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.