisms.

Science only makes robust advances by trying and failing to prove theories to be unreliable. Quite clearly, traditional theories about HIV and AIDS have proved completely incapable at making substantiated predictions at every level, from microbiological to epidemiological, when data is examined closely and not just glibly. This does rather undermine the credibility of the currently dominant paradigm of HIV and AIDS, don't you think?

There only seem to be a few who are convinced of that statement--indeed, I think it's Bethell and others who have examined the data "glibly," as I showed in my closer examination of the data.

Might pop in tomorrow or later tonight after the kids are in bed, so thanks in advance for your patience. --T

Tara said:

I'm aware of all the controversy. Are you aware that there's similar controversy over some of Pasteur's experiments as well? Does that rule out the germ theory of disease?

Quite true.

I would point out that this is generally a perfectly ordinary process for any new scientific idea. In the early days for example more than a few chemists could point to experiments that seemed to confirm phlogiston theory over the then new-fangled theory of combustion. But better means of carefully weighing chemicals and collecting gasses however eventually sealed the fate of the former theory. We would be laughed at today if we pointed to some of those early dissenters as providing evidence such that phlogiston theory should be still be considered valid.

And then there is the case of Walter Kaufmann, who in 1905 designed a brilliant experiment to test three competing theories of the electron: those of Abraham, Bucherer, and Einstein/Lorentz. Kaufmann's results were clear and unequivocal - Abraham's theory (not Einstein's) was likely correct. To quote him, "I anticipate right away the general result of the measurements to be described in the following: the results are not compatible with the Lorentz-Einstein fundamental assumptions." It was only in 1916, after careful analysis and new experiments was it determined Kaufmann had it wrong. Einstein himself never wavered, although Lorentz did.

The point is not that old experiment = bad experiment. The point is that we expect such conflicting results, especially when a theory is new.

The point is, thousands of subsequent experiments have shown the role that HIV plays in the causation of AIDS. That's not a matter of contention in the mainstream scientific sphere.

Just as there is no scientific controversy in the mainsteam evolution sphere.

That there are dissenters can be little doubted. That some of them may even be using scientific methods is yet to be demonstrated on these pages.

This is all getting vaporous and useless.

Here is one more attempt to identify what we all agree on so we can figure out what we are arguing about, rather than everything degenrating into chest-thumps about Bethell and who was appalled and whose uncle was even more appalled.

I'd like to encourage specific exchanges about the charges that were raised against the "denialist" perspective on AIDS in Africa. Is anybody willing to agree to parameters? Such as: One point being discussed at a time? We could start with, say, this question:

Q: Is has been assumed that HIV* spreads like "wildfire" in Africa for reasons that pertain to African culture and sexual preferences. Does the data show that HIV has indeed spread, sexually, rampantly, in any African populations that are tested directly, and not extrapolated from computer models?

Is that a question we can agree on, as a starting point?

As a sub-note: Could somebody define the current dogma in Africa? Is it this more or less:

1. HIV* spreads rampantly via heterosexual sex in Sub Saharan Africa and has been doing so since the mid 1980s, when HIV, (which originated in African monkeys,) made its way to the West.

2. The reason this is different, no, incomparablly different, from what we see in the west, epidemiologically, is that Africans prefer dry sex as well as anal sex.

3. There has been a catastrophic epidemic of sexually transmitted HIV in Africa, leading to AIDS and death, and X millions of deaths since the mid 1980s on the continent. (How many?)

4. The figures given by WHO et al have not been significantly exaggerated.

5. The only hope to save people lies in anti-retroviral drugs, for those who are positive, and for pregnant women.

6. The population on the continent of Africa has been blighted as a result of 20 years of AIDS, ie there are fewer people on the continent now, relative to the scale of time and population growth one would expect to see if there was no plague going on.

7. Clean water, adequate nutrition, improved health care structures, etc, would do little to affect AIDS since it is a sexually transmitted disease.

Is this more or less what those who are not in denial about Africa would put their names to? If not, please correct me.

(*Calm down Brink.)

By Celia Farber (not verified) on 11 Feb 2006 #permalink

Also, could we have a show of hands, from every person who has posted to this thread, how many have been to Africa?

Speaking for myself, I have traveled to the following countries: Mali, Senegal, Cote D'Ivoire, Uganda, (Tanzania, only briefly) Kenya, and South Africa. The last five countries on the list were specifically to investigate HIV/AIDS. The core research trip lasted almost a month and spanned west, central and east Africa, in the countries said to be the "epicenter" at the time the research trip was taken (1992.) I wrote up a two part article in the not heavy hitting magazine SPIN after that trip, in 1992, and would be happy to share the texts here.

By Celia Farber (not verified) on 11 Feb 2006 #permalink

Epidemiology is way out of my field of expertise, as is this debate whether HIV causes AIDS. Personally, I am convinced that it does, and frankly am perplexed why it makes any difference at all whether HIV is the culprit, since there seems to be no shortage of AIDS victims.

Celia's question whether anyone posting here has actually visited Africa is well taken. Dr. Bialy apparently has, since she refers to him in her SPIN article. Well, I have lived in South Africa and find both Mr Bethell's colonialist remarks and the general timbre of discussion here so appalling that words fail me.

Unlike much of sub-Saharan Africa, the RSA has a fairly robust economy, decent natural resources, and a stable government, even after 12 years of majority rule. Yet South Africa has a high death rate caused by AIDS, high enough that experts there fear decimation of the 20-30 age bracket with serious consequences for the future of the country. And where are most of the AIDS victims? In the poor rural and urban districts, the districts that the former apartheid government created to separate blacks from the whites. Despite its first world style economy, the RSA is still largely a third-world country. Huge sections of the bush have no running water, electricity, decent schools or decent medical care, a dozen years after the dismantling of apartheid. Similar situations exist in other former colonies in Africa. That Mr Bethell would credit the colonial powers for improving the lot of the natives is racist and hopelessly misinformed.

President Thabo Mbeki was ridiculed for several years for his stubborn insistence that HIV did not cause AIDS, despite evidence to the contrary, Mbeki finally retracted his objections. Whether it was for political or scientific reasons is hard to say. Tribal leaders recognize the problem as well and are not ashamed to identify sexual promiscuity as the root cause of the epidemic. Zulu commumities have revived an ancient custom of "aunties" inspecting young women for intact hymens.

As for the timbre of the debate here, the question of who served on which board and when is rather pointless and adds nothing to the debate. AIDS is a life-and-death matter for millions of people worldwide. Understanding its causes and finding possible cures are substantive subjects and should be the focus of debate. Arguing over minutiae is simply a waste of bandwidth and an obfuscation of the matter at hand.

Wheatdogg,

You wrote this?

"Unlike much of sub-Saharan Africa, the RSA has a fairly robust economy, decent natural resources, and a stable government, even after 12 years of majority rule."

You got a real name that you would put to this piece of racist filth?

>>The overwhelming scientific consensus on evolution is more important than the various lists that creationists can put out for example.

Not all consensuses are created equal. A squabble about the accuracy of the latest WHO statistics is not the same as a theory that has held up to 150 years of intense scrutiny. Yet they apparently fall into the same consensus basket.

Dr. Bialy,

Once again you seem to pick on minutiae and avoid the main argument. Even so, you have a lot of nerve to accuse someone of being racist when you apparently have no problem with Bethell's colonialist remarks.

My point was perhaps too oblique. It was the expectation of some whites in South Africa that once the black majority ruled, the nation would fall to pieces. The fact that it did not contradicts their expectations and is a testimony to the democratic ideals held by the vast majority of the South African public. Contrast SA politics with that of neighboring Zimbabwe, for example.

It is not racist to point out that majority-ruled South Africa has a robust economy, democratic government and substantial natural resources. Nor is it racist to point out that this country which I love dearly survived a seachange in political rule without violence or turmoil.

My name is on my own blog. You're welcome to pay me a visit, if you can manage to be civil.

I did some homework after I finished my last response. I did not realize until now that Dr Bialy was on Pres. Mbeki's AIDS advisory panel, the same panel that convinced Mbeki that HIV does not cause AIDS.

John, (Wheatdogg)

Indeed you do have a name, and a not unintersting at first peek weblog. But your attempt at an artful dodge doesn't quite make it.

You wrote that damming word EVEN, and you did not qualify its context as this was "the unrealized expectation of the racists in South Africa who wanted (and want) nothing more than to see Black majority rule fail". No my man, you let it stand naked and ugly, as your own thought. Indeed, our language often betrays our deepest thoughts.

I am glad that you have withdrawn, on closer inspection of what you wrote, the unintended but stark racism in the sentence.

I was in Cameroun the day Mandela walked out of prison, looking like a world leader, and the whole continent cheered him. And I was the first representative of UNESCO to visit a free South Africa a few months after he was elected. I am inordinately proud of the latter.

As I am inordinately proud to *still* be a member of Pres. Mbeki's Panel, which has never been dissolved, and neither has the President changed his mind that it is poverty, not sex, that is at the root of the beloved country's woes.

As I am inordinately proud to *still* be a member of Pres. Mbeki's Panel, which has never been dissolved, and neither has the President changed his mind that it is poverty, not sex, that is at the root of the beloved country's woes.

So, you are proud of spreading misinformation and ignorance? Charming.
People like you are dangerous, as they ensure that prevention of HIV/AIDS is not done properly.

BTW you still haven't provided any corrections of the facts in Tara's post, other than the minor point of Bethell not being a member of a group any more.

By Kristjan Wager (not verified) on 12 Feb 2006 #permalink

Harvey Bialy will most likely never provide corrections to the main facts in Tara's post. He will simply nibble at the edges, make bold assertions that he can't adequately back up, and attack those who disagree--as usual. I've seen him in action before on Dean Esmay's blog whenever Dean starts spouting his HIV denialism nonsense.

What are the statistics for "HIV-negative AIDS"?

Tara wrote:

As I've mentioned before, the central gist of AIDS denial is a fundamental misunderstanding of the germ theory of disease. Deniers point out, for example, that immunodeficiency is possible without HIV, and use this as a "blow" against the idea of HIV causation of the disease. This is, of course, patently ridiculous. Just because Streptococcus pneumoniae causes pneumonia doesn't rule out Staphylococcus causing it too. This also explains why there are conditions such as so-called "HIV-negative AIDS."

Tara, if it is true, as you wrote, that "there are conditions such as so-called 'HIV-negative AIDS'," what caused those people's AIDS?

The Encyclopedia Britannica entry for "immune deficiencies" states: "Poor nutrition also can undermine the immune system" A subsection, "Deficiencies caused by malnutrition" is devoted to this topic. http://www.search.eb.com/eb/article-215495

In a place like South Africa where poverty and poor nutrition are rampant, one would expect many cases of "malnutrition/AIDS"--that is, immune deficiency acquired by poor nutrition.

Tara, being a public health professional, perhaps you can provide us with a breakdown of South Africa (or any other part of Africa where poverty is a serious problem) AIDS statistics for:

        (1) AIDS caused by HIV
        (2) "HIV-negative AIDS"

I have tried to find such stats, but cannot. Perhaps I am looking in the wrong places.

Wouldn't you agree, however, that it would be tragic to help people suffering from malnutrition/AIDS by giving them anti-HIV drugs if their suffering is, at the root, caused by poor nutrition?

Thanks in advance.

By Anonymous Two (not verified) on 12 Feb 2006 #permalink

To go to Celia's point:

1. HIV spreads rampantly via heterosexual sex in Sub Saharan Africa and has been doing so since the mid 1980s, when HIV, (which originated in African monkeys,) made its way to the West.

I could maybe go with this--depends on what your definition of "rampantly" is.

2. The reason this is different, no, incomparablly different, from what we see in the west, epidemiologically, is that Africans prefer dry sex as well as anal sex.

Um, no. In the US, at least, I'd attribute the difference to the founder effect. As initial populations to be infected were homosexuals and IV drug users, and as HIV luckily doesn't spread easily via methods other than intimacy or injection, it's been much slower to spread to indiviuals outside of those initial groups (though, of course, heterosexual infections are now much more common--it's even hit the elderly thanks to Viagra). In Africa, heterosexual transmission was there from the start.

3. There has been a catastrophic epidemic of sexually transmitted HIV in Africa, leading to AIDS and death, and X millions of deaths since the mid 1980s on the continent. (How many?)

Okay. Again, depending on your definition of "catastrophic", I can agree with that. Not sure the total deaths--I believe it stands ~25 million worldwide since the start of the epidemic, and most of those would be in Africa.

4. The figures given by WHO et al have not been significantly exaggerated.

Indeed. And to go along with this, I'll ask you what I emailed both you and Harvey: other diseases, such as TB and malaria, are similarly estimated and are not frequently diagnosed with molecular tests--why aren't those said to be "inflated" and generally incorrect, as you claim with AIDS?

5. The only hope to save people lies in anti-retroviral drugs, for those who are positive, and for pregnant women.

No, I don't think this is the *only* hope--I think you're creating a strawman here. More on this later.

6. The population on the continent of Africa has been blighted as a result of 20 years of AIDS, ie there are fewer people on the continent now, relative to the scale of time and population growth one would expect to see if there was no plague going on.

I don't know that one is necessarily widely accepted either. 25 million worldwide is no small potatoes, but I don't think it's enough to "blight" an entire continent. There are, however, segments of the population that have been heavily hit--as wheatdogg mentions, specifically the 25-49 age group that is typically healthy.

7. Clean water, adequate nutrition, improved health care structures, etc, would do little to affect AIDS since it is a sexually transmitted disease.

No, no, no, no. Can I be a bit clearer? No. Wrong. No, no, no. No.

Clean water and adequate nutrition may not help much in stopping the spread of HIV, but they certainly would help fend off the secondary infections that result in clinical AIDS. While I strongly disagree with the idea put forth by Bethell et al. that the root cause of AIDS in Africa is really malnutrition, I don't think anyone disagrees that having good nutrition keeps one generally healthier and increases their ability to fend off a variety of diseases. And since so many diseases are currently acquired by terrible water in so many places, having safe water would help in this arena as well. I already addressed this in the post, so I'm a bit surprised you're repeating this strawman.

Improved health care structures would also help immensely. One risk factor that increases the odds of acquiring HIV in the first place is the presence of another STD. So if people could routinely be screened and treated for these, their chances of getting HIV in the first place would be decreased. Similarly, early diagnosis has been shown to be most effective in continuing to stay healthy, so better health care could also lead to earlier drug intervention (for both HIV drugs and simple antibiotics etc. to treat acquired infections), or at least recongnition that they are infected. The latter would also encourage, ideally, more careful sexual practices--including consistent use of condoms.

Is this more or less what those who are not in denial about Africa would put their names to? If not, please correct me.

I really find it hard to believe someone who's devoted as much time to the study of this issue would attribute many of those attitudes to those of us who accept that HIV causes AIDS. I don't doubt that perhaps someone has made such comments, but in no way does much of that represent the mainstream public health opinion.

Anonymous Two--

Tara, if it is true, as you wrote, that "there are conditions such as so-called 'HIV-negative AIDS'," what caused those people's AIDS?

Could be a number of things. Other infections, nutrition, chemical exposure, etc. That's why I really don't like grouping them together as "HIV-negative AIDS," and why medical professionals have given them the name of "idiopathic T-cell lymphopenia"--in other words, "something's destroying your T cells, but damned if we know what." The reason I don't like to include them under the "AIDS" umbrella is because we *do* know what causes AIDS, and we can treat that (or, ideally, prevent it in the first place). So-called "HIV-negative AIDS" could be caused by a dozen different reasons, and until they're further sorted out, they should be kept in a different category from AIDS.

The Encyclopedia Britannica entry for "immune deficiencies" states: "Poor nutrition also can undermine the immune system" A subsection, "Deficiencies caused by malnutrition" is devoted to this topic. http://www.search.eb.com/eb/article-215495

In a place like South Africa where poverty and poor nutrition are rampant, one would expect many cases of "malnutrition/AIDS"--that is, immune deficiency acquired by poor nutrition.

Sure, and as noted toward the beginning of the comments, AIDS isn't noted as a definition unless malnutrition and other known conditions that compromise the immune system have already been ruled out.

Tara, being a public health professional, perhaps you can provide us with a breakdown of South Africa (or any other part of Africa where poverty is a serious problem) AIDS statistics for:

(1) AIDS caused by HIV
(2) "HIV-negative AIDS"

I have tried to find such stats, but cannot. Perhaps I am looking in the wrong places.

I don't know off the top of my head, and I'm not sure any numbers are kept for "HIV-negative AIDS," especially if you're asking that they include malnutrition in the second group.

Wouldn't you agree, however, that it would be tragic to help people suffering from malnutrition/AIDS by giving them anti-HIV drugs if their suffering is, at the root, caused by poor nutrition?

Indeed, but as I already discussed, nutrition is examined when immunocompromise is found. As David Crowe noted when he tried to argue my point (but actually proved it), the 1985 definition includes:

To quote from: WHO/CDC case definition for AIDS. Wkly Epidemiol Rec. 1986 Mar 7; 61(10): 69-76. AIDS in an adult is defined by the existence of at least 2 of the major signs associated with at least 1 minor sign, in the absence of known causes of immunosuppression such as cancer or severe malnutrition or other recognized etiologies

Ngiyabonga, Dr. Bialy, for retracting your intended insult of my character. And it is true that Pres. Mbeki has likely not wavered from his belief that HIV and AIDS are unrelated. So far as I know, however, he has not made any public pronouncements reiterating that belief, since it is a belief not widely shared by anyone working with AIDS treatment and patients there. This reference from The Economist dated Jan. 20, 2005, supports that surmise.

Poverty exacerbates the spread of HIV, AIDS and many other diseases, that is clear, but how does one explain the miniscule incidence of AIDS in Muslim sub-Saharan Africa? There is a coincident low rate of premarital and extramarital sex in Muslim countries. So, are we looking at correlation or causation here? Clearly, sex has to be a factor in the transmission of HIV/AIDS, whether you or Pres. Mbeki care to accept it.

And for a different perspective on Rian Malan's coffin-maker investigation, here is an excerpt from a longer article from IslamOnline:

Presenting the findings of the research conducted in affected rural communities in Sub-Saharan Africa including Kenya, Namibia, South Africa and Uganda, Dr. Jane Dwasi, a law lecturer at University of Nairobi, Kenya and Attorney at Law said, "The impact of HIV/AIDS on Africa's environment could be demonstrated by an increase in timber consumption for coffins in areas such as in Kisumu, Kenya. In some areas, medicinal plants have been harvested unsustainably. Increased poaching and gathering of wild foods can also increase, as affected people cannot perform heavy labor for agriculture."
Dr. Dwasi said that in almost every trading centre in Sub-Saharan Africa there is a booming coffin-making industry.

Thank you for the comments, Tara. Perhaps I was too quick to limit AIDS to only two categories. Given what you have said, it seems we need statistics for:
        (1) AIDS caused by HIV
        (2) "HIV-negative AIDS"
        (3) AIDS caused by a mix of HIV and non-HIV factors

In impoverished places in South Africa, what is the breakdown of these three statistics?

In answer to my question of what else, besides HIV, can cause AIDS, you wrote:

Could be a number of things. Other infections, nutrition, chemical exposure, etc. That's why I really don't like grouping them together as "HIV-negative AIDS," and why medical professionals have given them the name of "idiopathic T-cell lymphopenia"--in other words, "something's destroying your T cells, but damned if we know what."

If "HIV-negative AIDS" and "idiopathic T-cell lymphopenia" include the same "number of things" that can cause AIDS, I fail to see the benefit of using this new jargon, "idiopathic T-cell lymphopenia."

Tara also wrote:

I don't know off the top of my head, and I'm not sure any numbers are kept for "HIV-negative AIDS," especially if you're asking that they include malnutrition in the second group.

Surely people in the field of public health are interested in knowing where to devote resources. How can this be decided without knowing what is causing immune deficiency--and therefore, learning where the biggest problems lie?

Tara wrote:

The reason I don't like to include them under the "AIDS" umbrella is because we *do* know what causes AIDS, and we can treat that.

Does AIDS have a concrete definition or is it an "umbrella" into which professionals can decide what they like to include on a personal basis? If AIDS does not have a concrete definition, why are scientists even using the term? If AIDS does have a concrete, scientific definition, what is it?

In addition, you stated instead of "HIV-negative AIDS," medical professionals use the term "idiopathic T-cell lymphopenia," which you said means "something's destroying your T cells, but damned if we know what." Is this not inconsistent with your statement that "we *do* know what causes AIDS"?

Thanks again.

By Anonymous Two (not verified) on 12 Feb 2006 #permalink

I'm heading out the door, just a few quick comments--

If "HIV-negative AIDS" and "idiopathic T-cell lymphopenia" include the same "number of things" that can cause AIDS, I fail to see the benefit of using this new jargon, "idiopathic T-cell lymphopenia."

AIDS is in a different category from "idiopathic T-cell lymphopenia" (which is just the formal name for "HIV-negative AIDS"). We know what causes AIDS and have a definition for that disease--we don't know what's causing the other immunodeficiencies *in the absence* of HIV. So to clarify:

In addition, you stated instead of "HIV-negative AIDS," medical professionals use the term "idiopathic T-cell lymphopenia," which you said means "something's destroying your T cells, but damned if we know what." Is this not inconsistent with your statement that "we *do* know what causes AIDS"?

We know what causes AIDS, and we do have a definition for it. However, it's like the pneumonia example I used in my post. There are multiple causes of pneumonia--many microbial, and some due to other factors. The microbes may present differently--for example, a primary pneumonia due to the influenza virus may be different than one caused by Streptococcus pneumoniae, which may be different than one caused by Staph aureus, etc. We may even have some pneumonias that don't have a known cause--that are "idiopathic." Right now, we have immunodeficiency disease that has a known cause and clinical spectrum--we call that AIDS. We have other immunodeficiencies that appear to be acquired, but that don't fall neatly into another group--ones that, for now, don't have a known cause. These are the idiopathic ones I mention.

Sorry, that's probably not any clearer--I'll give it a better go tomorrow. Out for now...

>>Indeed. And to go along with this, I'll ask you what I emailed both you and Harvey: other diseases, such as TB and malaria, are similarly estimated and are not frequently diagnosed with molecular tests--why aren't those said to be "inflated" and generally incorrect, as you claim with AIDS?

As far as I know nobody claimed that TB and malaria stats were "scientific consensus" just a reasonable guesstimate. If the guesstimate were questioned it would be in a dry journal and nobody would be labeled a "malaria denier"

The distinction between reasonable and scientific is important because the words "scientific consensus" tends to have a chilling effect on public policy debate.

While I don't intend to get caught up (at the moment) on the African AIDS debate, I would like to make some simple observations on the "list of 2,300" and the discussion about it above.

It had been pointed out that the list should not be taken seriously, because it included "engineers, economists, medical students and those without formal scientific qualifications".

However, the problems with the HIV/AIDS hypothesis are really quite elementary and to understand the objections raised and why the hypothesis is unproven requires little more background than a good selection of lower-division science courses. Is it the fault of the dissidents that the flaws of the hypothesis are so embarassingly obvious as to be easily recognized by "engineers, economists, medical students and those without formal scientific qualifications"? I think not.

Tara claims the list is "artificially inflated" and "not an honest list". On the contrary, all of the individuals I am personally acquainted with whose names appear on the list have all expended a tremendous amount of time and effort reading the literature, examining the arguments on either side, and thinking long and hard about the issues involved. I don't know of ANYONE on the list who takes the issue lightly or who does not take extremely seriously the choice to go public with their doubts. So, I don't see how the list is "dishonest". The relevant qualifications, degrees, or experience of everyone is listed. That much is perfectly transparent. And no one on the list was "rounded up" in "artifical" fashion to get as many names as possible, something which cannot be said for similar such lists like the Durban Declaration.

Myself -- I a mathematician, Ph.d. from University of California, Santa Barbara. I heard of the debate about 10 years ago, about the time of the Ho/Shaw Nature papers. I had heard something that mathematics was used. I stumbled across some different things, including some of Craddock's papers and Lang's cc-files. I was appalled both at the manipulative treatment given Duesberg and others by Nature and Science, and also the transparently inept use of mathematics in the Nature papers. Neither of these issues have yet to be addressed -- the journalistic manipulation that took place 10 years ago is still largely unknown to most scientists, and the Ho/Shaw papers...well, they became the next in the long line of discredited-but-hey-who-cares-look-what-the-drugs-have-done adventures. I would like to think I am competent enough to have an informed opinion on both of these issues -- the journalistic manipulation requires little or no scientific training to judge, while the mathematics happens to be my area of training.

As for taking your case to the public via the media, internet, books, instead of the traditional scientific journals -- well, when the mainstream scientific journals fail in their responsibilities and journalistic obligations, where else is there to turn?

âWe Science Journalistsâ¦too often serve as perky cheerleaders for our suject and our sourcesâ
â Natalie Angier, âThe Lab as Battlefieldâ NY Times Book Review, 1991.

Dear Tara,

You started the argument with the a priori assumption that any information provided by Bethell, or anyone who joined him, was false, or would be proven false.

The concept and word âScienceâ has roots in the Latin scientia or scire meaning âknowledgeâ or âto knowâ. (I also take its similarity to scissor or cisorium, âto cutâ).

I offer that science is the art and practice of weighing evidence in an attempt to best know and understand a phenomenon, and to cut through false perceptions surrounding the event.

If you are a scientist (one who wishes to know and understand), then you must read the totality of the literature necessary to form a critical and more correct description and understanding of the phenomenon in question. This is very different than âknowingâ, as in being able to repeat or defend the theory you believe describes the phenomenon.

The phenomenon is different than the theory

A theory seeks to describe a phenomenon, but will always do so incompletely or incorrectly. A theory is not a truth, it is the continuation of a received line of thinking that seeks, with its inherent limits, to describe a truth.

A theory functions as a structure built around perceived aspects of a complex phenomenon. This construct allows simple work to be done, but will fail to describe the phenomenon in degrees of accuracy and completeness.

All theories are limited, in that they must be built using the popular orthodoxies of the time, and only the tools available to practitioners of the orthodoxy.

If you have only read the dissenting theories, you must also read the orthodoxy. If you have only read the orthodoxy, you must read the dissenting theories.

  • In full,
  • with the allowance that your perceptions must be allowed to change, if they are influenced to do so.

Dissenting theories are generally formed in critical response to an established theory. It is therefore necessary and important for serious, well-constructed and thoughtful dissent to be aired, in order to correct imperfect, untrue and outdated orthodoxies.

In reading new material, you must offer no side a bias, except that of your own impulse to logical analysis. Politics must be acknowledged, and, for the purposes of understanding, disavowed.

In sum, there are at least four aspects to understanding.

  • You must read and understand the orthodoxy
  • You must read and understand the critical response to the orthodoxy.
  • You must read and evaluate the response of the orthodoxy to its critics.
  • You must read and evaluate the response of critics to the response of the orthodoxy.

Have you done this?

Iâm sure your loyal opposition would willingly provide some material for you to read, and vice versa. But itâs only meaningful if you do it with serious intent, and lack of prejudice.

All other arguments â straw men, red herrings, ad hominems, authority, bandwagon â are distractions from the question.

What Iâve outlined is a lot to do, but it is the requirement, I believe, for someone who is serious in their pursuit of greater truths.

For the record, the orthodox theory in question here is:

Acquired Immune Deficiency Syndrome caused by a single factor, distributed through a single vector, namely human sexual intercourse. Heterosexual, in the case of Africa.

You owe it to yourself and your readers to weigh the fullness of the evidence, or, let it be understood that you are more interested in politics than science.

I hope, sincerely that you will be able to find a little time in your schedule to make room for the powerful and inherent contradictions presented in this field (as well as oncology, genetics, et al).

Good luck.

Bests,

Liam Scheff

(Hi Tara, I reposted because of formatting errors on the blog, please delete previous)

We Science Journalists...too often serve as perky cheerleaders for our suject and our sources

Natalie Angier, The Lab as Battlefield NY Times Book Review, 1991.

Dear Tara,

You started the argument with the a priori assumption that any information provided by Bethell, or anyone who joined him, was false, or would be proven false.

The concept and word Science has roots in the Latin _scientia_ or _scire_ meaning knowledge or to know. (I also take its similarity to _scissor_ or _cisorium_, to cut).

I offer that science is the art and practice of weighing evidence in an attempt to best know and understand a phenomenon, and to cut through false perceptions surrounding the event.

If you are a scientist (one who wishes to know and understand), then you must read the totality of the literature necessary to form a critical and more correct description and understanding of the phenomenon in question. This is very different than 'knowing', as in being able to repeat or defend the theory you believe describes the phenomenon.

The phenomenon is different than the theory

A theory seeks to describe a phenomenon, but will always do so incompletely or incorrectly. A theory is not a truth, it is the continuation of a received line of thinking that seeks, with its inherent limits, to describe a truth.

A theory functions as a structure built around perceived aspects of a complex phenomenon. This construct allows simple work to be done, but will fail to describe the phenomenon in degrees of accuracy and completeness.

All theories are limited, in that they must be built using the popular orthodoxies of the time, and only the tools available to practitioners of the orthodoxy.

If you have only read the dissenting theories, you must also read the orthodoxy. If you have only read the orthodoxy, you must read the dissenting theories.

  • In full,
  • with the allowance that your perceptions must be allowed to change, if they are influenced to do so.

Dissenting theories are generally formed in critical response to an established theory. It is therefore necessary and important for serious, well,constructed and thoughtful dissent to be aired, in order to correct imperfect, untrue and outdated orthodoxies.

In reading new material, you must offer no side a bias, except that of your own impulse to logical analysis. Politics must be acknowledged, and, for the purposes of understanding, disavowed.

In sum, there are at least four aspects to understanding.

  • You must read and understand the orthodoxy
  • You must read and understand the critical response to the orthodoxy.
  • You must read and evaluate the response of the orthodoxy to its critics.
  • You must read and evaluate the response of critics to the response of the orthodoxy.

Have you done this?

Im sure your loyal opposition would willingly provide some material for you to read, and vice versa. But its only meaningful if you do it with serious intent, and lack of prejudice.

All other arguments, straw men, red herrings, ad hominems, authority, bandwagon, are distractions from the question.

What I've outlined is a lot to do, but it is the requirement, I believe, for someone who is serious in their pursuit of greater truths.

For the record, the orthodox theory in question here is:

Acquired Immune Deficiency Syndrome caused by a single factor, distributed through a single vector, namely human sexual intercourse. Heterosexual, in the case of Africa.

You owe it to yourself and your readers to weigh the fullness of the evidence, or, let it be understood that you are more interested in politics than science.

I hope, sincerely that you will be able to find a little time in your schedule to make room for the powerful and inherent contradictions presented in this field (as well as oncology, genetics, et al).

Good luck.

Bests,

Liam Scheff

I'm tempted to try a response to Tara's question of why we hold HIV to supposedly "higher standards" than other "infectious diseases". The first observation which comes to mind is that Tara's question presumes the fact, e.g. when she asks "why we hold HIV to a higher standard than other infectious diseases", it is implicit in this question that HIV causes an infectious disease. But that is the issue in the FIRST place. It is typical circular logic. You have to KNOW that a certain disease really is infectious before you "hold it to a higher standard" compared to other known infectious diseases. Comparisons with malaria, TB, influenza or similar types of diseases are red herrings. In fact, it's almost laughable to make comparison with those. Each of those has a somewhat specific diagnostic presentation. For example, TB is characterised by "productive, prolonged cough of three or more weeks, chest pain, and hemoptysis. Systemic symptoms include fever, chills, night sweats, appetite loss, weight loss, and easy fatigability." (Wikipedia article) Whereas "AIDS" is completely different. It has no specific diagnostic presentation such as the above. What is constantly forgotten (and this is SO important) is that "AIDS" was from the beginning an EPIDEMIOLOGICAL SURVEILLANCE TOOL, not a positive gestalt diagnosis. Only when HIV entered the scene did the diagnostic tool magically transform into a presumed disease with a single cause. Now, this would have been perfectly acceptable, provided there was some reasonable biological justification for transforming the epidemiological surveillance tool into a gestalt diagnosis. But such justification has never been coming. Gallo and Montagnier never provided it. Virologists have been struggling and struggling for 20 years to provide such justification. And no one has provided it since. Yet no one in HIV research seems to be bothered by this fact. It's an article of faith, like the Nicene Creed. The epidemiology is supposedly used to justify the biological "quest" for how HIV kills T cells or causes "AIDS", yet at the same time, the epidemiology REQUIRES some kind of biological justification to move itself from beyond the realm of epidemiological surveillance tool and into the realm of gestalt diagnosis. The biology is supposed to justify the epidemiology, yet at the same time, the epidemiology is supposed to justify the biology. Another example of the ubiquitous circular logic of "AIDS science". Caveat emptor.

Dave S. said:

>>But are not infections acquired? The two terms are not in direct opposition. Acquired is a more general term, to be sure, but one could acquire an infection, among other things.

Dave -- I believe "acquired" refers to "acquired (adaptive) immunity", as opposed to INNATE immunity. Duh.

Casually notes that the substance of Tara pots has not actually been adressed by the HIV causes AIDS deniers. Wonders why screening for HIV in blood transfusions has reduced the risk of transmission by blood transfusion and subsequent development of HIV/AIDS.

I must admit that I am rather shocked that apparently well educated and fairly intelligent people can actually be AIDS-deniers. Much the same way I got shocked the first time I ran into the Intelligent Design crowd.

Oh, and Steve - spot on.

By Kristjan Wager (not verified) on 13 Feb 2006 #permalink

[quote]Dave -- I believe "acquired" refers to "acquired (adaptive) immunity", as opposed to INNATE immunity. Duh.[/quote]
I don't think so. I am pretty sure "acquired" here stands in contrast to "congenital" immunodeficiency syndromes (e.g. Bruton's immunodeficiency, X-linked severe combined immunodeficiency, etc) which are genetically transmitted.

I also note that there has been no specific answer to Tara's post. In general, I find it disturbing that, while HIV-causes-AIDS deniers here seem to argue the viewpoint that the evidence that HIV causes AIDS is incomplete, the effect of their actions is to limit access of HIV-infected people to potentially life-saving medications. The fact is, anti-retroviral therapy is the main tool currently used in the fight against AIDS, and whatever we are doing (ART + whatever else) seems to be working.

If you really are just unsure that HIV causes AIDS, by all means criticize the science. But when you try to gain a disproportionate amount of influence on policy-makers or influence public opinion, and drastically change the current therapeutic approaches, then your actions could effectively make people die just because you are personally *unconvinced* by the evidence, and that's where you cross the line, in my opinion.

On the other hand, if you feel absolutely *sure* HIV does NOT cause AIDS, you know perfectly well there are simple self-experiments you can conduct to prove it. To my knowledge, no one of you has tried.

By Andrea Bottaro (not verified) on 13 Feb 2006 #permalink

Andrea Bottaro said:

[quote]Dave -- I believe "acquired" refers to "acquired (adaptive) immunity", as opposed to INNATE immunity. Duh.[/quote]
I don't think so. I am pretty sure "acquired" here stands in contrast to "congenital" immunodeficiency syndromes (e.g. Bruton's immunodeficiency, X-linked severe combined immunodeficiency, etc) which are genetically transmitted.

Yes, exactly my point.

Note: use "blockquote" instead of "quote" and angled brackets instead of square ones.

I also note that there has been no specific answer to Tara's post.

There's been much innuendo though.

If you really are just unsure that HIV causes AIDS, by all means criticize the science. But when you try to gain a disproportionate amount of influence on policy-makers or influence public opinion, and drastically change the current therapeutic approaches, then your actions could effectively make people die just because you are personally *unconvinced* by the evidence, and that's where you cross the line, in my opinion.

I agree, although such deniers tend not to be researchers in the field themselves, but rely on discrediting the research of others. This means the way to advance their views is mainly open via proselytization.

On the other hand, if you feel absolutely *sure* HIV does NOT cause AIDS, you know perfectly well there are simple self-experiments you can conduct to prove it. To my knowledge, no one of you has tried.

Good luck to the poor bugger who tries that one.

Hi Liam,

First, you say:

For the record, the orthodox theory in question here is:

Acquired Immune Deficiency Syndrome caused by a single factor, distributed through a single vector, namely human sexual intercourse. Heterosexual, in the case of Africa.

That's not the "orthodoxy" at all. I'm a bit tired of the strawmen. First, as I mentioned in my post, while HIV is certainly considered to be a necessary factor for the development of AIDS, it may not be sufficient by itself to cause it. This is an active area of investigation. Additionally, obviously sexual intercourse is not the only transmission vector. IV drug use has been, and continues to be, a transmission route as well (although clearly more of a problem in developed countries with easier access to needles than in many areas of Africa).

Additionally, you suggest I've not read the "challenges" to the "orthodoxy." Isn't that exactly what Bethell's book claims to be? I've also read, as I mentioned to Harvey, damn near everything of Duesberg's I've been able to find, the entire collection of articles on the virusmyth site, and Maggiore's book and website as well, in addition to a number of other things I've found here and there (including your own articles). Feel free to point me to anything important you think I've missed.

Tara said:

Additionally, obviously sexual intercourse is not the only transmission vector. IV drug use has been, and continues to be, a transmission route as well (although clearly more of a problem in developed countries with easier access to needles than in many areas of Africa).

From very early on (1982-83) the disease was identified to occur in - gay males, haemophiliacs, intravenous drug uses, and Haitians.

Screening of organs, blood and blood products have reduced or eliminated those vectors.

Feel free to point me to anything important you think I've missed.

And here we would obviously really like to see all fairly recent (say from within the last 10 year or so) peer-reviewed articles that support the lack of connection between HIV and AIDS.

As I have said before, on other subjects, it's not that we are anti-'your idea', but we are pro-science, so please provide us with any science that you might have.

By Kristjan Wager (not verified) on 13 Feb 2006 #permalink

Additionally, obviously sexual intercourse is not the only transmission vector. IV drug use has been, and continues to be, a transmission route as well

Blood transfusions also caused a lot of people to be infected in the early days, but as Dave said, screening has (more or less) removed this vector.

By Kristjan Wager (not verified) on 13 Feb 2006 #permalink

The HIV-AIDS Hypothesis: 16 Predictions Versus the Facts

Adapted from: Duesberg, P. H., Koehnlein, C., and Rasnick, D. 2003. The chemical bases of the various AIDS epidemics: recreational drugs, anti-viral chemotherapy and malnutrition. J. Biosci. 28:383?412, Table 4.

All quotes are from The Durban Declaration, the most authoritative edition of the HIV-AIDS hypothesis to date, which was signed ?by over 5000 people, including Nobel prizewinners? and published in Nature in 2000 (The Durban Declaration. 2000. Nature 406:15-16.). Numbers in parentheses are for the references given at the end of the text.

1.

Prediction: Since HIV is ?the sole cause of AIDS?, it must be abundant in AIDS patients based on ?exactly the same criteria as for other viral diseases.?

Fact But, only antibodies against HIV are found in most patients (1-7). Therefore, ?HIV infection is identified in blood by detecting antibodies, gene sequences, or viral isolation.? But, HIV can only be ?isolated? from rare, latently infected lymphocytes that have been cultured for weeks in vitro ? away from the antibodies of the human host (8). Thus HIV behaves like a latent passenger virus.

2.

Prediction: Since HIV is ?the sole cause of AIDS?, there is no AIDS in HIV-free people.

Fact: But, the AIDS literature describes at least 4621 HIV-free AIDS cases according to one survey ? irrespective of, or in agreement with allowances made by the CDC for HIV-free AIDS cases (55).

3.

Prediction: The retrovirus HIV causes immunodeficiency by killing T-cells (1-3).

Fact: But, retroviruses don?t kill cells because they depend on viable cells for the replication of their RNA from viral DNA integrated into cellular DNA. Thus, T-cells infected in vitro thrive, and those patented to mass-produce HIV for the detection of HIV antibodies and diagnosis of AIDS are immortal (9-15)!

4.

Prediction: With a RNA of 9 kilobases, just like polio virus, HIV should be able to cause at most one disease, or no disease if it is a passenger (22).

Fact: But, HIV is said to be ?the sole cause of AIDS?, or of 26 different immunodeficiency and non- immunodeficiency diseases, all of which also occur without HIV (Table 2). Thus there is not one HIV-specific disease, which is the definition of a passenger virus!

5.

Prediction: All viruses are most pathogenic prior to anti-viral immunity. Therefore, preemptive immunization with Jennerian vaccines is used to protect against all viral diseases since 1798.

Fact: But, AIDS is observed ? by definition ? only after anti-HIV immunity is established, a positive HIV/AIDS test (23). Thus HIV cannot cause AIDS by ?the same criteria? as conventional viruses.

6.

Prediction: HIV needs ?5-10 years? from establishing antiviral immunity to cause AIDS.

Fact: But, HIV replicates in 1 day, generating over 100 new HIVs per cell (24, 25). Accordingly, HIV is immunogenic, ie. biochemically most active, within weeks after infection (26, 27). Thus, based on conventional criteria ?for other viral diseases?, HIV should also cause AIDS within weeks ? if it could.

7.

Prediction: ?Most people with HIV infection show signs of AIDS within 5-10 years? ? the justification for prophylaxis of AIDS with the DNA chain terminator AZT (Section 4).

Fact: But, of ?34.3 million ? with HIV worldwide? only 1.4% (= 471,457 [obtained by subtracting the cumulative total of 1999 from that of 2000]) developed AIDS in 2000 (28). Likewise, in 1985, only 1.2% of the 1 million US citizens with HIV developed AIDS (29, 30). Since an annual incidence of 1.2-1.4% of all 26 AIDS defining diseases combined is no more than the normal mortality in the US and Europe (life expectancy of 75 years), HIV must be a passenger virus.

8.

Prediction: A vaccine against HIV should (?is hoped? to) prevent AIDS ? the reason why AIDS researchers try to develop an AIDS vaccine since 1984 (31).

Fact: But, despite enormous efforts there is no such vaccine to this day (31). Moreover, since AIDS occurs by definition only in the presence of natural antibodies against HIV (Section 3), and since natural antibodies are so effective that no HIV is detectable in AIDS patients (see Table 4,1), even the hopes for a vaccine are irrational.

9.

Prediction: HIV, like other viruses, survives by transmission from host to host, which is said to be mediated ?through sexual contact?.

Fact: But, only 1 in 1000 unprotected sexual contacts transmits HIV (32-34), and only 1 of 275 US citizens is HIV-infected (29, 30) (Fig. 1b). Therefore, an average un-infected US citizen needs 275,000 random ?sexual contacts? to get infected and spread HIV ? an unlikely basis for an epidemic!

10.

Prediction: ?AIDS spreads by infection? of HIV.

Fact: But, contrary to the spread of AIDS, there is no ?spread? of HIV in the US . In the US HIV infections have remained constant at 1 million from 1985 (29) until now (30) (see also The Durban Declaration and Fig. 1b). By contrast, AIDS has increased from 1981 until 1992 and has declined ever since (Fig. 1a).

11.

Prediction: Many of the 3 million people who annually receive blood transfusions in the US for life-threatening diseases (51), should have developed AIDS from HIV-infected blood donors prior to the elimination of HIV from the blood supply in 1985.

Fact: But there was no increase in AIDS-defining diseases in HIV-positive transfusion recipients in the AIDS era (52), and no AIDS-defining Kaposi?s sarcoma has ever been observed in millions of transfusion recipients (53).

12.

Prediction: Doctors are at high risk to contract AIDS from patients, HIV researchers from virus preparations, wives of HIV-positive hemophiliacs from husbands, and prostitutes from clients ? particularly since there is no HIV vaccine.

Fact: But, in the peer-reviewed literature there is not one doctor or nurse who has ever contracted AIDS (not just HIV) from the over 816,000 AIDS patients recorded in the US in 22 years (30). Not one of over ten thousand of HIV researchers has contracted AIDS. Wives of hemophiliacs don?t get AIDS (35). And there is no AIDS-epidemic in prostitutes (36-38). Thus AIDS is not contagious (39, 40).

13.

Prediction: Viral AIDS ? like all viral/microbial epidemics in the past ? should spread randomly in a population

Fact: But, in the US and Europe AIDS is restricted since 1981 to two main risk groups, intravenous drug users, of which 80% are males, and male homosexual drug users (Sections 1 and 4).

14.

Prediction: A viral AIDS epidemic should form a classical, bell-shaped chronological curve (41-43), rising exponentially via virus spread and declining exponentially via natural immunity, within months (see Fig. 3a).

Fact: AIDS has been increasing slowly since 1981 for 12 years and is now declining since 1993 (Fig. 1a), just like a lifestyle epidemic, as for example lung cancer from smoking (Fig. 3b)

15.

Prediction: AIDS should be a pediatric epidemic now, because HIV is transmitted ?from mother to infant? at rates of 25-50% (44-49), and because ?34.3 million people worldwide? were already infected in 2000. To reduce the high maternal transmission rate HIV-antibody-positive pregnant mothers are treated with AZT for up to 6 months prior to birth (Section 4).

Fact: But, less than 1% of AIDS in the US and Europe is pediatric (30, 50). Thus HIV must be a passenger virus in newborns

16.

Prediction: ?HIV recognizes no social, political or geographic borders? ? just like all other viruses.

Fact: But, the presumably HIV-caused AIDS epidemics of Africa and of the US and Europe differ both clinically and epidemiologically (Section 1, Table 2). The US/European epidemic is highly nonrandom, 80% male and restricted to abnormal risk groups, whereas the African epidemic is random.

References:

1. Marx, J. 1984. Strong new candidate for AIDS agent. Science 224:475?477.

2. Gallo, R. C., Salahuddin, S. Z., Popovic, M., Shearer, G. M., Kaplan, M., Haynes, B. F., Palker, T. J., Redfield, R., Oleske, J., Safai, B., White, G., Foster, P. and Markham, P. D. 1984. Frequent detection and isolation of cytopathic retrovirus (HTLV-III) from patients with AIDS and at risk for AIDS; Science 224:500?503.

3. Altman, L. K. 1984. Researchers believe AIDS virus is found. The New York Times, April 24, pp. C1, C3.

4. Duesberg, P. H. 1987. Retroviruses as carcinogens and pathogens: expectations and reality. Cancer Res. 47:1199?1220.

5. Duesberg, P. H. 1988. HIV is not the cause of AIDS. Science 241:514?516.

6. Duesberg, P. H. 1994. Infectious AIDS?stretching the germ theory beyond its limits. Int. Arch. Allergy Immunol. 103:131?142.

7. Duesberg, P., and Bialy, H. 1996. Duesberg and the Right of Reply According to Maddox?Nature; in AIDS: Virus- or drug-induced? (ed.) P. H. Duesberg (Dordrecht : Kluwer) pp. 111?125.

8. Levy, J. A., Hoffman, A. D., Kramer, S. M., Landis, J. A., and Shima-bukuro, J. M. 1984. Isolation of lymphocytopathic retroviruses from San Francisco patients with AIDS. Science 225:840?842.

9. Hoxie, J. A., Haggarty, B. S., Rakowski, J. L., Pillsbury, N., and Levy, J. A. 1985. Persistent noncytopathic infection of normal human T lymphocytes with AIDS-associated retrovirus. Science 229: 1400?1402.

10. Anand, R., Reed, C., Forlenza, S., Siegal, F., Cheung, T., and Moore, J. 1987. Non-cytocidal natural variants of human immunodeficiency virus isolated from AIDS patients with neurological disorders. Lancet 2:234?238.

11. Langhoff, E., McElrath, J., Bos, H. J., Pruett, J., Granelli-Piperno, A., Cohn, Z. A., and Steinman, R. M. 1989. Most CD4+ T cells from human immunodeficiency virus-1 infected patients can undergo prolonged clonal expansion. J. Clin. Invest. 84:1637?1643.

12. Duesberg, P. H. 1996b. Inventing the AIDS Virus (Washington , DC : Regnery Publishing, Inc.).

13. Weiss, R. 1991. Provenance of HIV strains. Nature 349:374.

14. Cohen, J. 1993. HHS: Gallo guilty of misconduct. Science 259:168?170.

15. McCune, J. M. 2001. The dynamics of CD4+ T-cell depletion in HIV disease. Nature 410:974?979.

16. Harper, M. E., Marselle, L. M., Gallo, R. C., and Wong-Staal, F. 1986. Detection of lymphocytes expressing human T-lymphotropic virus type III in lymph nodes and peripheral blood from infected individuals by in situ hybridization. Proc. Natl. Acad. Sci. USA 83:772?776.

17. Schnittman, S. M., Psallidopoulos, M. C., Lane, H. C., Thompson, L., Baseler, M., Massari, F., Fox, C. H., Salzman, N. P., and Fauci, A. 1989. The reservoir for HIV-1 in human peripheral blood is a T cell that maintains expression of CD4. Science 245:305?308.

18. Hazenberg, M. D., Hamann, D., Schuitemaker, H., and Miedema, F. 2000. T cell depletion in HIV-1 infection: how CD4+ T cells go out of stock. Nature Immunol. 1:285?289.

19. Duesberg, P. H. 1988. HIV is not the cause of AIDS. Science 241:514?516.

20. Blattner, W. A., Gallo, R. C., and Temin, H. M. 1988. HIV causes AIDS. Science 241:514?515.

21. Enserink, M. 2001. Old guard urges virologists to go back to basics. Science 293:24?25.

22. Fields, B. 2001. Field?s Virology (Philadelphia : Lippincott Williams & Wilkins).

23. Centers for Disease Control 1992/1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. Morb. Mortal. Weekly Rep. 41 (No. RR17) 1?19.

24. Duesberg, P. H., and Rasnick, D. 1998. The AIDS dilemma: drug diseases blamed on a passenger virus. Genetica 104:85?132.

25. Duesberg, P. H. 1992. AIDS acquired by drug consumption and other noncontagious risk factors; Pharmacol. Therapeutics 55:201?277.

26. Clark, S. J., Saag, M. S., Decker, W. D., Campbell-Hill, S., Roberson, J. L., Veldkamp, P. J., Kappes, J. C., Hahn, B. H., and Shaw, G. M. 1991. High titers of cytopathic virus in plasma of patients with symptomatic primary HIV-infection. N. Engl. J. Med. 324:954?960.

27. Daar, E. S., Moudgil, T., Meyer, R. D, and Ho, D. D. 1991. Transient high levels of viremia in patients with primary human immunodeficiency virus type 1 infection. N. Engl. J. Med. 324:961?964.

28. World Health Organization. 2001b. Global situation of the HIV/AIDS pandemic, end 2001, Part I. Weekly Epidemiological Records 76 (49):381?384.

29. Curran, J. W., Morgan, M. W., Hardy, A. M., Jaffe, H. W., Darrow, W. W., and Dowdle, W. R. 1985. The epidemiology of AIDS: current status and future prospects. Science 229:1352?1357.[[search me]] Daar, E. S., Moudgil, T., Meyer, R. D., and Ho, D. D. 1991. Transient high levels of viremia in patients with primary human immunodeficiency virus type 1 infection. N. Engl. J. Med. 324:961?964.

30. Centers for Disease Control and Prevention. 2001. U.S. HIV and AIDS cases reported through December 2001. HIV/AIDS Surveillance Rep. 13:1?44.

31. Cohen, J. 2003. HIV/AIDS: Vaccine results lose significance under scrutiny. Science 299:1495.

32. Jacquez, J. A., Koopman, J. S., Simon, C. P., and Longini Jr., I. M. 1994. Role of the primary infection in epidemics of HIV infection in gay cohorts. J. Acquir. Immune Defic. Syndr. 7:1169?1184.

33. Padian, N. S., Shiboski, S. C., Glass, S. O., and Vittinghoff, E. 1997. Heterosexual transmission of human immunodeficiency virus (HIV) in Northern California : results from a ten-year study. Am. J. Epidemiol. 146:350?357.

34. Gisselquist, D., Rothenberg, R., Potterat, J., and Drucker, E. 2002. HIV infections in sub-Saharan Africa not explained by sexual or vertical transmission. Int. J. STD AIDS 13:657?666.

35. Duesberg, P. H. 1995c. Foreign-protein-mediated immunodeficiency in hemophiliacs with and without HIV. Genetica 95:51?70; Hoots, K., and Canty, D. 1998. Clotting factor concentrates and immune function in haemophilic patients. Haemophilia 4:704?713.

36. Mims, C., and White, D. O. 1984. Viral pathogenesis and immunology (Oxford : Blackwell).

37. Rosenberg, M. J., and Weiner, J. M. 1988. Prostitutes and AIDS: A health department priority? Am. J. Public Health 78:418?423.

38. Root-Bernstein, R. 1993. Rethinking AIDS: The tragic cost of premature consensus (New York : Free Press).

39. Hearst, N., and Hulley, S. 1988. Preventing the heterosexual spread of AIDS: Are we giving our patients the best advice? JAMA 259:2428?2432.

40. Sande, M. A. 1986. Transmission of AIDS: The case against casual contagion. N. Engl. J. Med. 314:380?382.

41. Bregman, D. J., and Langmuir, A. D. 1990. Farr?s law applied to AIDS projections. J. Am. Med. Assoc. 263:50?57.

42. Anderson, R. M. 1996. The spread of HIV and sexual mixing patterns. In AIDS in the World II (Oxford : Oxford University Press), pp. 71?86.

43. Fenner, F., McAuslan, B. R., Mims, C. A., Sambrook, J., and White, D. O. 1974. The biology of animal viruses (New York : Academic Press).

44. Blattner, W. A., Gallo, R. C., and Temin, H. M. 1988. HIV causes AIDS. Science 241:514?515.

45. Duesberg, P. H. 1988. HIV is not the cause of AIDS. Science 241:514?516.

46. Blanche, S., Rouzioux, C., Moscato, M. L. G., Veber, F., Mayaux, M. J., Jacomet, C., Tricoire, J., Deville, A., Vial, M., Firtion, G., de Crepy, A., Douard, D., Robin, M., Courpotin, C., Ciran-Vineron, N., Le Deist, F., Griscelli, C., and The HIV Infection in New-borns French Collaborative Study Group. 1989. A prospective study of infants born to women seropositive for human immunodeficiency virus type 1. N. Engl. J. Med. 320:1643?1648.

47. Rogers, M. F., Ou, C.-Y., Rayfield, M., Thomas, P. A., Schoenbaum, E. E., Abrams, E., Krasinski, K., Selwyn, P. A., Moore, J., Kaul, A., Grimm, K. T., Bamji, M., Schochetman, G., and the New York City Collaborative Study of Maternal HIV Transmission and Montefiori Medical Center HIV Perinatal Transmission Study Group. 1989. Use of the polymerase chain reaction for early detection of the proviral sequences of human immunodeficiency virus in infants born to seropositive mothers. N. Engl. J. Med. 320:1649?1654.

48. European Collaborative Study. 1991. Children born to women with HIV-1 infection: natural history and risk of transmission. Lancet 337:253?260.

49. Connor, E. M., Sperling, R. S., Gelber, R., Kiselev, P., Scott, G., O?Sullivan, M. J., VanDyke, R., Bey, M., Shearer, W., Jacobson, R. L., Jimenez, E., O?Neill, E., Bazin, B., Delfraissy, J.-F., Culnane, M., Coombs, R., Elkins, M., Moye, J., Stratton, P., Balsley, J., and Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. 1994. Reduction of Maternal-Infant Transmission of Human Immunodeficiency Virus Type 1 with Zidovudine Treatment. N. Engl. J. Med. 331:1173?1180.

50. World Health Organization. 2000. Global AIDS surveillance, Part I. Weekly Epidemiological Records 75 (26 November):379?383.

51. Duesberg, P. H. 1992. AIDS acquired by drug consumption and other noncontagious risk factors. Pharmacol. Therapeutics 55:201?277.

52. Ward, J. W., Bush, T. J., Perkins, H. A., Lieb, L .E., Allen, J. R., Goldfinger, D., Samson, S. M., Pepkowitz, S. H., Fernando, L. P., Holland, P. V., Kleinman, S. H., Grindon, A. J., Garner, J. L., Rutherford, G. W., and Holmberg, S. D. 1989. The natural history of transfusion-associated infection with human immunodeficiency virus. N. Engl. J. Med. 321:947?952.

53. Haverkos, H. W., Drotman, D. P., and Hanson, D. 1994 (May). Surveillance for AIDS-related Kaposi's sarcoma (KS): update. NIDA/CDC, Rockville , MD /Atlanta , GA.

54. Simmonds, P., Balfe, P., Peutherer, J. F., Ludlam, C. A., Bishop, J. O., and Leigh-Brown, A. J. 1990. Human immunodeficiency virus-infected individuals contain provirus in small numbers of peripheral mononuclear cells and at low copy numbers. J. Virol. 64:864?872.

55. Duesberg, P. H. 1993d. The HIV gap in national AIDS statistics. Bio/Technology 11:955?956.

By Anonymous 4 (not verified) on 13 Feb 2006 #permalink

Anonymous 4--that's exactly what I'm talking about when I asked why AIDS-deniers treat HIV differently than other infectious diseases--many of those same criticisms can be levied at influenza, streptococcus, and on and on.

Regarding Darin Brown's go at answering that question,

I'm tempted to try a response to Tara's question of why we hold HIV to supposedly "higher standards" than other "infectious diseases". The first observation which comes to mind is that Tara's question presumes the fact, e.g. when she asks "why we hold HIV to a higher standard than other infectious diseases", it is implicit in this question that HIV causes an infectious disease. But that is the issue in the FIRST place. It is typical circular logic.

Not at all. One, we know that HIV is detected in AIDS patients, by a number of methods (showing evidence of current or prior infection with the virus). Therefore, we know that there is an infectious agent that is correlated with disease development, and we move on from there. It's not circular logic because we've not decided that HIV causes any disease--that's what we're testing. I say it does based on the weight of the evidence. Deniers say it doesn't, and trot out arguments such as those Anonymous 4 posted above.

For example, point #2 ignores the fact that immunosuppression can be due to a number of factors in additon to HIV--the pneumonia stuff I discussed earlier. #4 ignores the fact that it's not HIV that's causing the specific diseases--it causes the *immunosuppression* that *leads* to the other diseases. #5 ignores what we know about other viruses that can be latent (such as herpesviruses) and resurface later--following adaptive immune responses--and cause more disease (such as chickenpox and shingles). I also addressed points 13 and 16 above. As you can see, those "predictions" are mostly due to a misrepresentation or misunderstanding of the literature, and the holding of HIV up to a standard that other microbial causes of disease simply aren't held to.

Tara,

Buen dia

I really didn't think *anything* could get me to return to this discussion, especially after the brilliant posts of anon II, which caused you run away sputtering, but you have amazed even me with your last comments.

You did write, I think, the following:

That's not the "orthodoxy" at all. I'm a bit tired of the strawmen. First, as I mentioned in my post, while HIV is certainly considered to be a necessary factor for the development of AIDS, it may not be sufficient by itself to cause it.

How did I ever miss *that* in your post? If I had seen it, almost everything I wrote to you previously would have been unnecessary.

¡Felicidades! You are in fact an *orthodox* "AIDS denier".

I can hardly believe it, and I am sure neither can Tony the paper tyger

As you can see, those "predictions" are mostly due to a misrepresentation or misunderstanding of the literature, and the holding of HIV up to a standard that other microbial causes of disease simply aren't held to.

So in other words, it shows all the symptoms of pseudo-science, if not outright anti-science. This is pretty much what the Intelleigent Design crowd does, and the Mercury->Autism crowd does. It's depressing.

By Kristjan Wager (not verified) on 13 Feb 2006 #permalink

BTW

There is a new entry in "bialy/s" that I am certain will take this very elevated "scientific discussion" to even greater heights.

(And for the peanut gallery: It contains the "spanking" I thought Tom make take the time to administer here. My style, of course, is quite different from what his might have been.

Harvey Bialy said:

You did write, I think, the following:

That's not the "orthodoxy" at all. I'm a bit tired of the strawmen. First, as I mentioned in my post, while HIV is certainly considered to be a necessary factor for the development of AIDS, it may not be sufficient by itself to cause it.

How did I ever miss *that* in your post? If I had seen it, almost everything I wrote to you previously would have been unnecessary.

In the opening post we find:

Conversely, the fact that not everyone who is HIV-positive develops AIDS is also to be expected. There are very few, if any, pathogens that cause disease in every single person who is infected. Every other disease has people who are infected, but healthy--we call this the "carrier state." There's no reason this couldn't happen with HIV as well.

As an analogy, the fact that some people may not get killed in car accidents does not prove that car accidents don't kill people.

and a further btw

There is also to be found there "A Petition" that anybody, no matter what side of the debate they be, should be not only happy to sign but eager to as well, as it provides a clean way for the *real* scientific community to shut Peter up once and forever, and all could be accomplished in 72 hours, electronically and completely anon.

Read the petition and think about what it says, and what it implies.

This is not tongue-in-cheek "bialy"-type wordplay. It is as serious as the history detailed in my fast becoming very famous book (that Tara has promised to "try and find the time to review here"...I can't wait, and I am sure neither can "you")

I think that's really it. Although, you never know with us little sneeky Colombo types...there could always be "just one more *little* thing".

Harvey,

Did you miss this in the OP?

For instance, it's been suggested that other viruses may play a role in progression of AIDS, either speeding it up or slowing it down.

If that makes me an "AIDS denier," you have a mighty open definition of the term. Most of the scientists researching HIV would then be classified as "AIDS deniers."

Additionally, you mention that

There is a new entry in "bialy/s" that I am certain will take this very elevated "scientific discussion" to even greater heights.

(And for the peanut gallery: It contains the "spanking" I thought Tom make take the time to administer here. My style, of course, is quite different from what his might have been.

Can you provide the direct link, please?

Harvey Bialy writes:

There is also to be found there "A Petition" that anybody, no matter what side of the debate they be, should be not only happy to sign but eager to as well, as it provides a clean way for the *real* scientific community to shut Peter up once and forever ...

I'm sorry, but how would a "series of debates between David Baltimore and Peter Duesberg" settle the "pseudo-debate over the cause of AIDS that has been simmering in the pages of the journals and popular media for almost two decades"? Is there to be some kind of vote afterwards where people phone or write in to support their favorite debator?

And what is a pseudo-debate anyway? That implies to me that there is no real debate at all.

And is there really a debate in the journals? That would imply to me that currently a significant proportion of scientists in the relevant field are arguing for and against the hypothesis at question and publishing data to support their views. Is that the situation we actually see?

Is that the situation we actually see?

I obviously haven't studied the field extensively, but that's certainly not my impression.

By Kristjan Wager (not verified) on 13 Feb 2006 #permalink

BTW it's really interesting how certain subjects seems to generate huge amounts of comments on science blogs - AIDS denial, Mercury-Autism links, Intelligent Design...

Why do we have to use so much energy on these subjects, instead of focusing on real science/research?

By Kristjan Wager (not verified) on 13 Feb 2006 #permalink

Tara,

You cause me to return, to the delight of a few and the groans of many.

Let me clear up your first confusion. The petition *only* asks the editors of the two most important *general* scientific journals to *anon. and electronically poll their subscribers* and ask them if they think the issue is so damn dead that a series of real old time scientific debates between the two most credentialed and well-recognized champions of the two sides (a little like Bohr and Schrodinger)in the most dignified of arenas under the auspices and conditions of the NAS would be a waste of time. It does not ask for such a debate. If the issue is as closed among real scientists as you and your peanuts continue to claim, then there should instantly be a flood of "no"s. It's really very, very, very simple. Elementary in fact.

As to your attempt at a dodge...Gimme a break

You are actually saying that

..it's been suggested that ...>/b>

is the functional equivalent of

That's not the "orthodoxy" at all. I'm a bit tired of the strawmen. First, as I mentioned in my post, while HIV is certainly considered to be a necessary factor for the development of AIDS, it may not be sufficient by itself to cause it.

No wonder you think DNA viruses cause cancer in humans and HIV is a pathogen.

Harvey Bialy says:

If the issue is as closed among real scientists as you and your peanuts continue to claim, then there should instantly be a flood of "no"s. It's really very, very, very simple. Elementary in fact.

If the issue was open as you claim, then there should be all sorts of dissent by the relevant scientists in the modern scientific literature, complete with the data to back them up.

It's really that simple.

Nonsensical petitions for pointless debates notwithstanding.

Nonsensical petitions for pointless debates notwithstanding.

Excuse me ... a nonsensical petition asking the editors to ask their subscribers if they want to see such a pointless debate.

Apparently such a debate could possible solve the pseudo-debate (whether that means there is or isn't a debate is a mystery).

Harvey,

Call it a "dodge" if you wish, but I think it's rather clear here who's been dodging the issues.

Additionally,

No wonder you think DNA viruses cause cancer in humans and HIV is a pathogen.

For the benefit of all readers, I'll also mention here that Dr. Bialy denies that the human papilloma virus (HPV) causes cervical cancer. I'm not sure of Harvey's position on this, but Peter Duesberg also denies that prions are the cause of scrapie and "mad cow." Perhaps all of infectious disease is just a big sham?

Hello Tara,

I will respond to your points.

I will also point out that the ad hominems from other members audience have not ceased. Calling someone a "denier" or "denialist" takes you out of a serious discussion. There is no reason to assume that anyone who is fixated in this a priori stance has any real interest in discussing public health, or anything else, openly.

Okay, Let's see if I get this right ; your first point is that what I stated is not the orthodox point of view regarding Acquired Immune Deficiency.

I stated that:

Acquired Immune Deficiency Syndrome caused by a single factor, distributed through a single vector, namely human sexual intercourse. Heterosexual, in the case of Africa.

You responded:

[O]bviously sexual intercourse is not the only transmission vector. IV drug use has been, and continues to be, a transmission route as well (although clearly more of a problem in developed countries with easier access to needles than in many areas of Africa).

To transmission: I certainly will grant you that other methods of transmission are considered, batted about, rejected, argued over behind the monolithic, earnest face of academic science.

If I am reading this correctly, you are saying that IV drug use, as a method of transmission, is a major transmission route in the US, but not so in Africa, where HIV is a sexually transmitted problem.

I certainly grant that the CDC likes to test drug users in the US, as long as they're not wealthy (white) drug users, but are poor (black) drug users.

But your analysis comes into strong contradiction with that of David Gisselquist and company, who were unable to account for the stated rate of HIV prevalance in Africa by studying the sexual practices of Africans.

His group attempts to explain estimated HIV prevalence through contaminated needles. (He did not consider the most obvious explanation, that the tests stink and the estimates are garbage).

Gisselquist:

"The conventional wisdom that heterosexual transmission accounts for most adult HIV infections in Africa emerged as a consensus among influential HIV/AIDS experts no later than 1988.

In that year, the World Health Organization's (WHO) Global Program on AIDS circulated estimates that 80 percent of HIV infections in Africa was due to heterosexual transmission..."

"First, it was in the interests of AIDS researchers in developed countries-where HIV seemed stubbornly confined to MSMs, IDUs, and their partners-to present AIDS in Africa as a heterosexual epidemic...

"Second, there may have been an inclination to emphasize sexual transmission as an argument for condom promotion, coinciding with pre existing programmes and efforts to curb Africa's rapid population growth."

"Third, 'the role of sexual promiscuity in the spread of AIDs in Africa appears to have evolved in part out of prior assumptions/ about the sexuality of Africans'"

"Fourth, health professionals in WHO and elsewhere worried that public discussion of HIV risks during health care might lead people to avoid immunizations."

Gisselquist D et al. Let it be sexual: how health care transmission of AIDS in Africa was ignored. Int J STD AIDS. 2003;14:148 161.

Interesting that we allow ourselves to 'study' the sexual practices of certain people : Gay, Black, etc, isn't it?

  • I will ask you how you square your assessment with that of Gisselquist and co.

.
But for AIDS around the country and around the world, Sex remains the name of the game.

We are all asked to believe that there is a sexual transmitted disease that especially affects the poor, Black, Hispanic (now Indian, now Asian) sectors of the population, and world, despite no reasonable evidence for sexual transmission.

I assume that you and I will read Padian (and other transmission studies) differently. [see below for study excerpts on sexual transmission].

The results of Padian, a 10 year study on sexual transmission of HIV between couples (one partner HIV positive, one HIV negative):

"The constant per contact infectivity for male to female transmission was estimated to be 0.0009 (95% CI 0.0005 0.001)...

"We observed no seroconversions after entry into the study...No transmission occurred among the 25 percent of couples who did not use their condoms consistently, nor among the 47 couples who intermittently practiced unsafe sex during the entire duration of followup."

"This evidence argues for low infectivity in the absence of either needle sharing and/or other cofactors "

Padian NS et al. Heterosexual Transmission of Human Immunodeficiency Virus (HIV) in Northern California: Results from a Ten Year Study. Am J Epidemiol. 1997 Aug;146(4):350 7.

I will ask you to describe how you read Padian.

I read it as follows:

Either

  • HIV is not a sexually transmitted virus

or

  • There is no HIV virus in people who test HIV positive

or

  • There is no such thing as an HIV test

For more on HIV testing and transmission, I suggest poring through the always growing collection of citations on the little guys, over at Alberta Reappraising AIDS Society or Rethinking AIDS:

Testing: http://www.aras.ab.ca/test.html

Transmission: http://www.aras.ab.ca/transmission.html

Have a look, it's edifying. Or the opposite, depending on your point of view.

To your first point, second. You wrote:

"That's not the "orthodoxy" at all. I'm a bit tired of the strawmen. First, as I mentioned in my post, while HIV is certainly considered to be a necessary factor for the development of AIDS, it may not be sufficient by itself to cause it. This is an active area of investigation." [emphasis added]

I will take your point here, that within academia, there is an allowance, however slight, that AIDS is not a single disease, with a single cause, that is a single retrovirus, that is gleaned or implied through examination of laboratory artifact, or interpretive antibody response....

It is a slight allowance, and it disappears when you hit the streets.

Where AIDS is diagnosed.

With single rapid antibody tests, in impoverished and ghettoized populations.

I'm pleased that you know that Acquired Immune Deficiency can be Acquired almost any way that it wants to be. But for those who are considered by the CDC and WHO to be "at risk" for a deadly sexually transmitted disease, those allowances dissappear.

We're not really interested in granting people in the world amnesty from this death curse of a diagnosis. The definitions of AIDS throughout the world rely on clinical analysis, of no particular symptoms. That is, of no symptoms that are new or unique to any particular illness.

That's the beauty of Acquired Immune Deficiency Syndrome; it's everything you want it to be.

I've recently interviewed an epidemiologist returning from Kampala. She showed me pictures of the corrugated metal houses, packed and stacked against quarter mile drainage ditches, filled with trash, human waste, and of course, children playing.

I asked her how she was able to distinguish AIDS from local illness. She looked at me a bit wildly. She said that was the problem. Not a problem.

The problem.

I suggested that perhaps there was no difference. I asked why we weren't more concerned with water quality, and quality of life issues. She agreed that no drug treatment made sense within the context of devastating poverty.

She added, with some exhasperation, that it was impossible to get a grant to do Anything in Africa, if you didn't have the word "HIV/AIDS" in the title.

Clean water for Africa? Maybe for taking pills, but not else.

To the final point

Tara, you say you've read nearly everything at Virusmyth, and some of my stuff.

That implies that you've read about the drugs. So you understand that whether or not there is such a thing as a unique retrovirus that does anything to TCells (the 'we need more time to prove it' hypothesis), we are drugging people to death, in the name of saving them, for testing reactive on antibody tests that are read for risk group, not for specific reaction.

Please have a look through the citations on the drugs: http://www.aras.ab.ca/haart.html

on AZT, the drug most given to pregnant women who test reactive (positive): http://www.aras.ab.ca/

and again, on the tests: http://www.aras.ab.ca/test.html

I also ask you to please have a look at this story, and tell me what you think about the practice of force drugging of children with the drugs desribed:

http://nypress.com/18/30/news&columns/liamscheff.cfm

Finally, a personal question. You're a mother. Would you do what is described in this story to your own children?

We're all human, and we all claim to care about people who are diagnosed as HIV positive. It's not just an academic exercise. I think it's a fair question.

Thanks for your time,

Liam Scheff

Not all infectious disease at all, Dr. Smith, only the post-modern, economically propagated ones you mention.

They share, along with ID, *all* the properties of pseudo-science, except mainstream consensual support.

And since in post-HIV biomedicine (translate, biotechnology) that has been represented *only* by its cash equivalent (i.e. integrity left moleclar biology almost immediately when some moleclar biologists had visions of dancing media-driven sugarplums in the form of previously unimaginable dollar wealth and cover boy or girl status), it is a *critical* difference between the IDs and HIVists.

But the difference is critical only because of the present totally (almost) debased state of biomedicine. The logic and the dynamic stuctures of the two groups of pseudo-scientists are otherwise isomorphic.

You are much, much too young, as I "spanked" you for in my internet play that you pretend to be unable to locate easily, to have any first or even second (or perhaps even third hand) experience of what *real* science was like only a relatively short time ago.

Perhaps you can get a sense of it from a certain recent *sleeper* of a book, whose title you should not have to guess.

Responding to my message, Tara finished her posting with:

Sorry, that's probably not any clearer--I'll give it a better go tomorrow. Out for now...

Not to rush you, but I am still very interested in your "better go".

Thank you.

By Anonymous Two (not verified) on 13 Feb 2006 #permalink

(I tried posting this earlier, but it must've bounced! Sorry if it duplicates - LS)

Hello Tara,

I will respond to your points.

I will also point out that the ad hominems from other members audience have not ceased. Calling someone a "denier" or "denialist" takes you out of a serious discussion. There is no reason to assume that anyone who is fixated in this a priori stance has any real interest in discussing public health, or anything else, openly.

Okay, Let's see if I get this right ; your first point is that what I stated is not the orthodox point of view regarding Acquired Immune Deficiency.

I stated that:

Acquired Immune Deficiency Syndrome caused by a single factor, distributed through a single vector, namely human sexual intercourse. Heterosexual, in the case of Africa.

You responded:

[O]bviously sexual intercourse is not the only transmission vector. IV drug use has been, and continues to be, a transmission route as well (although clearly more of a problem in developed countries with easier access to needles than in many areas of Africa).

To transmission: I certainly will grant you that other methods of transmission are considered, batted about, rejected, argued over behind the monolithic, earnest face of academic science.

If I am reading this correctly, you are saying that IV drug use, as a method of transmission, is a major transmission route in the US, but not so in Africa, where HIV is a sexually transmitted problem.

I certainly grant that the CDC likes to test drug users in the US, as long as they're not wealthy (white) drug users, but are poor (black) drug users.

But your analysis comes into strong contradiction with that of David Gisselquist and company, who were unable to account for the stated rate of HIV prevalance in Africa by studying the sexual practices of Africans.

His group attempts to explain estimated HIV prevalence through contaminated needles. (He did not consider the most obvious explanation, that the tests stink and the estimates are garbage).

Gisselquist:

"The conventional wisdom that heterosexual transmission accounts for most adult HIV infections in Africa emerged as a consensus among influential HIV/AIDS experts no later than 1988.

In that year, the World Health Organization's (WHO) Global Program on AIDS circulated estimates that 80 percent of HIV infections in Africa was due to heterosexual transmission..."

"First, it was in the interests of AIDS researchers in developed countries-where HIV seemed stubbornly confined to MSMs, IDUs, and their partners-to present AIDS in Africa as a heterosexual epidemic...

"Second, there may have been an inclination to emphasize sexual transmission as an argument for condom promotion, coinciding with pre existing programmes and efforts to curb Africa's rapid population growth."

"Third, 'the role of sexual promiscuity in the spread of AIDs in Africa appears to have evolved in part out of prior assumptions/ about the sexuality of Africans'"

"Fourth, health professionals in WHO and elsewhere worried that public discussion of HIV risks during health care might lead people to avoid immunizations."

Gisselquist D et al. Let it be sexual: how health care transmission of AIDS in Africa was ignored. Int J STD AIDS. 2003;14:148 161.

Interesting that we allow ourselves to 'study' the sexual practices of certain people : Gay, Black, etc, isn't it?

  • I will ask you how you square your assessment with that of Gisselquist and co.

.
But for AIDS around the country and around the world, Sex remains the name of the game.

We are all asked to believe that there is a sexual transmitted disease that especially affects the poor, Black, Hispanic (now Indian, now Asian) sectors of the population, and world, despite no reasonable evidence for sexual transmission.

I assume that you and I will read Padian (and other transmission studies) differently. [see below for study excerpts on sexual transmission].

The results of Padian, a 10 year study on sexual transmission of HIV between couples (one partner HIV positive, one HIV negative):

"The constant per contact infectivity for male to female transmission was estimated to be 0.0009 (95% CI 0.0005 0.001)...

"We observed no seroconversions after entry into the study...No transmission occurred among the 25 percent of couples who did not use their condoms consistently, nor among the 47 couples who intermittently practiced unsafe sex during the entire duration of followup."

"This evidence argues for low infectivity in the absence of either needle sharing and/or other cofactors "

Padian NS et al. Heterosexual Transmission of Human Immunodeficiency Virus (HIV) in Northern California: Results from a Ten Year Study. Am J Epidemiol. 1997 Aug;146(4):350 7.

I will ask you to describe how you read Padian.

I read it as follows:

Either

  • HIV is not a sexually transmitted virus

or

  • There is no HIV virus in people who test HIV positive

or

  • There is no such thing as an HIV test

For more on HIV testing and transmission, I suggest poring through the always growing collection of citations on the little guys, over at Alberta Reappraising AIDS Society or Rethinking AIDS:

Testing: http://www.aras.ab.ca/test.html

Transmission: http://www.aras.ab.ca/transmission.html

Have a look, it's edifying. Or the opposite, depending on your point of view.

[continues]

While waiting for Dr, Smith to muster her arguments and references:

Dave S
wrote

"If the issue was open as you claim, then there should be all sorts of dissent by the relevant scientists in the modern scientific literature, complete with the data to back them up.

It's really that simple."

Is it? I know of know one on the dissenting side who ever claimed it was an open scientific issue among mainstream scientists whether HIV was a sexually transmissible pathogen. Examined from an objective point of view, such as might be provided by the NAS, we certainly make such a claim. But it is exactly the mainstream that has claimed for years and years and years and very loudly all over the damn place that the issue has already been decided in the journals by an overwhelming abundance of "pure scientific data", and that to even raise the matter in a back and forth series of editorials between Peter and any of them is a big waste of everybody's time, and dangerous to public health to boot.

So...if that claim is even remotely true, what have the editors of Nature and Science to lose by asking their very scientific readership whether indeed it is a closed book.

Like I said, the issue could be decided quantitatively, simply and once and for all.

What do Phil and Ed (I can call them that, you can't) have to lose?

Harvey Bialy said:

Is it? I know of know one on the dissenting side who ever claimed it was an open scientific issue among mainstream scientists whether HIV was a sexually transmissible pathogen.

There is either a debate in the scientific community or there isn't. A scientific debate implies exactly what I already said. It would involve a significant number of scientists today publishing in the scientific journals with opposing viewpoints, making predictions and testing them.

The reason there is no serious debate is because people who actually know the science, see the evidence as overwhealming. Certainly as convincing as for most any other virus.

Same as intelligent design. There simply is no scientific debate. Only scientific-y sounding arguments that many easily mistake for science.

Like I said, the issue could be decided quantitatively, simply and once and for all.

Complete nonsense. Such a debate would settle nothing and be pointless except as spectator sport. Science does not proceed by such debate but by theory, prediction and evidence. I'm frankly embarassed to have to tell you this.

I am curious as to why you don't just directly ask them to debate (since you apparently know them by first name) or directly petition them to debate. Why the tortuous route of making a petition asking them to circulate a petition, which asks if a debate would be desirous? It's not even clear that the signitories of the first petition would agree to the question that would be asked in the second petition (though we assume so). Seems like you want to ask the question without being the ones to ask the question. Is your credibility really so non-existant?

And you never did answer my questions about how this debate would settle the issue and what is meant by 'pseudo-debate'.

Doesn't sound very "clean" to me. Sounds like a low-grade set-up.

What do Phil and Ed (I can call them that, you can't) have to lose?

Yes I can, Phil and Ed.

People here have compared the HIV denier community to the ID community. I think the ID community is much more sophisticated.

This is more like the moon hoaxers. But more harmful than nuisance.

Dave S (I may call you that I assume)

Thank you very much for that last comment, and I mean that with no sarcasm at all.

I now understand something that I never understood before, and that answers a very big question raised as an overarching mysterious dark cloud that penetrates all the amusing prose of my biography of Peter.

Most Americans I now see, even those with college and university degrees, and even some perhaps with scientific degrees, like the owner of this blog, are so convinced of the fantasy of major-journal peer review, etc as being the real way to settle scientific arguments among scientists, that to even suggest that this is maybe not the case in the real world any longer (if it ever was) is viewed as so far beyond any comprehension that they cannot even endorse an objective anon poll of scientists to ask them if that indeed is what they all think.
.

I repeat once more, such a poll could be accomplished in a few days. Its result would be clear.

X readers of Nature/Science support such a "hypothetical" debate, y don't.

I know Ed and Phil would have no trouble acceding to such a petiton if the subject was ID vs Darwin, and suitable names were put forth.

So if scientific AIDS dissent is the same as ID, what's "your" problem with the poll? I know what the boy's prob is.

Deniers,
i've yet to see anything remotley convincing, just plenty of misrepresentation, and still non addressing of the original article.

I've also noticed that the psuedo science and medical quacks tend to arrive mob handed, be free with insults, try to find personal data about people with opposing viewpoints and often post anonymously to give the appearance of support for their positions. IP addresses would be interesting :)

The course of disease progression in transfusion recipients and occupational health exposures is very well documented and mapped. Cell counts and viral loads give good supporting evidence. I'd love to hear a parsimonius explanation of these actual facts.
(Actually its just occured to me, that like the ID crowd, the AIDS deniers have no evidence for their designer, don't want to talk about him or put a falsiyable face to him)
gnight ,its late in the Republic of Wales :o

OK Dylan

Please provide me with a series of letters or papers in the medical journals *documenting the clinical course of AIDS progression* in needle-stick and other occupational or accidental infections, or presumptive sexual exposures for that matter. (Whatever happened to Rock Hudson's boyfriend after he got however many million in his lawsuit against the late actor's estate? I am sure had he died of AIDS we would have heard of it. And what about the Argentinian doctor who was famous for a while in the NY papers in the late 80s. She got a couple million too from the city and like Mathilda took the money and run Argentina. Or how about just *one* good one, like the lioness.

Do this and I will enter into a thorough analysis of the paper(s) right here online with you (at whatever time of the day or night you wish) - but with *you* only, no meddlers or interlopers -- on its *real* scientific merits.

Deal?

So I'm curious. What exactly would Duesberg and Baltimore debate? What does Duesberg have to offer in the way of arguments beyond what he offered back in the late 80s and early 90s and that have already been addressed?

I can't take it any more. The level of denial of the deniers is breathtaking. Bialy quotes Tara saying

First, as I mentioned in my post, while HIV is certainly considered to be a necessary factor for the development of AIDS, it may not be sufficient by itself to cause it.

and says it makes her an AIDS denier. Helllo?????
A NECCESSARY FACTOR!!!!
if it's a neccessary factor, then it makes sense to try and address that factor by, I don't know....

MEDICINE!

yeesh

Anon II: The primary affect of HIV is immunosupression, which you can get from other conditions. So immunosuppression does not neccessarily mean AIDS. But since AIDS is so prevalent these days, immunosupression is often assumed to be AIDs, and someone without HIV may be diagnosed
(incorrectly) as having non-HIV AIDs.

Ivan

Dear Tara,
As moderators of forums and bulletin boards well know, there comes a time when he/she should pull the plug on a discussion and close the topic. I apologize if I sound presumptuous, since I know little about epidemiology or the exact connections between HIV and AIDS, but frankly the level of this discussion has deteriorated to the point that I can no longer remember what the original post was by the time I reach the bottom of the page. The two "sides" have not yet reached the point of flaming each other, but they're real close.
Perhaps we could direct our comments to the OP instead of sniping at each other.

I would also like to know who our anonymous posters are. Since Dr. Bialy demanded to know my real name, it seems only fair that Anonymous 1,2,3 and 4 also come clean. I would like to be reassured the four are not in fact the same person.

I have not heard any comment from Dr. Bialy, et alia, about my naive observation that AIDS infection rates are very low in Muslim Sub-Saharan Africa, indicating there is some connection between sexual activity and infections. Am I misinterpreting the data, as a layman, or are you ducking the question? Please enlighten me.

I am a physics teacher who is trying to understand the issue.
John Wheaton
St. Francis High School
Louisville, Kentucky
Member AAPT and NSTA

Liam--

I find it interesting that you take offense to the use of the term "deniers," yet you make assertions about the "monolithic" face of academic science, as if all of us have exactly the same view on HIV and AIDS. Perhaps y'all should stop trying to pin down a single "AIDS orthodoxy" to rally against, and instead, take a little bit more time to understand the nuances of the research?

Regarding the studies you cite--first, Gisselquist was a review published 15 years after the fact, and as I'm sure you know, there have been numerous published objections to his conclusions. And while I don't agree with all of his conclusions, sure, there's no reason to think that health care in Africa didn't also contribute to viral spread. It sure did in America, and we've seen the hazards of re-used needles in Africa (for instance, they certainly played a role in the intensification of Ebola outbreaks once patients arrived at a hospital). Do I agree that it's been a major factor? Nope. Gisselquist's paper is interesting, but I've not seen more data to really back him up. So, that's how I "square" my assessment with that paper.

Regarding Padian--it's been awhile since I read that paper, and it appears that it's not online at the AJE website. However, even from just re-reading the abstract, it seems you're leaving out some critical info there. I'll paste the entire abstract (empahsis is mine):

To examine rates of and risk factors for heterosexual transmission of human immunodeficiency virus (HIV), the authors conducted a prospective study of infected individuals and their heterosexual partners who have been recruited since 1985. Participants were recruited from health care providers, research studies, and health departments throughout Northern California, and they were interviewed and examined at various study clinic sites. A total of 82 infected women and their male partners and 360 infected men and their female partners were enrolled. Over 90% of the couples were monogamous for the year prior to entry into the study; less than 3% had a current sexually transmitted disease (STD). The median age of participants was 34 years, and the majority were white. Over 3,000 couple-months of data were available for the follow-up study. Overall, 68 (19%) of the 360 female partners of HIV-infected men (95% confidence interval (CI) 15.0-23.3%) and two (2.4%) of the 82 male partners of HIV-infected women (95% CI 0.3-8.5%) were infected. History of sexually transmitted diseases was most strongly associated with transmission. Male-to-female transmission was approximately eight-times more efficient than female-to-male transmission and male-to-female per contact infectivity was estimated to be 0.0009 (95% CI 0.0005-0.001). Over time, the authors observed increased condom use (p less than 0.001) and no new infections. Infectivity for HIV through heterosexual transmission is low, and STDs may be the most important cofactor for transmission. Significant behavior change over time in serodiscordant couples was observed.

So there *was* documented transmission, and since it went in the way expected (easier for males to pass it to females than vice-versa), it seems unlikely it's all due to needle sharing and other factors, as your post suggests. But without looking at their M&M, that's about all I can muster at the moment, unless you want to pass along a copy of the paper. As far as the infectivity rate, we've known it's low for some time (and that coincident STDs increase the efficiency of transmission), so that's not a surprise. I also disagree with your three options--I choose none of the above.

Anonymous Two--I'm happy to elaborate, but it would help if you had some specific questions on what I wrote, so I can focus rather than just re-hash.

As far as the remainder of Bialy's posts, unfortunately, he's gotten rather abusive via email, and I find his comment on the "post-modern" infectious disease conspiracy to be so ludicrous, he's proven himself to be an utter waste of my time. So it goes, I guess...

Tara,

Do you recall in one of my letters to you reproduced in my new "bllog book" where I assumed you knew and had studied the famous Padian study which demonstrated so well that sexually transmitted HIV was a figment, and I believe even gave you a clue that you need to actually read the paper and not the abstract. The real data in the paper is not easy to find because it so damaging to the orthodoxy it had to be massaged for publication to have something to put in an abstract that pseudo-scientists like you could trot out at low level science forums like this to look like you actually knew something.

I reproduce below the comments from Hank Barnes, a commenter in the Dean's World marathon of last year that is known hereabouts as "Eleven Days of CyberDrama" (all the bllog/books as pdfs are available at "bialy/s" and can be found with only a minimun of searching)

There is quite an extensive discussion of this paper that can be found therein. Since you can't seem to locate a copy of the actual paper but see fit to trot out the abstract here with emboldens too, consider these remarks of Mr. Barnes, and then consider if you, a professional epidemiologist would care to go one on one with this layperson about the details of this landmark study.

"Hank Barnes ( mail) (www):
Dr. Harvey,
Sadly, I'm away from my office, so I don't have the Padian paper in front of me.
Also, I'm on the road tomorrow so, won't be able to get it until probably Tuesday.
But, from memory:

1. The study started in 1985, so there were no licensed drugs to treat AIDS then.
And, I recall no mention that anyone in the study was taking those dreaded
drugs;

2. I recall nothing in the study on the cause of death of anyone. Not even a
suggestion that anyone died of AIDS. The focus was on sex, the whole sex and
nothing but the sex.

3. Table 3 says, essentially, some couples used condoms, some did not; some
couples had anal sex, some did not. I can't recall the actual numbers.
My bottom line on Padian:

Raw data: Out of 175 discordant couples having a lot of sex over 10 years,
exactly ZERO contract HIV.

Adjusted Data: Padian is bewildered by her own findings, does some goofy
"meta-analysis" extrapolation, concludes:
a. 1/1000 odds of woman getting HIV from sex with HIV+ man
b. 1/10000 odds of man getting HIV from sex with HIV+ woman.
So, even if you accept Padian's spin, most men (certainly the nerds on this b log)
are never gonna have 10,000 sexual liaisons in their life, so are never gonna get
HIV from sex.

So, the Hank question:
How can you have a sexually transmitted disease that is never transmitted by
sex?

Good day, Gentlemen
Hank Barnes
1.14.2005 12:57am"

Funny how you think it's OK for him not to have a copy of the paper in front of him, but not for me. I have indeed read it as I mentioned, but it's a 9-yr-old paper; I don't have the M&M memorized, and our library closed over an hour ago. I ain't gonna jump just because you have nothing better to do than wait for my replies, Harvey. Patience is a virtue.

Hi Tara,

Just read the portion of your note addressed to me:

Anonymous Two--I'm happy to elaborate, but it would help if you had some specific questions on what I wrote, so I can focus rather than just re-hash.

No problem. Here are my specific questions.

Question One. You wrote:

there are conditions such as so-called 'HIV-negative AIDS',

I asked, if this is true, then what caused those people's AIDS? You answered:

Could be a number of things. Other infections, nutrition, chemical exposure, etc.

Given what you have said, it seems we need statistics for:
        (1) AIDS caused by HIV
        (2) "HIV-negative AIDS"
        (3) AIDS caused by a mix of HIV and non-HIV factors

For (1) and (2), you responded:

I'm not sure any numbers are kept for "HIV-negative AIDS,"

Surely such statistics are important. How can one decide where to devote resources before knowing what is causing immune deficiency--and therefore, learning where the biggest problems lie?

Question Two. You have stated:

AIDS is in a different category from "idiopathic T-cell lymphopenia" (which is just the formal name for "HIV-negative AIDS"). We know what causes AIDS and have a definition for that disease--we don't know what's causing the other immunodeficiencies *in the absence* of HIV.

I confirm that you have equated "HIV-negative AIDS" with "idiopathic T-cell lymphopenia", the latter being "just the formal name for" the former.

I am having trouble understanding how "AIDS" can be in a different category than "HIV-negative AIDS", which to me would seem to be a subset of "AIDS"--by definition.

If "HIV-negative AIDS" is not "AIDS", than all "AIDS" would presumably be "HIV-postive AIDS", unless there are people who have "HIV-neither-positive-nor-negative AIDS".

Following this logic, if all "AIDS" is "HIV-positive AIDS", than any discussion/debate about a correlation between HIV and AIDS is meaningless--they are perfectly correlated, by definition.

Question Three. You previously wrote:

The reason I don't like to include them under the "AIDS" umbrella is because we *do* know what causes AIDS, and we can treat that.

I asked, does AIDS have a concrete definition or is it an "umbrella" into which professionals can decide what they like to include on a personal basis?

You responded that:

We know what causes AIDS, and we do have a definition for it.

If "we" (who?) do have a definition for AIDS, why are you describing it as an "umbrella" into which you decide what you personally "don't like to include" (and presumably like to include) in it?

Hopefully that's a clear summary of my questions for you, based on what you have written. Thanks again.

By Anonymous Two (not verified) on 13 Feb 2006 #permalink

Well, the level of the debate is here for all to see. At least Tara makes an *attempt* to actually respond to various points, as opposed to others who have quickly taken refuge in well-worn rhetorical tactics. Here I respond to Tara.

Not at all. One, we know that HIV is detected in AIDS patients, by a number of methods (showing evidence of current or prior infection with the virus).

You still are not recognizing my main point. I will repeat it once again, as it's very important: "AIDS" was originally an epidemiological surveillance tool. At one point in time, HIV was not a part of the definition of AIDS. In order to PROPERLY show that HIV causes any syndrome or collection of diseases, you should be able to do this WITHOUT the putative cause being a part of the definition. This was how the whole thing slipped by: We got a new syndrome (1981-83). We weren't able to show that HIV causes the syndrome. So, we make a big press conference, convince the whole world to accept this without proof, and now that we have convinced the world of this, they will let us slip HIV into the definition, so that whenever we attempt to go BACK and re-explore the original question of whether the infectious agent really causes the syndrome, this attempt is profoundly muddled by the current definition. And this is precisely the essence of the circular logic: the definitions that have been in use since 1986 have been based on the assumption that proof of causation was demonstrated at the time (meaning, 1983-85). And we now know that was definitely not the case. You CANNOT use epidemiological data which is profoundly muddled by the assumption that HIV causes AIDS as evidence to PROVE HIV causes AIDS.

I don't know how else to explain this any simpler. If you do NOT recognize why this is circular logic, then I have a real loss of faith in the critical reasoning skills scientists are supposed to be taught now. Sometimes I wonder, is it just because I'm a mathematician that this bothers me?? In mathematics, we are constantly taught to be on the lookout for mistakes like this, because IF you make a mistake like this in math, you are SUNK. TOTALLY sunk.

The major difference (and it is major) between the orthodox and dissidents is that dissidents actually look at the reality of the data without looking through a cloud of definitions and hypotheses. When you actually look at the REAL emperical data, stripped away from the lens of HIV, it all completely falls apart. But you simply cannot extricate yourself from the theoretical morass long enough to see epidemiological reality.

Therefore, we know that there is an infectious agent that is correlated with disease development, and we move on from there. It's not circular logic because we've not decided that HIV causes any disease--that's what we're testing.

Tara, would you listen what you're saying. How can you POSSIBLY say "we've not decided that HIV causes any disease--that's what we're testing". When HIV is such an explicit part of the CDC definition. It's right there, in plain English in the CDC definition. Again, if you really want to do it right, come up with a definition of the syndrome that has nothing to do with HIV, THEN show the epidemiological correlation, THEN show that it behaves something like an infectious disease, THEN show that it has some PLAUSIBLE biological mechanism of action, (as opposed to the fairy tales we're told) and THEN I will start to take you seriously. These are not impossible things to show. They have been done in the past.

You are basically saying "Look, there is HIV. It's present at the scene of the crime. It must be the murderer." In other words, correlation is enough, and forget the fact it's manufactured. This is the same argument that's been used for 20 years. And it's precisely this argument that's been answered by Duesberg over and over and over again. If you really have read all his papers so closely, I KNOW you couldn't have missed his answer.

For example, point #2 ignores the fact that immunosuppression can be due to a number of factors in additon to HIV--the pneumonia stuff I discussed earlier.

Your language betrays you. Immunosuppresion due to HIV is "AIDS", whereas immunosuppression "due to a number of factors in addition to HIV" is just plain old ordinary vanilla imunosuppression.

#4 ignores the fact that it's not HIV that's causing the specific diseases--it causes the *immunosuppression* that *leads* to the other diseases.

Imagine saying that 25, 30 years ago. You realise how SILLY it sounds. HIV is the first microbe in human history of the world that is claimed to attack the immune system itself. Every other infectious disease or illness has a more or less restricted diagnostic presentation. Every other infectious disease or illness takes advantage of a compromised immune system to cause some more or less specific CLINICAL state which can then be observed directly or at most one or two levels removed from direct observation. Every KNOWN cause of immunosuppression that I am aware of (besides HIV) is either NON-infectious or a combination of infectious and non-infectious causes. (e.g. autoimmune diseases, genetic diseases, recreational drugs, malnutrition, etc.) HIV is the first claimed infectious cause of immunosuppression. HIV is the first microbe whose diagnostic presentation is supposed to be a destruction of the immune system itself. HIV is the first microbe whose diagnostic presentation REQUIRES observation several levels removed from direct observation. That is a very big claim. And very big claims require very big evidence. I think someone else said that before once.

Do you have nothing to say on the Ho/Shaw papers? Are you not bothered that so many mistakes in those papers were allowed to go through peer review smooth sailing? Do you deny that there are huge problems with Ho/Shaw?? You can't say you aren't familiar with them, if you've really read all of Infectious AIDS and all Duesberg's papers.

Not that this was jermaine to the discussion but the reason Marc Christian (Rock Hudson's boyfriend) never died of AIDS is because he was never positive for HIV. No HIV = no AIDS, huh, go figure.

And, I don't have the Padian paper either but, just from the abstract Hank's recollection of the data appears to be wrong.

"Overall, 68 (19%) of the 360 female partners of HIV-infected men (95% confidence interval (CI) 15.0-23.3%) and two (2.4%) of the 82 male partners of HIV-infected women (95% CI 0.3-8.5%) were infected."

Hank:"Out of 175 discordant couples having a lot of sex over 10 years, exactly ZERO contract HIV."

Someone said:

>>Complete nonsense. Such a debate would settle nothing and be pointless except as spectator sport. Science does not proceed by such debate but by theory, prediction and evidence. I'm frankly embarassed to have to tell you this.

HELLO! The claim at hand which Harvey was referring to was not the HIV/AIDS hypothesis, it was whether the HIV/AIDS remained an "open" question. And he provided an emperical, quantitative way of testing the hypothesis of whether such a question remained "open". That is what scientists do -- provide emperical tests of hypotheses.

Dave S. --

"Psuedo-debate" is exactly the perfecto description of the sorry state of affairs of the past 20 years. PSEUDO = FAKE.

Darin,

You still are not recognizing my main point. I will repeat it once again, as it's very important: "AIDS" was originally an epidemiological surveillance tool. At one point in time, HIV was not a part of the definition of AIDS. In order to PROPERLY show that HIV causes any syndrome or collection of diseases, you should be able to do this WITHOUT the putative cause being a part of the definition. This was how the whole thing slipped by: We got a new syndrome (1981-83). We weren't able to show that HIV causes the syndrome. So, we make a big press conference, convince the whole world to accept this without proof, and now that we have convinced the world of this, they will let us slip HIV into the definition, so that whenever we attempt to go BACK and re-explore the original question of whether the infectious agent really causes the syndrome, this attempt is profoundly muddled by the current definition. And this is precisely the essence of the circular logic: the definitions that have been in use since 1986 have been based on the assumption that proof of causation was demonstrated at the time (meaning, 1983-85). And we now know that was definitely not the case. You CANNOT use epidemiological data which is profoundly muddled by the assumption that HIV causes AIDS as evidence to PROVE HIV causes AIDS.

I don't know how else to explain this any simpler. If you do NOT recognize why this is circular logic, then I have a real loss of faith in the critical reasoning skills scientists are supposed to be taught now. Sometimes I wonder, is it just because I'm a mathematician that this bothers me?? In mathematics, we are constantly taught to be on the lookout for mistakes like this, because IF you make a mistake like this in math, you are SUNK. TOTALLY sunk.

Maybe it is because you're a mathemetician, 'cause while I understand what you're saying, it still ain't circular. You're leaving out a few critical details--I'll elaborate.

So let me start at the beginning as well. Indeed, as you mention, AIDS was a surveillance tool in the early years--a collection of strange, rare infections found originally in gay men in the US. In 1984 it was announced that a virus associated with this syndrome--by then called AIDS--had been found. But you act like this was just accepted without any testing. If it had been, and if the definition had been modified to simply include HIV without any further study, sure, it would be circular. But that ain't how it happened. (In fact, you're kind of arguing against Bethell here--he's pissed because HIV wasn't even included in Africa's 1985 definition of AIDS, and you're claiming it's circular logic when HIV *was* eventually introduced into the definition of AIDS here in America. Rather funny).

See, Darin, the part you're missing is the tests that were carried out following ye big ol' press conference. Examinations like this one, where a cohort of patients was already in place and many had been diagnosed with AIDS prior to the recognition of HIV, and where stored blood samples could be examined to see if HIV seroprevalence had increased since 1978 (it did, of course) and then if presence of HIV correlated with what had already been identified as AIDS. You've left out other natural, tragic experiments where people received the virus via blood transfusions or occupational exposure, then developed AIDS and died. The identification of the virus in people who died of previously rare infections that came to be hallmarks of AIDS--Kaposi's sarcoma, Pneumocystis, etc. Some of these were diagnosed while living--others were diagnosed with AIDS prior to HIV's identification, and were retrospectively found to have the virus. It wasn't just blindly accepted, despite what spin you may put on the issue.

The major difference (and it is major) between the orthodox and dissidents is that dissidents actually look at the reality of the data without looking through a cloud of definitions and hypotheses. When you actually look at the REAL emperical data, stripped away from the lens of HIV, it all completely falls apart. But you simply cannot extricate yourself from the theoretical morass long enough to see epidemiological reality.

I disagree. Sure, we all have our biases, but I submit that many of the "dissidents" pick and choose which data to focus on, say "aha!" over a few points, and claim that those little nitpicks "disprove" HIV causation. Looking at the fuller picture--the virology, the epidemiology, the pathology, the immunology, the evolutionary history--I don't see anything that stands out. Indeed, it makes a nice little picture.

Tara, would you listen what you're saying. How can you POSSIBLY say "we've not decided that HIV causes any disease--that's what we're testing". When HIV is such an explicit part of the CDC definition. It's right there, in plain English in the CDC definition. Again, if you really want to do it right, come up with a definition of the syndrome that has nothing to do with HIV, THEN show the epidemiological correlation, THEN show that it behaves something like an infectious disease, THEN show that it has some PLAUSIBLE biological mechanism of action, (as opposed to the fairy tales we're told) and THEN I will start to take you seriously. These are not impossible things to show. They have been done in the past.

Indeed, they have been done in the past. They have been done with HIV. You don't agree with them--fine and dandy. And I hate to point this out here, but as you said, you're a mathematician. The HIV-AIDS link has been looked at by thousands of people with relevant expertise all over the world--microbiologists, virologists, epidemiologists, immunologists, geneticists, physicians, and on and on. Don't you think, perhaps, there's a reason why we accept it? Are we really just so "brainwashed," stupid (or, if you really want to get into the conspiracy theory angle, paid off) to fall for the HIV causation angle?

You are basically saying "Look, there is HIV. It's present at the scene of the crime. It must be the murderer." In other words, correlation is enough, and forget the fact it's manufactured. This is the same argument that's been used for 20 years. And it's precisely this argument that's been answered by Duesberg over and over and over again. If you really have read all his papers so closely, I KNOW you couldn't have missed his answer.

That's not what I'm saying at all--indeed, it seems that you missed or have forgotten my original point here. HIV fulfills all of Koch's postulates as well as any other infectious disease does. I'm not just saying "HIV's present at the scene of the crime". I'm saying it's there with a bloody knife, matching stab wounds in the victim and a dozen eyewitnesses.

Your language betrays you. Immunosuppresion due to HIV is "AIDS", whereas immunosuppression "due to a number of factors in addition to HIV" is just plain old ordinary vanilla imunosuppression.

That's not a betrayal at all--that's my point. Yes, now that we're 20+ years into HIV research, we do indeed have a definition of AIDS that is based on the presence of HIV--like we have a definition of streptococcal pneumonia based on the presence of S. pneumo. That's how things progress in infectious disease--once we have a causal agent that's well-established, we use that agent for diagnostic testing and it becomes part of the definition of that disease. If it's not there, we look elsewhere for the cause of the disease. Surely this isn't a surprise or novel to you?

Imagine you have a sore throat. If your strep test is positive, you now have streptococcal pharyngitis. If it's negative, your sore throat is probably due to one of a dozen-odd viruses. Is requiring Streptococcus pyogenes to be present to diagnose streptococcal pharyngitis now "circular reasoning?" Because other infectious agents also cause sore throats, does that lessen the strength of association between S. pyogenes and this condition? That's all I'm saying with HIV/AIDS. HIV is one cause of immunosuppression. After a large body of work in a number of areas, we can confidently say HIV fulfills Koch's postulates (as much as any other infectious agent does). So, now HIV + immunosuppression leading to secondary infections = AIDS, just as S. pyogenes + sore throat, fever etc. = streptococcal pharyngitis.

Imagine saying that 25, 30 years ago. You realise how SILLY it sounds. HIV is the first microbe in human history of the world that is claimed to attack the immune system itself. Every other infectious disease or illness has a more or less restricted diagnostic presentation. Every other infectious disease or illness takes advantage of a compromised immune system to cause some more or less specific CLINICAL state which can then be observed directly or at most one or two levels removed from direct observation. Every KNOWN cause of immunosuppression that I am aware of (besides HIV) is either NON-infectious or a combination of infectious and non-infectious causes. (e.g. autoimmune diseases, genetic diseases, recreational drugs, malnutrition, etc.) HIV is the first claimed infectious cause of immunosuppression. HIV is the first microbe whose diagnostic presentation is supposed to be a destruction of the immune system itself. HIV is the first microbe whose diagnostic presentation REQUIRES observation several levels removed from direct observation. That is a very big claim. And very big claims require very big evidence. I think someone else said that before once.

I suggest you spend a bit more time boning up on the literature, then. I don't mean to be patronizing or dismissive, but all kinds of microbes can target the immune system--it's really an incredible area of study. I don't see why anyone would think that was a silly hypothesis--it makes perfect sense for microbes to attack our defenses in order to further their own survival. For example, Strep pyogenes (can you tell what my dissertation was on?) makes a protein that specifically cleaves a protein important to our immune response--the C5a molecule, part of the complement cascade. Mycobacterium tuberculosis causes apoptosis of certain cells of the immune system. Our own gut flora appear to play a huge role in modulating our immune responses. This is a giant and fascinating field, and getting larger every day. HIV may have been the first (I dunno about that), and while it may be the most dramatic, it's certainly not the only one to take a bite out of the host immune system.

Do you have nothing to say on the Ho/Shaw papers? Are you not bothered that so many mistakes in those papers were allowed to go through peer review smooth sailing? Do you deny that there are huge problems with Ho/Shaw?? You can't say you aren't familiar with them, if you've really read all of Infectious AIDS and all Duesberg's papers.

Heh. Am I supposed to comment on every HIV paper written over the past 20 years? I think I've been much more amenable to questions than your colleagues, and I've not seen those papers brought up yet (but with over 100 comments and limited time, it's quite possible I missed it). I don't have much to say about them, anyway. Yes, I'm quite familiar with them, and with both the critiques by Duesberg et al. and with the responses to the critiques and responses to the critiques of the critiques etc. etc. In the end, I think the proof is in the pudding, and the drug cocktails have largely worked. Does this mean Ho et al. were correct? I can't say, but again, that paper was 11 years ago, and the field has progressed since then.

Sheesh! Well, Tara, I thought that was a great post and you've followed it up with a lot of sustantive and patient responses in the comments... Top hole!

I'm exhausted after reading it all, though.

Harvey Bialy said:

Dave S (I may call you that I assume)

By all means. Beats "peanut".

Most Americans I now see, even those with college and university degrees, and even some perhaps with scientific degrees, like the owner of this blog, are so convinced of the fantasy of major-journal peer review, etc as being the real way to settle scientific arguments among scientists, that to even suggest that this is maybe not the case in the real world any longer (if it ever was) is viewed as so far beyond any comprehension that they cannot even endorse an objective anon poll of scientists to ask them if that indeed is what they all think.

That "fantasy" has worked out pretty well over the last several centuries for many different sciences. And you still haven't explained how a series of debates between 2 individuals would be a superior option. Unless of course you think scientific truths can be decided by rhetoric, popularity and decibel level.

Also, science is done by those other than Americans too.

Like I said, the issue could be decided quantitatively, simply and once and for all.

Still waiting for you to explain how this decides the issue. I mean, the Durban Declation apparently didn't convince anybody, so why should this? It's a stunt Harvey Bialy, pure and simple. And a badly attempted one at that.

Darin Brown said:

HELLO! The claim at hand which Harvey was referring to was not the HIV/AIDS hypothesis, it was whether the HIV/AIDS remained an "open" question. And he provided an emperical, quantitative way of testing the hypothesis of whether such a question remained "open". That is what scientists do -- provide emperical tests of hypotheses.

And if that were the case, then we'd already be seeing the debate being played out in the literature and at scientific conferences. That's what scientists do.

"Psuedo-debate" is exactly the perfecto description of the sorry state of affairs of the past 20 years. PSEUDO = FAKE.

Thank you Darin Brown for explicitly admitting that this petition has nothing to do with asking an honest and clear question, and everything to do with a public relations stunt. Harvey Bialy avoided this question for a reason.

42 year old hemophec

By michael kouchavlis (not verified) on 14 Feb 2006 #permalink

I suggest you spend a bit more time boning up on the literature, then. I don't mean to be patronizing or dismissive, but all kinds of microbes can target the immune system--it's really an incredible area of study. I don't see why anyone would think that was a silly hypothesis--it makes perfect sense for microbes to attack our defenses in order to further their own survival.

Tara, please do be patronizing AND dismissive to Darin. A comment as incredibly ignorant and ill-informed as his claim that HIV is the "first microbe in human history of the world that is claimed to attack the immune system itself" reveals such a profound lack of knowledge about what he is talking about that Darin really doesn't deserve the politeness you are showing him.

Forgot to add:

Even if HIV were the first virus ever to be postulated to attack the immune system, that wouldn't invalidate its role in causing AIDS or mean that the hypothesis that bacteria and viruses can target the immune system isn't a valid hypothesis. It is irrelevant whether the concept "sounded silly" over 30 years ago. Science advances and has discovered since then that microbes do indeed target the immune system.

One problem with HIV/AIDS denialists is that, like altie followers of, say Beauchamps over Pasteur, they like to cite old and outdated science to support their claims.

Orac says:

Tara, please do be patronizing AND dismissive to Darin. A comment as incredibly ignorant and ill-informed as his claim that HIV is the "first microbe in human history of the world that is claimed to attack the immune system itself" reveals such a profound lack of knowledge about what he is talking about that Darin really doesn't deserve the politeness you are showing him.

But aren't you CONVINCED by his compelling use of CAPITALIZATION? FACTS? Bah, they can be used to prove ANYTHING that's even remotely TRUE*.

* Apologies to Homer Simpson.

Hello Dr. Harvey!

You mentioned me above regarding the famous Padian paper!

I was just reviewing it last week, so I have the salient facts at my cyber fingertips:

1. It was the longest and largest epidemiological study of heterosexual tranmission of HIV (1986-1996);

2. For 10 years, it followed 175 discordant couples, who had a lotta sex. "Discordant" means for each couple, 1 person was HIV+, and one was not.

3. So, obviously, if you're gonna have lots of sex with an HIV+ person, you're gonna get the virus, get AIDS and die, right?

4. After 10 years, the scientists found NO seroconversions.

5. The couples who used condoms, did not transmit the virus
6. The couples who failed to use condoms, did not transmit the virus
7. The couples that exclusively engaged in vaginal intercourse did not transmit the virus;
8. In fact, 39% of the couple engaged in anal sex -- they too did not transmit the virus.

The only logical, scientific conclusion from the Padian report is that AIDS is not a sexually transmitted disease.

Indeed, How can you have a sexually transmitted disease, that is not transmitted by sex?

If anyone here disputes any of the fact I've recited above re Padian, please feel free to read the paper and tell me where I've erred.

More importantly, assume my recitation of the paper is true. Then, what logical, scientific conclusion would YOU reach regarding HIV?

Fondly,

Hank Barnes

By Hank Barnes (not verified) on 14 Feb 2006 #permalink

Hello, Tara!

Nice blog, you are one smart babe!

2 simple questions, both of which are purely scientific:

1. If you believe that HIV causes AIDS, please cite the actual peer-reviewed published paper that established this connection. It probably was published in the early 1980's.

2. If you believe that HIV causes AIDS, what evidence would falsify this contention?

Hammerin' Hank Barnes

By Hank Barnes (not verified) on 14 Feb 2006 #permalink

Hi Hank,

1. If you believe that HIV causes AIDS, please cite the actual peer-reviewed published paper that established this connection. It probably was published in the early 1980's.

Funny, this is just what Harvey asked me about HPV, and I'll tell you what I told him: there's no "one paper" that establishes this connection. (Indeed, this is a typical creationist tactic as well--show the "one paper" that "proves evolution.") Rather, it's the entire sphere of evidence that I mentioned earlier.

Second, any number of things, but again, it would be a number of studies over varied disciplines. If, for example, HIV hadn't been found in those early studies I referenced earlier, that would have killed the hypotheses before it even got off the ground.

Hank- thanks for stopping by to repeat your summary of a paper which is completely discredited by the actual abstract of said paper. Someday we hope to see you in reality.

Ivan

That's pretty weak, Tara. Stay focused. I'm not Harvey, I'm not talking about HPV, I'm not a creationist, and we're not talking evolution. We're talking about the t-cells of the immune system, which supposedly is your field of expertise.

Lemme understand your response: You can't name "one paper," yet there is an "entire sphere" of evidence? Hmmm.

Lemme try again:

1. In 1979, nobody believed that HIV caused AIDS, right? (Because AIDS wasn't known).

2. In 1982, nobody believed that HIV caused AIDS, right? (Because while AIDS was known, HIV was not)

3. By 1985, a lotta people started to assert that HIV (HTLV-III) caused AIDS, right?

So, What was the seminal paper -- published in the peer reviewed literature -- that demonstrated that HIV causes AIDS?

It's a very simple question. Either there is a paper and you can cite it or there is not.

For example, if someone were to assert that the DNA molecule is structured as a say, single strand of nucleic acid, not as a double-helix, I would cite this famous 1953 paper in Nature, by Messrs. Watson & Crick to refute that position.

So, with respect to AIDS, Do you have a paper or not?

If yes, great! Then, we can intelligently discuss it, scrutinize, point out its strengths and weaknesses.

If not, when did AIDS science become faith-based, rather than fact-based?

Also, humor me on the falsification question, too. Surely, the HIV-AIDS hypothesis is falsifiable, No?

Ever Yours,

Hank

By Hank Barnes (not verified) on 14 Feb 2006 #permalink

Ivan,

Have you read the body of the Padian paper or did you just read the abstract?

The abstract doesn't faithfully report the data contained therein.

It happens sometimes, dumbass. See recent Stem Cell fraud.

Fondly,

Hank Barnes

p.s Happy Valentine's Day

By Hank Barnes (not verified) on 14 Feb 2006 #permalink

It's not online. Post it (or send it to Tara, I'm sure she will), I will read it.

FYI, in science, if you disagree with the methodology or interpretation, you can submit letters to the editor, or you can publish critiques. Those do not constitute a summary of the paper. Your posts were written in a way that conveyed that you were merely passing along the results and conclusions that the authors published.

And it's Dr. Dumbass to you.

Ivan

Hi Tara,

this blog must be getting to be a time-eater for you!

Appreciate your efforts.

And so, to your points:

You say that the Padian paper *documented* transmission. I think that's been covered here. I quoted from within the paper, not the abstract.

"We observed *no seroconversions* after entry into the study...*No transmission occurred* among the 25 percent of couples who did not use their condoms consistently, nor among the 47 couples who intermittently practiced unsafe sex during the entire duration of followup."

"This evidence argues for low infectivity in the absence of either needle sharing and/or other cofactors "

Padian NS et al. Heterosexual Transmission of Human Immunodeficiency Virus (HIV) in Northern California: Results from a Ten Year Study. Am J Epidemiol. 1997 Aug;146(4):350 7.

Lesson? Don't believe the abstracts, I'd guess.

Again, it raises three questions in my mind:

1) Is this a sexually-transmitted virus?

2) Are HIV tests accurate?

3) Are persons who test antibody-reactive on HIV tests actually infected?

To your first point, second: AIDS is not exclusively a sexually-transmitted disease.

You wrote:

"First, Gisselquist was a review published 15 years after the fact, and as I'm sure you know, there have been numerous published objections to his conclusions."

I am indeed aware that the standard view of AIDS in Africa is that it is sexual, and that Gisselquist and co's observations met with strong opposition from the orthodoxy, or monolithic face of AIDS.

When I first made this point, you reprimanded me, stating that HIV is not considered to be exclusively sexual.

I stated that I am aware of the slight allowance for considering other methods of transmission, but that the primary is considered to be born through sex (and then, by extension, through childbirth).

You continued:

"And while I don't agree with all of his conclusions, sure, there's no reason to think that health care in Africa didn't also contribute to viral spread. It sure did in America, and we've seen the hazards of re-used needles in Africa (for instance, they certainly played a role in the intensification of Ebola outbreaks once patients arrived at a hospital)."

"Do I agree that it's been a major factor? Nope. Gisselquist's paper is interesting, but I've not seen more data to really back him up. So, that's how I "square" my assessment with that paper."

Well, Tara, you have just objected to your own point.

* I say it's believed to be primarily sexual, you say there are other methods.

** I say that it's not primarily sexual, you say it's primarily sexual.

* Data? How about the Padian data? You've certainly seen that by now.

The primary observation of Gisselquist, et al's critical analysis of African AIDS, was that it does not compute as a sexually-transmitted illness.

* There are no systemic differences between African sexual conduct and US/European sexual conduct that would explain why Africa is considered to be beset by a raging sex-epidemic, But not us.

You live in Iowa. How's the great heterosexual AIDS plague affecting the local residents? What? Not at all? Wow.

I live near San Francisco, in the Bay Area.

Guess where there's never been a heterosexual epidemic of AIDS among non-drug abusing heterosexuals (this is the criteria for AIDS in Africa, India, etc - standard heterosexual sex)?

You guessed it - San Francisco.

Also not in New York, Chicago. Newark, Omaha, Dallas, Tampa, San Diego, La Jolla, Beverly Hills, Long Island, Paris, London, Nice, Stockholm, Amsterdam, Prague, Budapest, Istambul (that's Constantinople), Tokyo, Calgary, Moscow, or any other fantastic vacation destination you care to name.

No 40 million infected here. But Lots of sex. Lots and lots of screwing, cheating, child-birth, propogation, mini-vans, family vacations, church picnics, 2nd divorces, bisexual waspy marriages ending in "The Wapshot Chronicle", etc.

But no heterosexual AIDS.

And that's the beauty of it.

AIDS appears where we decide it's the appropriate diagnosis for persons affected by poverty, drug-abuse, social isolation, ghettoization, and the other nice things we do to people we're uncomfortable with.

In short, AIDS, or Immune Deficiency occurs in groups where people are inducing immune deficiency. It is a moderately useful clinical assessment, turned into a death sentence.

We give (some of) these people tests for a virus that we say causes a disease. But the tests do not find the virus.

In fact, there simply is no such thing as an antibody or PCR test that you can apply equally to all populations, and draw a result that indicates infection with a particular retrovirus.

We test populations that we say are at risk with tests that are only meaningful for those populations that we say are at risk.

It's a clever, clever thing we've done. Good intentions be damned.

And of course, when we give these "at risk" people tests for a sexually-transmitted virus that we assure them will kill them, we also tell them that they must take extraordinarily dangerous drugs, in order to, I don't know, get sick more slowly, I guess.

But getting sick is part of the deal when you're forced to take the drugs.

You never got back to me on that point, by the way.

Please, have a read: http://nypress.com/18/30/news&columns/liamscheff.cfm

and another: http://www.aras.ab.ca/haart.html

and another: http://www.aras.ab.ca/azt.html

And tell me if this is what you would do, as a mother, to your children.

It's a fair question.

Regards,

Liam Scheff

Tara,

I just submitted a reply, but it won't post. Other people are able to post instanty - in fact, this short reply might do so.

Why is that?

LS

Ivan,

It's not online.

Well, surely as a doctor, you have access to a Medical Library. Go find the bound volumes of American Journal of Epidemiology.

Post it (or send it to Tara, I'm sure she will), I will read it.

Well, it's a 1997 paper, so that means you haven't heard of it let alone read it in the past 9 years. I doubt you will read it now, I doubt you will understand it. Yes, I will post it to someone who is honestly interested in the issue. Your assinine response indicates you are not.

FYI, in science, if you disagree with the methodology or interpretation, you can submit letters to the editor, or you can publish critiques.

FYI, did you get a Phd in the obvious? Yeah, I know that --thanks.

Those do not constitute a summary of the paper.

Huh? Again, keen grasp of the obvious, Doc. I read the paper years ago, if called upon to recite the facts, I do so here. For some reason, the underlying data are not faithfully represented in the abstract.

Your posts were written in a way that conveyed that you were merely passing along the results and conclusions that the authors published.

Bovine scatology. The authors misinterpreted their own data. I wasn't passing along squat.

And it's Dr. Dumbass to you.

Yes, it certainly is.

Barnes, Hank

By Hank Barnes (not verified) on 14 Feb 2006 #permalink

Ivan,

Hank is factually correct about some aspects of the Padian paper. No seroconversions occurred during the course of Padian's study although some may have occurred prior to the study. Over 400 individuals in stable relationships were initially identified as potential participants in this study. When their partners were tested, 15% of the 400 couples were excluded at the outset because the partner was already HIV positive. There was no way to know whether the partners had acquired HIV from each other but neither was there any way to demonstrate that they hadn't.

However, Hank is wrong about the duration of the study. Individuals were recruited over a ten year period. No couple was actually followed for anything even approaching ten years. 3000 couple months of follow-up for 175 serodiscordant couples - that's an average of less than two years per couple.

Also there have been other studies of heterosexual transmission of HIV that do show apparent seroconversion in individuals with no known risk factors other than a seropositive spouse. The conclusion of heterosexual transmission is subject of course to all the caveats that apply to studies of human beings.

Id like to address a few comments to the several posts of John Wheaton (wheatdogg).
My name is Anthony Brink. Im an advocate by profession (a High Court litigation attorney), now working fulltime as a researcher-activist in Cape Town, South Africa, in the field that has generated all the heat in this blog.
I claim responsibility for having ignited the AIDS controversy in South Africa in 1999 by sending government the manuscript of my book Debating AZT: Mbeki and the AIDS drug controversy (then subtitled: Questions of safety and efficacy). This caused President Mbeki and Health Minister Dr Tshabalala-Msimang to swing 180 degrees in their opinion of the drug, and resulted in the former ordering an enquiry into its safety in Parliament on 28 October that year. (That was the first time I became aware of the alternative viewpoint, Mbeki told veteran journalist Allister Sparks; Beyond the Miracle: Inside the New South Africa, p286.) Debating AZT can be read online free at www.tig.org.za and on several other websites around the world.
In my new book in preparation, Just say yes, Mr President: Mbeki and AIDS, I make the point that before he became a lapsed sceptic, President Mbeki (then Deputy President) had been the leading, energetic architect of government AIDS policy at a time when President Mandela wasnt the least bit interested in all the fuss. (He became a reborn convert later on.) My new book comprehensively documents the history of the AIDS controversy and the shifting positions of the big political players and in the case of Mbeki and Mandela, how they moved in opposite directions and why.
It was quite incorrect of John to assert that President Thabo Mbeki was ridiculed for several years for his stubborn insistence that HIV did not cause AIDS, despite evidence to the contrary, Mbeki finally retracted his objections. Whether it was for political or scientific reasons is hard to say.
Whatever his private opinions in the matter, which I know, President Mbeki has never said HIV doesnt cause AIDS. He has questioned the integrity of the sexually transmitted viral explanation of widespread broken health among the poor African majority in South Africa, and has sought to encourage debate between scientists and clinicians holding a wide array of views. He has never retracted his objections. A policy decision was democratically made by Cabinet that hed pull back from further active personal and political involvement in the controversy, such as his personal initiative in convening his international AIDS Advisory Panel.
I respectfully dispute Johns claim that Tribal leaders recognize the problem as well and are not ashamed to identify sexual promiscuity as the root cause of the epidemic. The orthodox understanding that sexual promiscuity is the root cause of the epidemic is very much a white mans thinking, both here and in the US. Black people living here in abject poverty in arid rural slums and miserable peri-urban ghettoes around our beautiful modern cities dont widely subscribe to the belief that a sexually transmitted germ is making them sick; they appreciate full-well that its their dire living conditions and chronic under- and malnourishment.
In fact the germ theory of disease per se is alien to African culture in my country, 80% of whose people rely on traditional African medicine, a system of indigenous healing knowledge in which germs dont feature as the cause of disease at all. (The Xhosa people (Mandela, Mbeki etc) have a wry aphorism: Iintsholongwane ize nabelungu. (Germs arrived with white people.)
I will shortly return to deal with Johns claim that Africans are sick because they have so much sex; its an idea very much to the fore in his thinking, as is evident from the fact that he raises it twice again in his posts.
John claims, Zulu commumities have revived an ancient custom of aunties inspecting young women for intact hymens. In fact, my close friend and comrade, Sam Mhlongo, Professor of Family Medicine and Primary Health Care at the Medical University of Southern Africa, tells me, the custom isnt indigenous: it came into being under the puritan influence of missionaries in Zululand in the nineteenth century. Hes a Zulu and ought to know. And its not specifically with AIDS in mind. To the rural Zulu mind and that of other African cultures here, the idea that you can get sick and die from lovemaking is inherently ridiculous, whereas it sits perfectly comfortably in the Western mind, even among atheists, which has had the message drummed in for centuries by the Church that the wages of sin is death.
John asks how does one explain the miniscule incidence of AIDS in Muslim sub-Saharan Africa? There is a coincident low rate of premarital and extramarital sex in Muslim countries. So, are we looking at correlation or causation here? Clearly, sex has to be a factor in the transmission of HIV/AIDS, whether you or Pres. Mbeki care to accept it.
Well I confirm that indeed President Mbeki doesnt accept it. He doesnt think any more that sex has to be a factor in broken health among the poor. He used to though, before I got him thinking Debating AZT included my essays in the appendices: How could they all be wrong: Doctors and AIDS and Why the AIDS test is useless and pathologists agree. It was Mbeki, no less, who had appeared on television on 9 October 1998 to make a special emergency address to the nation, warning that the country was in the grip of a terrible sexually transmitted new disease epidemic. His alarming speech is up at: http://www.info.gov.za/issues/hiv/aidsdeclaration.htm
A year later he thought the whole thing was nonsense.
In December last year, the Human Sciences Research Council released a report on HIV Prevalence in South Africa. In January I sent its lead author Dr Olive Shisana a letter sharply critiquing it, in which I cite President Mbekis several public statements about Johns sort of assumptions about the fantastic, unique sexual promiscuity of Africans to account for their broken health (among the poor, not the employed). My letter appears at the foot my website, www.tig.org.za where my work is archived for free access and use, and more specifically at: http://www.tig.org.za/pdf-files/Shisana.pdf
Employing a similar ironic tone, my letter to the CEO of the South African National Blood Service (at: http://www.tig.org.za/pdf-files/Heyns.pdf) takes the ramifications of the HSRC report to their logical conclusions.
(A reminder to Dr Shisana, dished up with some extra chilli, and a letter to the president of the Southern African HIV/AIDS Clinicians Society, will be posted at www.tig.org.za in the next couple of days. And in a couple of weeks, Ill be done with an affidavit Im working on, which Ill post too: it will address Johns suggestion that because more wood is being used in Kenya, it suggests that South Africans are currently being cut down by AIDS as never before, and that the consumption of timber in Kenya somehow invalidates Rian Malans findings, door to door, that the undertaking industry was in the doldrums in South Africa in 2001, rather than cooking, which hed expected from all the noise in the newspapers about everyone dying in the terrible AIDS epidemic. As he told me at the time: I got into AIDS with a view to bashing Mbeki, only to find the facts reluctant to cooperate.)
John presses for an answer to my naive observation that AIDS infection rates are very low in Muslim Sub-Saharan Africa, indicating there is some connection between sexual activity and infections. Am I misinterpreting the data, as a layman, or are you ducking the question? Please enlighten me. I am a physics teacher who is trying to understand the issue.
I think the second half of my letter to Dr Shisana of the HSRC will be found enlightening concerning the connection between sexual activity and infections, because I give it the full treatment. I do hope John and anyone else trying to understand the issue will do so after reading it.
Anthony Brink

Oh, goody, Tara. You know you're really hitting a nerve when trolls like Hank Barnes (a regular fixture on Dean Esmay's blog and an annoyance that MUSC Tiger had to slap down a while back) start showing up and making pests of themselves.

You could bury this guy in a mountain of papers supporting the hypothesis that HIV causes AIDS and he'd still cherry pick one bit of data that casts a little bit of doubt on the connection, while ignoring the hundreds of papers supporting it. The comparison to creationists is quite apt; he uses the same fallacious argument of Falsus in Uno, Falsus in Omnibus, meaning one thing mistaken equals all things mistaken, taken from the legal principle that if a witness lies in one thing that he can be assumed to be unreliable in all. The problem is, this is a legal, not a scientific, principle. The literature is littered with papers whose results were later shown to be either incorrect or only partially correct. In most cases, being incorrect doesn't mean the scientists were lying, and it is the totality of the evidence that must be weighed. Just as creationists try to find bits of data that seem to cast doubt on evolution (but never enough to falsify it, one must note) and ignore the mass of data that supports evolution, HIV/AIDS denialists try to find bits of data that seem inconsistent with the HIV/AIDS hypothesis, ignoring all the other data that is entirely consistent with the hypothesis that HIV causes AIDS.

Hank-

Well, it's a 1997 paper, so that means you haven't heard of it let alone read it in the past 9 years. I doubt you will read it now, I doubt you will understand it. Yes, I will post it to someone who is honestly interested in the issue. Your assinine response indicates you are not.

Well, you are wrong about that, I am quite interested in reading the paper.

I read the paper years ago, if called upon to recite the facts, I do so here. For some reason, the underlying data are not faithfully represented in the abstract.

I'm sorry, I thought you had the paper at hand and could save me some diving in the stacks across campus. Where could I have gotten that impression?

Hank-
>Hello Dr. Harvey
>
>You mentioned me above regarding the famous Padian paper!
>
>I was just reviewing it last week, so I have the salient
>facts at my cyber fingertips

Oh there it is, only few posts up.

Yet somehow in your review you mixed up

Individuals were recruited over a ten year period.

with

For 10 years, it followed 175 discordant couples

So in summary:
1. Harvey posted your misleading charaterization of the paper.
2. Tara posted the abstract, showing evidence that the paper did find partners who showed HIV infection (although none within the time of the study (thanks Dale).
3. You join in, and instead of discussing how you disagree with the methodology of the authors and reach your reported conclusions, you simply repeat your misrepresentations of the study.

Ivan

BTW, I have a Ph.D, not an MD in Obvious, and in 1997 I was just starting grad school in another field, so it's not the most suprising thing that I missed this paper. But, as I said, I'm very interested to read it now.

Hola Harvey,

If *you* want to surprise *me*, you'll post a substantive rebuttal to Dr. Smith's original post.

Dr. Ivan,

You are beyond clueless. Go find the paper and go read it. I wrote clearly that I had reviewed it last week, and had the facts at my fingertips, not the paper. Nobody here is preventing you from getting the paper. If you think that HIV is spread thru heterosexual transmission, and you haven't read the paper, well, then, you're a substandard scientist.

Dale is a friendly adversary of mine (at least thru the internet). He has integrity, I often interact with him. We differ on many aspects of this issue, which is ok. That is why he wrote:

Hank is factually correct about some aspects of the Padian paper. No seroconversions occurred during the course of Padian's study although some may have occurred prior to the study

But (as usual) he is remarkably silent on the proper interpretation of the salient portion of the paper, where NO seroconversions occurred.

I anticipated all this fluffery and puffery by "AIDS experts" who opine on matters without reading the underlying papers or who only read the abstracts. Typical shoddiness, but not surprising.

That's why at the end I wrote:

More importantly, assume my recitation of the paper is true. Then, what logical, scientific conclusion would YOU reach regarding HIV?

175 discordant couples + lotsa sex + 10 years of observation = No seroconversions.

If you think it was only 2 years of observation, you can still answer the question, however, I'm more interested in Dr. Smith's epidemiological observations, not your ignorant distractions.

Fondly,

Hank

By Hank Barnes (not verified) on 14 Feb 2006 #permalink

You know, it just occurred to me. If, as HIV/AIDS denialists like Hank sometimes claim outright (and frequently imply), scientists are trying to "suppress" or "cover up" the "holes" in the HIV/AIDS hypothesis, one can't help but wonder why they let such papers as the Padian paper pass peer review and be published.

It would seem that the conspiracy isn't as effective as claimed.

Orac,

1. I ain't an HIV denialist. Nice strawman.

2. Your post is vacuous. It adds nothing to the discussion. Why even bother?

3. I don't claim a conspiracy. Nice strawman.

4. It's not a question of "suppressing" or "covering up" the holes in the HIV/AIDS. It's a failure to properly interpret the data.

5. Had you even heard of the Padian paper, before today?

6. Lemme see if you're an honest scientist. I assume you contend that HIV causes AIDS. That's fine. A lot of reasonably smart people do.

The question is: What scientific evidence would falsify this contention?

Please respond or flitter away.

Hank Barnes

By Hank Barnes (not verified) on 14 Feb 2006 #permalink

Hi Tara,

again, my response has not posted. I hesitate to resubmit, because it will come up as a duplicate. Please either post, or let me know how to post without encountering this problem.

LS

This is becoming truly astonishing. This is a living monument to projection, denialism, irrationality, and anti-scientific post-modern lunacy. The Padian paper by itself shatters the myth of HIV's infectivity, which was branded as profligate,effective, and wild-fire like in the mid 80s(using, for now, "HIV" as a coherent viral entity and not a level of retroviral static not yet understood, except by those who understand it fully, which I do not.)Those splitting hairs seem to be saying that it does not shatter the possibility of ANY transmission. Is that correct? Are we now erasing, in the grand tradition of HIV/AIDS determinism and erasure, the resounding fact that HIV was branded, marketed, sold to the public, post 1984, (at one point with a US Surgeon General brochure to every American household,) as a highly infectious virus that was likely to transmit in ANY given "unsafe" sexual encounter?

I have read the Padian paper and it says what Hank Barnes says it does. But we don't need the Padian paper to see that HIV has never risen in the US blood supply. We don't need it to look around and see that unlike say, herpes, "HIV" does not appear where sex has occurred--where sex alone has occurred. Prostititues have never been a risk group for HIV or AIDS in the US. Nor porn stars, rock stars etc. This is old stuff. I live in New York City; I know of no person who has "contracted" HIV through sex. (Now you're saying they're all black?) (That makes no sense either.)

Learn to face defeat. You are defeated on this. If you do not concede, then we are all wasting our time, because it means we have left the realm where two plus two equals four.

What do the Oracs and others think the Padian study DOES show, if anything? That HIV is very HARD to transmit but it can be done? If you keep at it for over 1000 attempts?

How many of you have had 1000 sex encounters in your lifetime? How many does an African person have to have? 100,000?

This is lunacy. It's denial. Something is very very WRONG with the reigning model of HIV/AIDS and it is high time it be revised or thrown out.

Can any HIV anti-denialists tell us what the Padian paper says to THEM?

By Anonymous (not verified) on 14 Feb 2006 #permalink

The Padian paper by itself shatters the myth of HIV's infectivity, which was branded as profligate,effective, and wild-fire like in the mid 80s(using, for now, "HIV" as a coherent viral entity and not a level of retroviral static not yet understood, except by those who understand it fully, which I do not.)

When you have one paper that doesn't reach the same conclusion as the rest of the research in a field, there are two options:
1) the paper is flawed
2) the rest of the research is flawed
The first option is much more likely than the second, and every good scientist knows this.

This doesn't mean that the second senario doesn't happen, since the paper might take something into account that the rest of the research doesn't. However, this would then be clear to the rest of the researchers (or at least a very large group), and they can then reproduce the result.
That is not the case here - the HIV/AIDS connection, and HIV as a sexual transmitted disease, are still the results of the other papers in the field.

Prostititues have never been a risk group for HIV or AIDS in the US. Nor porn stars, rock stars etc.

Are you aware that porn stars actually have to present a clean test before participating in porn movies? Porn stars at least, have no doubt about how HIV is spread. Just look at the panic when John Holmes died.

And I have one very simple question to Anonymous - if HIV is not sexually transmitted, how come information campaigns and free condoms stopped increase in the number of cases in Denmark?

By Kristjan Wager (not verified) on 14 Feb 2006 #permalink

I'm curious as to how the Hanks of this world imagine HIV does actually spread. Oh how close that Nobel prize is to their fingertips.....

Liam,
The Padian paper contains two pieces of data relevant to HIV heterosexual transmission rates. Also the Padian paper can't be interpreted in isolation from the rest of the literature any more than any other single paper can. But just looking at Padian. No seroconversions in 3000 couple months means less than 1 per 250 couple years. Less than 1, not zero, because neither you nor Hank nor Dr. Padian can possibly know what might have happened in month 3001. Still that is a pretty low number. But there's a second piece of a data.

The second piece of data is the seropositive partners of the 400 index cases. If HIV were not sexually transmitted then the frequency of seropositives amongst partners of seropositives should be the same as the frequency of seropositives in the general population. In the US I think that's less than 0.5%. 0.5% of 400 would be 2. In fact there were 70. Which suggests that stable partners of HIV positive individuals do indeed have a risk factor for becoming seropositive themselves. This is consistant with other data in the literature. So let's assume those 400 couples have been in serodiscordant relationships for an average of 5 years each. Probably an overestimate but where does it lead? At 5 years each that's 2000 couple years for 400 couples. 70 seroconversions per 2000 couple years works out to a little over 3 conversions per 100 couple years. So one number gives you less than 1 seroconversion per 250 couple years and the second gives you 3 conversions per 100 couple years. In the context of other studies in the literature one possible explanation for the difference in the two numbers is that HIV positive individuals are more likely to infect others immediately following their own infection, when their viral loads are high, than latter on when viral loads are reduced. However, given the constraints of human studies that is a very difficult hypothesis to test as HIV positive individuals are rarely identified prior to seroconversion.

Is there additional data that pertains to the likelihood of heterosexual transmission of HIV? Well yes there is. There are several examples in the literature of linked transmission cohorts - small groups of individuals in whom sequencing of viral isolates shows a close relationship between the virus found in one individual and another. There is also data showing that virus is present in seminal fluid and vaginal secretions. So either several million people who all claim to have no risk factor other than a heterosexual relationship with an HIV positive partner are ALL lying, or heterosexual transmission occurs at some rate less than once per encounter but definately greater than zero.

And FYI, 3 seroconversions per hundred couple years doesn't mean 1 serodiscordant couple can go at it in relative safety for 33 years; or to use your numbers, that an HIV negative individual can have 999 sexual encounters before running into a problem. It means if 1000 HIV negative individuals have one encounter each with an HIV positive individual, on average, one unlucky individual will end up HIV positive. To argue otherwise is like saying that because the odds of winning a lottery are less than one in 10 million and no one individual ever buys 10 million tickets then clearly no one ever wins a lottery.

Dale said:

The Padian paper contains two pieces of data relevant to HIV heterosexual transmission rates. Also the Padian paper can't be interpreted in isolation from the rest of the literature any more than any other single paper can. But just looking at Padian. No seroconversions in 3000 couple months means less than 1 per 250 couple years. Less than 1, not zero, because neither you nor Hank nor Dr. Padian can possibly know what might have happened in month 3001. Still that is a pretty low number. But there's a second piece of a data.

The second piece of data is the seropositive partners of the 400 index cases. If HIV were not sexually transmitted then the frequency of seropositives amongst partners of seropositives should be the same as the frequency of seropositives in the general population. In the US I think that's less than 0.5%. 0.5% of 400 would be 2. In fact there were 70.

Good points Dale.

It should be emphasized again that there were two portions to this study, not one. In the retrospective portion (where the 70 seroconversions come in) and in the prospective portion. In that portion, indeed there were no seroconversions directly observed, but this was also after the couples were councilled to avoid unsafe sexual practices.

This councilling may have made the scientific case for this paper much weaker than it could have been had these people not been so councilled, but was absolutely necessary ethically to do so. It also shows that safer sexual practices like wearing of condoms can reduce risk.

Of course this paper is hardly the only one looking at the sexual transmission of HIV. Hundreds of papers all point to sex as a vector (but not the only vector) in HIV transmission.

I would also point out that the fatality rate in driving a car is about 1 per 75,000,000 miles driven. Does anyone doubt traffic accidents can be fatal because of that statistic? Would anyone seriously suggest that if you only drive 74,000,000 miles and then hung up the keys you'd be perfectly safe? That seems to be the argument some are making for HIV transmission via sex.

Sorry, I'm in shock at this claim:

Prostititues have never been a risk group for HIV or AIDS in the US. Nor porn stars, rock stars etc.

Someone clearly doesn't read the pappers (or reads some damned odd ones, anyway). Despite the care taken (generally) in the US porn industry, the case of Darren James convulsed the porn world just a couple of years ago, especially as he also infected an actress, Lara Roxx:

Last month [May 2004], the porn industry's increasingly global risks surfaced when an American porn actor contracted HIV after shooting unprotected sex scenes with more than a dozen Brazilian women. Thirty US porn studios halted production, virtually shutting down the $4.4 billion per year industry based in California's San Fernando Valley. ... Brazilian actresses, many of whom moonlight as prostitutes, can double the $175 they earn per scene if they work with actors not wearing condoms.

Additionally, I don't know why the distinction should be made for US sex workers (maybe because condom use is more prevalent?) but in terms of prostitution and HIV there are tons of paperslinking the two - take Cowan et al, 2005:

A total of 19.6% of HIV infections in men could be attributed to ever having had sexual contact with an SW ... An appreciable proportion of HIV infection in [Zimbabwean] men is attributable to sexual contact with SWs.

Well, PubMed's a public resource - just take a look.

But anyway...

If the oft-cited Padian paper was so critical that it falsified the thesis that HIV is sexually transmissible, would it not be logical to suppose that its author would be among those convinced? I can't get the paper - I have access to most online journals but not to thjat one - but a look at Padian's papers listed on PubMed show that he for one continues to consider HIV a sexually transmitted disease. Unless he's failing to read his own papers?

Sorry, I'm in shock at this claim:

Prostititues have never been a risk group for HIV or AIDS in the US. Nor porn stars, rock stars etc.

Someone clearly doesn't read the pappers (or reads some damned odd ones, anyway). Despite the care taken (generally) in the US porn industry, the case of Darren James convulsed the porn world just a couple of years ago, especially as he also infected an actress, Lara Roxx:

Last month [May 2004], the porn industry's increasingly global risks surfaced when an American porn actor contracted HIV after shooting unprotected sex scenes with more than a dozen Brazilian women. Thirty US porn studios halted production, virtually shutting down the $4.4 billion per year industry based in California's San Fernando Valley. ... Brazilian actresses, many of whom moonlight as prostitutes, can double the $175 they earn per scene if they work with actors not wearing condoms.

Additionally, I don't know why the distinction should be made for US sex workers (maybe because condom use is more prevalent?) but in terms of prostitution and HIV there are tons of paperslinking the two - take Cowan et al, 2005:

A total of 19.6% of HIV infections in men could be attributed to ever having had sexual contact with an SW ... An appreciable proportion of HIV infection in [Zimbabwean] men is attributable to sexual contact with SWs.

Well, PubMed's a public resource - just take a look.

But anyway...

If the oft-cited Padian paper was so critical that it falsified the thesis that HIV is sexually transmissible, would it not be logical to suppose that its author would be among those convinced? I can't get the paper - I have access to most online journals but not to thjat one - but a look at Padian's papers listed on PubMed show that he for one continues to consider HIV a sexually transmitted disease. Unless he's failing to read his own papers?

outeast writes:

- but a look at Padian's papers listed on PubMed show that he for one continues to consider HIV a sexually transmitted disease. Unless he's failing to read his own papers?

Nancy Padian is a she, not a he. Nitpick I know.

Northern California couples with good health care, AIDS councilling, and ready access to condoms and other means of ameliorating the sexual transmission of this virus do indeed have lower instances of sexual transmission than say, Zimbabweans.

I see this has disintigrated into name-calling since I last was online. I'm shutting this down for now, but I've already told Anonymous Two that I plan to respond to his questions in a new post, and I'll put up an analysis of the Padian paper as well (hoping to have time to get to the library today for a copy). Additionally, I'll note that, despite the allegations of mistakes in the actual post, the claims therein remain essentially unchallenged. Thanks to everyone for the discussion--in the meantime, you can email me if there's something you'd like to discuss before I get the next post up.