World AIDS day 2007 - Denialism is still a problem

Today is World AIDS day, and it's important to take a minute to discuss HIV and AIDS since this blog addresses HIV/AIDS denialism.

While the the UN made a mistake overestimating world HIV/AIDS statistics (it is good news and not for the reasons cranks like) Estimates of new HIV transmission in the US are rising. This is bad news. At the same time you have HIV/AIDS denialists still persisting in spreading their nonsense, cranks like Michael Fumento spreading the misinformation that heterosexual transmission of HIV is a "myth", and that the figures for Africa are a conspiracy by UNAIDS and WHO to get more money (he thinks 32 million is still too high and it's more likely to be around 8 million).

Let's go over some of the current data on HIV transmission, who is most at risk, why HIV/AIDS is still a problem in the US and worldwide, and why people like Fumento should keep their crank nonsense to themselves. As an added incentive, I'll include a little email Fumento sent me a couple weeks ago at the bottom of the post. Before looking, guess which adjectives I receive, you might be pleasantly surprised.

From the WaPo article:

New government estimates of the number of Americans who become infected with the AIDS virus each year are 50 percent higher than previous calculations suggested, sources said yesterday.

For more than a decade, epidemiologists at the Centers for Disease Control and Prevention have pegged the number of new HIV infections each year at 40,000. They now believe it is between 55,000 and 60,000.

So what is responsible for the revised numbers? A mixture of better screening and more sophisticated analysis of tests:

The higher estimate is the product of a new method of testing blood samples that can identify those who were infected within the previous five months. With a way to distinguish recent infections from long-standing ones, epidemiologists can then estimate how many new infections are appearing nationwide each month or year.

Basically, they've determined how to detect people who have recently seroconverted to being HIV+, and that allows them to detect who acquired an infection more recently. Further, for years HIV in most states has not required reporting to public health authorities. The concern was because HIV status leads to discrimination against individuals, it would scare people away from testing and invade privacy. Thus for years it's been difficult to get accurate numbers on new HIV cases and track the epidemic as states required reporting AIDS cases, but HIV reporting was more patchy. Since the implementation of Highly Active Anti-Retroviral Therapy (HAART) the time between identification of HIV infection and developing AIDS has become too long to easily associate reported cases of AIDS with rates of infection in a geographic location. Now most states require reporting in some form, and the surveillance of the HIV epidemic has improved.

Some recent testing results from the CDC are here and comes from outreach testing for those at risk - so it can't be extrapolated to the general population:

About 30 of the males in the survey that tested positive did not report sex with men, and even if the entire injection drug use category is included in that group, that's still about 20%. Women are at much higher risk of acquiring HIV from heterosexual sex (and about half as likely to use injection drugs).

Further, national surveillance suggests about 11% of transmission in males and 75% of transmission in females is from heterosexual sex. The CDC estimates that overall, a minimum of 32% of all HIV transmission in 2005 was from heterosexual contact.

So while cranks like Fumento suggest heterosexual transmission is a "myth", or that worldwide AIDS is a myth because of a the low risk of heterosexual sex, he is way off the mark. Fully a third of new cases of HIV in this country are from heterosexual transmission.

We must also emphasize that HIV/AIDS is not just a problem of the third world and it is not just a problem for men who have sex with men. It is a problem for everybody and should be treated as such. One also has to remember that the homosexual-predominant spread of HIV in this country is not typical of its pattern in Africa and elsewhere in the world where it is predominantly a heterosexual disease. Health officials in this country have every reason to be concerned about heterosexual spread, and the false-complacency that Fumento suggests for heterosexuals is dangerous and stupid. It is particularly absurd of Fumento to suggest that because heterosexual transmission is less risky, that that is the reason that rates were revised or that the epidemic is overblown. It doesn't explain, for instance, how all these women get HIV. It's not all injection drug use and transfusions.

Finally, as promised, here's my crank email from Fumento:

Subj:One problem you have in calling me a "denialist" is . . .

. . . that I'm on record as opposing many of the points of view you regard as denialist. Any fool you can see that all you're trying to do is tell people: "Shut these people down before they get out the first syllable, because I, Mark, disagree with them in some area." Hitler would have been proud of you.

You probably guessed it, today I'm a Nazi! Fumento, is of course, an idiot for thinking that believing the earth is round or whatever disqualifies him from being a denialist, when he's more than happy to spout nonsense about HIV/AIDS, DDT, stem cells or any other science he doesn't happen to like. Denialism isn't about disagreement, or what I think of you, it's about the tactics used to spread pseudoscience. If they're there, it's denialism. His UN conspiracy-mongering and idiotic assertion that heterosexual transmission is a myth are what makes him a denialist.

More like this

When Duesberg was recently given space in Scientific American I think the blogosphere was rightly chagrinned that they would give space to a crank whose crackpot ideas are thought to be responsible for the deaths of hundreds of thousands. But it seemed at the time he had been keeping his denialism…
Seth Kalichman is a better man than I. Kalichman is a clinical psychologist, editor of the journal Aids and Behavior and director of the Southeast HIV/AIDS Research and Evaluation (SHARE) product, and he has devoted his life to the treatment and prevention of HIV. Despite a clear passion for…
Student guest post by Francis Mawanda. HIV/AIDS is a major public health problem worldwide. To date, it is estimated that more than 60 million people have been infected with HIV and more than 25 million people have died as a result of HIV/AIDS worldwide1. Despite the high prevalence and mortality…
By Rebecca Kreston “Pneumocystis Pneumonia --- Los Angeles,” in the June 5, 1981 edition of the CDC’s Morbidity and Mortality Weekly Report, was an economical seven paragraph clinical report cataloging five observed cases, accompanied by an explanatory editorial note on the rarity of this fungal…

Looking at the chart you posted, the number of people who actually test positive is really small.

70 out of 10,842 heterosexual men became infected with HIV? Only 38 out of 8,583 women tested positive?

"Fully a third of new cases of HIV in this country are from heterosexual transmission."

I'm actually surprised how low that is...

By antihumanist (not verified) on 01 Dec 2007 #permalink

I have another comment regarding your statement that "Fully a third of new cases of HIV in this country are from heterosexual transmission".

This doesn't take into account that homosexuals only make up anywhere from 1-10% of the population. This makes the fact that only a third of all new HIV cases are a result of heterosexual transmission even more surprising.

While I agree that it's silly to call heterosexual HIV transmission a myth, it's much less of a risk in reality than it is as portrayed by the media.

By antihumanist (not verified) on 01 Dec 2007 #permalink

Aids is a defiantly a problem for everyone. It's easy to think it's not a problem that will effect you.

The facts are in though, people are dieing all over the world because they can afford the 5$/week medication.


Oh the pain!
The pain!
The suffering!

They do not understand!
For they do not see
the difference

The Meh, the Lah.

Do they not see?
They have been given science!
By which
to investigate
The Lah.

What else do they want?
They did not accept
the previous Lah.
They do not accept
the Meh.

And so they fight,
they kill.
For Meh and Lah,
are non-overlapping

Fumento is obviously a crank, if not, how does he explain HIV spread in Africa. Here in South Africa we have well over 5 Million people infected with the virus. How does he explain that?!

I have been wondering, maybe you (Mark) can answer some of these questions:

1) What is the relationship between HIV/AIDS and STIs?
- Would treating STIs reduce the transmission rate of HIV? If yes, why is there so little emphasis on treating STIs relative lets say to treating already infected people? Shouldn't prevention be the most urgent and important weapon against the virus? Treatment is important, but it is already too little too late. Behavior change is important, but we are seeing very little behavioral change.
2) What is the relationship between HIV/AIDS and poverty?
- Would reducing poverty reduce the infection rate, thus the number of people infected with the virus? If yes, why is there so little emphasis on this?
3) What is the relationship between HIV/AIDS and the trucking industry, soldier camps, etc?
- Would improving the working conditions of the long distance truck drives for instance reduce the transmission rate of the virus?

By T. Kwetane (not verified) on 03 Dec 2007 #permalink