Tara and Steven assess HIV?AIDS criticism on the Internet and find it hollow, misleading and a danger to the community
We admire Tara, but is this scientific argument – or toadying propaganda?
With the Internet as with truth, time will tell
According to an item at Science Daily, HIV Denialists Spread Misinformation Online: Consequences Could Be Deadly, one great danger of the Web is that it allows critics of the science of HIV?AIDS full rein, and they have taken advantage of this license to undermine the faith of patients and the public at large in the validity of the globally established paradigm.
Science Daily is reporting the essay published last week on line at the Library of Science, HIV Denial in the Internet Era. The message of this broadside against critical reviewers of the HIV?AIDS paradigm is the same as John P. Moore of Weill Cornell’s Deadly Quackery, the scientifically embarrassing Times Op-Ed piece last June: Don’t question accepted wisdom, it might alarm the clients.
HIV deniers accuse scientists of quashing dissent regarding the cause of AIDS, and not allowing so-called ‘alternative’ theories to be heard. However, this claim could be applied to any well-established scientific theory that is being challenged by politically motivated pseudoscientific notions, for example, creationist challenges to evolution. Further, as HIV denial can plausibly reduce compliance with safe sex practices and anti-HIV drugs, potentially costing lives, this motivates the scientific and health care communities to exclude HIV denial from any public forum. (As one editorial has bluntly phrased it, HIV denial is ‘deadly quackery’ . Because HIV denial is not scientifically legitimate, such exclusion is justified, but it further fuels the deniers’ claims of oppression.
Or, please join us in assuming that what is being questioned is true without question, so that high level review can be politically repressed as “pseudoscience” rather than answered with science, and there will be no danger that patients question the need to take extremely dangerous drugs.
The only problem with this line of paradigm defense, of course, is that the serious paradigm debunking has in fact occurred in peer reviewed scientific literature at the highest level, and has gone unanswered there at the same, peer reviewed level, in the same journals. Instead, the defense team has abandoned ship and gone to lower levels, where peer review does not handicap bad argument and misleading assertions, where “fact sheets” can be quoted in response to peer-reviewed critique, and where lay critics can be answered with politically charged prejudice (“dangerous” “pseudoscience”) and smearing (“not scientifically legitimate” “denialist” (similar to Holocaust denialists) “conspiracy theorists” motivated by “profit”) and so on.
A notable blogger
The authors of the complaint are two, the first being none other than Tara Smith, the youthful epidemiologist blogger who at her scienceblogs site, Aetiology, has maintained a reflex scorn for HIV critics (“deniers”) based on her under researched (because very little is without question in the paradigm literature now) support of the conventional wisdom, a handicap which is understandable since assistant professor Tara has a very busy life as well as covering a wide range of topics on her lively blog.
Her main contribution to HIV?AIDS enlightenment has been to host several long threads where second level supporters of both sides of the debate have battled it out, typically on the level of the trees rather than the forest. Sorry to say all this has had little effect in clarifying the issue for the average reader, since the discussion is handicapped by the prejudice of the hostess, and more informed thinkers tend to avoid such arenas, as we do.
As a bonus attraction, visits to the site were long enhanced by the sight of Tara’s svelte portrait in form fitting costume, and the latest one is just as pretty as the first one she posted for a long time, though perhaps less like a bathing suit (we hope our appreciation of this first portrait here was not responsible for the replacement). We have reproduced it above, at the start of the mention of this attractive scientist.
However, the meeting this last weekend of science bloggers corralled at Seed Magazine’s ScienceBlogs site yielded some more realistic pictures of Tara and others from the beer drinking gatherings involved, and here is the best one we could find (left). Others are at A Blog Around the Clock, Neurophilosophy and Pharyngula. Readers with an interest in such research will see if intelligence correlates with beauty in the science blogging world.
More mudslinging at HIV critics
Meanwhile, back to the more serious topic of the lengthy diatribe against “AIDS denialists” penned by Smith and another writer for the Library of Science. Her co-author is Steven P. Novella, who is with the Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, United States of America.
Intelligent readers will read HIV Denialists Spread Misinformation Online: Consequences Could Be Deadly through for themselves and immediately see that it is nothing more than a John P. Moore type piece of prejudicial propaganda, a rote recitation of all the reasons why established wisdom endorsed by long established and trusted institutions relied upon by the media and the public, not to mention almost all scientists, physicians, health workers, policymakers and government officials around the globe, should not be questioned by independent critics, especially those without professional expertise in the science concerned, retrovirology and its two human diseases alleged so far, even if the scientific literature at the top level contains an ever growing pile of rejecting reviews and studies which contradict the basic tenets of the paradigm and its medical approach.
While being presented with a reasonably good historical update readers will note that the authors in deploring the dissenting view present no good scientific arguments of their own and reference inaccurate sources as often as they reference accurate sources for their point of view (Christine Maggiore’s child was not HIV positive). In all these politics and generalities, the points made against the group they attacked can just as easily be used to condemn the writers, which we will show when we return to expand this post. (Note: We have moved this to a new post, since another Scienceblogs blogger, Orac, has in his riposte supporting the Tara essay as Essential Reading on HIV Denialism and an “essential primer on the dangerous pseudoscience and quackery that is HIV/AIDS denialism” accused us of making feeble points in reply, so we feel we had better pull up our socks and put our best foot forward, given the respect we have for Scienceblog bloggers, even though apparently none of them have read the literature on the topic (the Proceedings of the National Academy does not publish ‘pseudoscience’, Orac!)).
Its chief value lies in the fact that it will inform readers of the existence of substantial criticism of HIV?AIDS and that some will be provoked into checking the full list of references for themselves, including as it happens this blog, New AIDS Review, which is referenced.
The Net’s biggest danger – long run embarrassment
It is true that the Net is a wonderful thing, allowing all voices to speak out, from the illiterate and juvenile to the scholarly and thoughtful, some of them bringing to the attention of the public good information which would otherwise be kept from view. But there are other, less obvious perils.
In the long run, Tara Smith and Steven Novella will learn the biggest danger of the Internet, which will eventually emerge as its dominant long run characteristic: its permanence.
Every single half baked, under researched opinion everybody writes on the world’s bulletin board will be there twenty years from now, when time itself will have ensured that any nonsense one ventures too precipitately for the wrong reasons will be exposed for all to see, as clear as the day it was scribbled, hanging like dirty laundry in the sun.
Let’s hope for their sake that all the signs in the scientific literature that Tara and her friend Steven are ignoring are somehow proven to be wrong, as they like to assume, apparently without examining them carefully enough. Since they all point in the same direction, to the eventual defeat of a paradigm which never genuinely flew, scientifically speaking, even at the beginning, this seems unlikely. More likely is their embarrassment, as grownups, at what they wrote as babes in the woods.
Right or wrong, their piece with its absurd reasoning is shameful enough at this very moment. Anyone in science who argues against examining any assumption is no scientist worthy of the name. Maybe the editors at the Library of Science should read their own front page, which displays this quote:
I thoroughly support universal free access to research. The wonderful thing about ideas is more people being exposed to more ideas leads to still more ideas.” â€” Dr. Richard Smith, former Editor of the British Medical Journal, member of the PLoS Board of Directors
What they are, and reveal themselves to be, is…political babes in the wood. Unless … of course, they may be knowing babes whose secret motivation, hidden even from themselves, is toadying. But we wouldn’t know, and have no further data to prove it.
Not that Tara Smith sets a very good example for informed opinion at the best of times, judging from her other posts. For example, she attacked the New York popularizer of nutrient and dietary research, Gary Null, for selling magnetic trousers and other products which interest people who think magnetism has good effects on their systems.
Calling this a “despicable” moneymaking “scam”, Tara shows no sign of being informed on any of the research on magnetic fields and their effects on biological activity conducted over the past thirty years, which have resulted in entire books on the topic. These studies have found some effects, for instance, on the digestion of proteins by the proteolytic enzyme trypsin, which is more active in a polarized magnetic field , as we recall.
Well, we’ve certainly seen HIV deniers advocate a number of quack cures to replace antiretroviral drugs, including megadoses of vitamins and the aforementioned potato cure, so it probably won’t come as a surprise to anyone that Null also espouses some, erm, rather “wacky” ideas regarding what makes one healthy. But some of these were new even to me; more after the jump.
Let me first note that none of these are specifically recommended for HIV. Rather, Null is anti- lots of mainstream medical science, of which HIV/AIDS is just a part. So rather than the evil drugs pushed upon unsuspecting, naive Americans, what does Null recommend for healthy living?
Magnetic pants. And magnetic bras–a bargain at only $72. If you really want to splurge, how about a king-sized magnetic mattress pad for $400 more? Or try his “new and improved!” Brainy caps, only $50 for a month’s supply. And don’t forget your pets!
Once again, I find it hard to believe the hypocrisy of HIV deniers, including Null himself, who decry the “profits” supposedly made by all these “unethical” HIV researchers, and yet go and make money off of scams like magnetic pants. Despicable.
Whether trousers (or magnetic bras) would work any biological magic beyond the placebo effect we do not know (we too very much doubt it, since it is hard to imagine how the fields could be polarized), but it would be better if Tara would do a little research before shooting from the hip, if she is going to indulge her common reflex prejudice that something she has never heard of must lack any basis in research just because it sounds wacky.
We happen to know that Gary Null has in the past gone to some lengths to check out the potential of various novel notions by having research experiments done, and when these failed to find any effect, accepted the results.
It is this kind of self righteous opinionating, based on mistaking a familiarity with the conventional wisdom of one’s elders and better for being genuinely informed on a disputed topic, which renders so much Web commentary empty and foolish, and HIV Denial in the Internet Era is a classic of this kind.
We sympathize with the critics of HIVâˆ«AIDS in having to dodge this mudslinging, when all they have ever asked for is that responsible people should learn to read the scientific literature or have it independently analyzed for them before assuming that all is well in HIVâˆ«AIDS science just because HIV researchers tell them so.
Instead they have these blog dogs snapping at their heels, imagining they are barking in defense of the citadel of true science when all they are doing is getting in the way of its proper operation, which is to double check assumptions when contradictions multiply.
The full article, HIV Denial in the Internet Era, is as follows:
A peer-reviewed, open-access journal published by the Public Library of Science
The Policy Forum allows health policy makers around the world to discuss challenges and opportunities for improving health care in their societies.
HIV Denial in the Internet Era
Tara C. Smith*, Steven P. Novella
Funding: Tara C Smith received research start-up funding from the University of Iowa, but received no specific funding for this article.
Competing Interests: The authors have declared that no competing interests exist.
Citation: Smith TC, Novella SP (2007) HIV Denial in the Internet Era. PLoS Med 4(8): e256 doi:10.1371/journal.pmed.0040256
Published: August 21, 2007
Copyright: © 2007 Smith and Novella. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Tara C. Smith (to whom correspondence should be addressed. E-mail: email@example.com) is with the Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, United States of America. Steven P. Novella is with the Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, United States of America.
HIV Denial in the Internet Era
It may seem remarkable that, 23 years after the identification of the human immunodeficiency virus (HIV), there is still denial that the virus is the cause of acquired immune deficiency syndrome (AIDS). This denial was highlighted on an international level in 2000, when South African president Thabo Mbeki convened a group of panelists to discuss the cause of AIDS, acknowledging that he remained unconvinced that HIV was the cause . His ideas were derived at least partly from material he found on the Internet . Though Mbeki agreed later that year to step back from the debate , he subsequently suggested a re-analysis of health spending with a decreased emphasis on HIV/AIDS .
HIV denial has taken root in the general population and has shown its potential to frustrate public education efforts and adversely affect public funding for AIDS research and prevention programs. For example, the AIDS Coalition to Unleash Power (ACT UP) was for many years on the front lines of AIDS education and activism. But now a San Francisco chapter of the group has joined the denialist movement, stating on its Web site that â€œHIV does not cause AIDSâ€¦ HIV antibody tests are flawed and dangerousâ€¦AIDS drugs are poisonâ€ (http://www.actupsf.com/aids/index.htm). In 2000 the chapter wrote letters to every member of Congress asking them to stop funding research into HIV . ACT UP San Francisco’s position has been condemned by other ACT UP chapters, such as ACT UP Philadelphia and ACT UP East Bay (http://www.actupny.org/indexfolder/actupgg.html). Rock stars have weighed in on the topic. Members of the group â€œThe Foo Fightersâ€ provided music for a soundtrack of the recent documentary, â€œThe Other Side of AIDSâ€ (http://www.theothersideofaids.com/), which questions whether HIV is the cause of AIDS. The band has spread its message that HIV does not cause AIDS at concerts , and it lists the HIV denial group â€œAlive and Wellâ€ as a worthy cause on its Web site (http://www.foofighters.com/community_cause.html).
As these challenges to mainstream theories have largely occurred outside of the scientific literature, many physicians and researchers have had the luxury of ignoring them as fringe beliefs and therefore inconsequential. Indeed, the Internet has served as a fertile and un-refereed medium to spread these denialist beliefs. The Group for the Scientific Reappraisal of the HIV/AIDS Hypothesis (â€œReappraising AIDSâ€) noted, â€œThanks to the ascendance of the internet, we are now able to reinvigorate our informational campaignâ€ . The Internet is an effective tool for targeting young people, and for spreading misinformation within a group at high risk for HIV infection.
Two excellent online fact sheets have been prepared to counter many of the most commonly used arguments to deny HIV causation of AIDS [8,9]; as such, we will not discuss these in this article. Instead, we will review the current intellectual strategies used by the HIV denial movement. Although other forms of science denial will not be specifically discussed, the characteristics described below apply to many other forms of popular denial, including denial of evolution, mental illness, and the Holocaust.
Three Prominent Deniers and Denial Groups
One of the prominent HIV denial groups currently is Christine Maggiore’s â€œAlive and Wellâ€ (formerly â€œHEAL,â€ Health Education AIDS Liaison) (http://www.aliveandwell.org/). Maggiore’s life story is at the center of this group. Diagnosed with HIV in 1992, Maggiore claims she has since been symptom-free for the past 14 years without the use of antiretroviral drugs, including protease inhibitors . She has risen to prominence, and been embroiled in controversy, in recent years after giving birth to and openly breast-feeding her two children, Charles and Eliza Jane. She had neither child tested for HIV, and did not take antiretroviral medication during her pregnancy or subsequent breast-feeding . Eliza Jane died in September 2005 of HIV-related pneumonia , though Maggiore remains unconvinced that HIV had any role in her daughter’s death , and continues to preach her message to other HIV-positive mothers.
Peter Duesberg initiated the HIV denial movement with a 1987 article suggesting that HIV does not cause AIDS . While he is no longer on the front lines of this movement, the arguments put forth by others trace back to his publications.
Celia Farber is a journalist who has spent much of her career covering HIV. Farber is the author of a recent Harper’s article repeating Duesberg’s claims that HIV does not cause AIDS , and has recently authored a book on â€œthe shadowy story of AIDS scienceâ€ .
There are serious inconsistencies within the broad HIV denial movement, and the individuals mentioned above are only the tip of the iceberg. HIV denial groups diverge even on the most basic tenet: does HIV exist at all? Nevertheless, disagreements within the movement are overlooked for the sake of presenting a unified front.
Conspiracy Theories and Selective Distrust of Scientific Authority
That HIV is the primary cause of AIDS is the strongly held consensus opinion of the scientific community, based upon over two decades of robust research. Deniers must therefore reject this consensus, either by denigrating the notion of scientific authority in general, or by arguing that the mainstream HIV community is intellectually compromised. It is therefore not surprising that much of the newer denial literature reflects a basic distrust of authority and of the institutions of science and medicine. In her book, Christine Maggiore thanks her father Robert, â€œwho taught me to question authority and stand up for what’s rightâ€ . Similarly, mathematical modeler Dr. Rebecca Culshaw, another HIV denier, states: â€œAs someone who has been raised by parents who taught me from a young age never to believe anything just because â€˜everyone else accepts it to be true,â€™ I can no longer just sit by and do nothing, thereby contributing to this crazinessâ€ .
Distrusting mainstream medical practitioners, many HIV deniers turn to â€œalternativeâ€ medicine in search of treatment. One such practitioner, Dr. Mohammed Al-Bayati, suggests that â€œtoxinsâ€ and drug use, rather than HIV, cause AIDS . Dr Al-Bayati personally profits from his HIV denialism: for $100 per hour, Al-Bayati will consult â€œon health issues related to AIDS, adverse reactions to vaccines and medications, exposure to chemicals in the home, environment or workplaceâ€ (http://www.toxi-health.com/). Similarly, German vitamin supplier and HIV denier Matthias Rath not only pushed his vitamins as a treatment for AIDS , but his spokesman refused to be interviewed by Nature Medicine about the case because he claimed the journal is â€œfunded to the hilt with drug moneyâ€ .
Deniers argue that because scientists receive grant money, fame, and prestige as a result of their research, it is in their best interest to maintain the status quo . This type of thinking is convenient for deniers as it allows them to choose which authorities to believe and which ones to dismiss as part of a grand conspiracy. In addition to being selective, their logic is also internally inconsistent. For example, they dismiss studies that support the HIV hypothesis as being biased by â€œdrug money,â€ while they accept uncritically the testimony of HIV deniers who have a heavy financial stake in their alternative treatment modalities.
Portraying Science as Faith and Consensus as Dogma
Since the ideas proposed by deniers do not meet rigorous scientific standards, they cannot hope to compete against the mainstream theories. They cannot raise the level of their beliefs up to the standards of mainstream science; therefore they attempt to lower the status of the denied science down to the level of religious faith, characterizing scientific consensus as scientific dogma . As one HIV denier quoted in Maggiore’s book  remarked,
â€œThere is classical science, the way it’s supposed to work, and then there’s religion. I regained my sanity when I realized that AIDS science was a religious discourse. The one thing I will go to my grave not understanding is why everyone was so quick to accept everything the government said as truth. Especially the central myth: the cause of AIDS is known.â€
Others suggest that the entire spectrum of modern medicine is a religion .
Deniers also paint themselves as skeptics working to break down a misguided and deeply rooted belief. They argue that when mainstream scientists speak out against the scientific â€œorthodoxy,â€ they are persecuted and dismissed. For example, HIV deniers make much of the demise of Peter Duesberg’s career, claiming that when he began speaking out against HIV as the cause of AIDS, he was â€œignored and discreditedâ€ because of his dissidence . South African President Mbeki went even further, stating: â€œIn an earlier period in human history, these [dissidents] would be heretics that would be burnt at the stake!â€ .
HIV deniers accuse scientists of quashing dissent regarding the cause of AIDS, and not allowing so-called â€œalternativeâ€ theories to be heard. However, this claim could be applied to any well-established scientific theory that is being challenged by politically motivated pseudoscientific notionsâ€”for example, creationist challenges to evolution. Further, as HIV denial can plausibly reduce compliance with safe sex practices and anti-HIV drugs, potentially costing lives, this motivates the scientific and health care communities to exclude HIV denial from any public forum. (As one editorial has bluntly phrased it, HIV denial is â€œdeadly quackeryâ€) . Because HIV denial is not scientifically legitimate, such exclusion is justified, but it further fuels the deniers’ claims of oppression.
Expert Opinion and the Promise of Forthcoming Scientific Acceptance
Although the HIV deniers condemn scientific authority and consensus, they have nevertheless worked to assemble their own lists of scientists and other professionals who support their ideas. As a result, the deniers claim that they are just on the cusp of broader acceptance in the scientific community and that they remain an underdog due to the â€œestablished orthodoxyâ€ represented by scientists who believe that HIV causes AIDS.
In an effort to support its claim that an increasing number of scientists do not believe that HIV causes AIDS, Reappraising AIDS has published a list of signatories agreeing to the following statement:
â€œIt is widely believed by the general public that a retrovirus called HIV causes the group [of] diseases called AIDS. Many biochemical scientists now question this hypothesis. We propose that a thorough reappraisal of the existing evidence for and against this hypothesis be conducted by a suitable independent group. We further propose that critical epidemiological studies be devised and undertakenâ€ .
These signatories do not, however, suggest who the â€œsuitable independentâ€ group should be, since, presumably, many scientists have already been â€œindoctrinatedâ€ into believing that HIV causes AIDS. (Indeed, many of the signatories to this statement lack any qualifications in virology, epidemiology, or even basic biology.) They also ignore thousands of epidemiological studies that have already been published in the scientific literature. And the signatories fail to provide a convincing case that there is widespread acceptance in the scientific community for their marginal position.
Nevertheless, Farber wrote in a 1992 article that â€œmore and more scientists are beginning to question the hypothesis that HIV single-handedly creates the chaos in the immune system that leads to AIDSâ€ . Similarly, a March 2006 article appearing on the AIDS denial Web site â€œNew AIDS Reviewâ€ claims that, in reference to the theory that HIV causes AIDS: â€œâ€¦the fabric of this theoretical mantle is threadbare to the point of disintegrationâ€ . Mainstream scientists, of course, do not believe in the imminent demise of the HIV theory; instead they continue to produce novel research on preventing and treating HIV and publish thousands of papers every year on the topic.
Further, deniers exploit the sense of fair play present in most scientists, and also in the general public, especially in open and democratic societies. Calling for a fair discussion of dissenting views, independent analysis of evidence, and openness to alternatives is likely to garner support, regardless of the context. But it is misleading for the HIV denial movement to suggest that there is any real doubt about the cause of AIDS.
Pushing Back the Goalpost
Of all the characteristics of deniers, repeatedly nudging back the goalpostâ€”or the threshold of evidence required for acceptance of a theoryâ€”is often the most telling. The strategy behind goalpost-moving is simple: always demand more evidence than can currently be provided. If the evidence is then provided at a later date, simply change the demand to require even more evidence, or refuse to accept the kind of evidence that is being offered.
In the 1980s, HIV deniers argued that drug therapy for AIDS was ineffective, did not significantly prolong survival, and in fact was toxic and damaged the immune system . However, after the introduction of a cocktail of newer and more effective agents in the 1990s, survival rates did impressively increase . HIV deniers no longer accept this criterion as evidence for drug effectiveness, and therefore the HIV theory of AIDS. Even stacks of papers and books published on the subject are not enough. Christine Maggiore writes in her book, â€œSince 1984, more than 100,000 papers have been published on HIV. None of these papers, singly or collectively, has been able to reasonably demonstrate or effectively prove that HIV can cause AIDSâ€ .
HIV deniers also arbitrarily reject categories of evidence, even though they are generally accepted across scientific disciplines. For example, they deny inferential evidence that HIV causes AIDS, including data examining the closely related simian immunodeficiency virus (SIV) in genomic and animal studies . Likewise they reject correlation as insufficient to establish causation . However, multiple independent correlations pointing to the same causationâ€”in this case that HIV causes AIDSâ€”is a legitimate and generally accepted form of epidemiological evidence used to establish causation. The same type of evidence, for example, has been used to establish that smoking causes certain types of lung cancer.
What Are Their Alternatives?
After so much criticism levied upon the prevailing theories by deniers, one might think they would have something to offer to replace HIV as the cause of AIDS. However, the alternatives they offer are much more speculative than the mainstream theories they decry as lacking evidence. Further, their arguments amount to little more than another logical fallacy, the false dichotomy: they assume that overturning the prevailing theory will prove their theory correct, by default.
Interestingly, alternative hypotheses for AIDS causation depend on where the patient lives. In Africa, HIV deniers attribute AIDS to a combination of malnutrition and poor sanitation, i.e., they believe that AIDS is simply a relabeling of old diseases. In America and other wealthy countries, they claim AIDS is caused by drug use and promiscuity. Duesberg has long been an advocate of the idea that the use of â€œpoppers,â€ or amyl nitrate, is a cause of AIDS in the gay community . With the identification of AIDS in individuals who have never used poppers, this hypothesis has been widened by HIV deniers to implicate a number of recreational drugs (cocaine, crack, heroin, methamphetamines) as well as prescription drugs such as antibiotics and steroids in the etiology of AIDS. HIV deniers have criticized the idea that immunosuppression due to infection with HIV could result in all of the different infections that characterize AIDS, and yet they support the idea that poppers or other drugsâ€”including many that have not been shown to cause severe immune deficienciesâ€”could cause AIDS. In the past decade, the very drugs used to treat HIV/AIDS have come under fire by HIV deniers, who have suggested that the medicines themselves are a cause of AIDS (http://www.aliveandwell.org/) .
Because these denialist assertions are made in books and on the Internet rather than in the scientific literature, many scientists are either unaware of the existence of organized denial groups, or believe they can safely ignore them as the discredited fringe. And indeed, most of the HIV deniers’ arguments were answered long ago by scientists. However, many members of the general public do not have the scientific background to critique the assertions put forth by these groups, and not only accept them but continue to propagate them. A recent editorial in Nature Medicine  stresses the need to counteract AIDS misinformation spread by the deniers.
While the descriptions of HIV denialism above refer to relatively organized campaigns, there are other less orchestrated examples of such denialism. A recent study, for example, showed that a large percentage of African Americans are suspicious of mainstream AIDS theories due to a general distrust of government authorities . Arguments by denial groups may have played a role in the formation of their opinion. Indeed, the effect of denial groups on public perception of HIV infection is an area ripe for careful research, as this denial can have lethal consequences. In the recent study, stronger conspiracy beliefs were significantly associated with more negative attitudes towards using condoms and with inconsistent condom use, independent of selected sociodemographic characteristics, partner variables, sexually transmitted disease history, perceived risk, and psychosocial factors .
How much of this lingering denial is the fault of scientists and the media for originally proclaiming AIDS a universal â€œdeath sentenceâ€? Even though this idea may no longer appear in the scientific literature, it remains a public perception of the disease. It is difficult to strike the correct balance between providing information conveying on one hand the severity of the disease, and on the other optimism about treatment and advances in understanding HIV pathogenesis (including research about individuals who may indeed be somewhat resistant to the virus). Oversimplifying AIDS science to the public lends itself to exploitation by AIDS deniers who remain â€œalive and wellâ€ years after diagnosis with HIV. Yet these concerns must be balanced with the desire to convey the proper gravity of the situation and motivate those who are known to be HIV positive to seek treatment: a difficult line to walk.
This balancing act, in fact, deserves increasing attention from medical scientists in the age of the Internet and a broadening gap between the practice of science and public understanding of science. Successful public health education requires the presentation of a clear and simple message supported by a solid consensus of the medical community. Yet the reality behind the scenes is often quite different. Every medical field has its legitimate controversies and complexities, and the process of science is often messy. Denial groups exploit the gap between public education and scientific reality.
Further, countering the misinformation of HIV deniers needs to be conducted in the broader societal context of countering anti-science and pseudoscience. The strategies of HIV deniers, like many other denialist movements, seek to undermine the very philosophy of science itself, to distort public understanding of the scientific process, and to sow distrust of scientific institutions. Unscientific alternative medical modalities have made significant inroads into the institutions of health care through political means, despite a continued lack of scientific legitimacy: vaccines are characterized as dangerous instead of life-saving; psychiatry is mocked by celebrities and others in the public eye. Meanwhile, many leaders in science and business are concerned that the United States is losing its edge as a scientific powerhouse.
There remains a deep problem of overall scientific illiteracy in this country and others, creating fertile soil for those who wish to spread scientific misinformation . The scientific community must collectively defend and promote the role of science in society, and combat the growing problem of scientific illiteracy. We must all strive to do our part to make science accessible to the general public, and to explain the process by which scientific evidence is gathered, analyzed, and eventually accepted, and academic institutions should provide greater incentive for their researchers to expend the time and effort to do so. A solid understanding of the scientific method may not eliminate science denial, but it may act as a buffer against the further spread of such denialist beliefs.
Example of a typical slogan from an HIV denialist group
1. Sidley P (2000) Mbeki appoints team to look at cause of AIDS. BMJ 320: 1291. Find this article online
2. Mbeki T (1999) Address to the National Council of Provinces, Cape Town. Available: http://www.dfa.gov.za/docs/speeches/1999/mbek1028.htm. Accessed 16 July 2007.
3. Cherry M (2000) Mbeki agrees to step back from AIDS debate. Nature 407: 822. Find this article online
4. Sidley P (2001) Mbeki plays down AIDS and orders a rethink on spending. BMJ 323: 650. Find this article online
5. Wohlfeiler D, Lew S, Wilson H (2000) Enough of ACT UP S.F. acting out. San Francisco Chronicle. Available: http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2000/09/21/ED83985.DTL. Accessed 16 July 2007.
6. Talvi S (2000) Foo Fighters, HIV deniers. Mother Jones. Available: http://www.motherjones.com/news/feature/2000/02/foo.html. Accessed 16 July 2007.
7. Group for the Scientific Reappraisal of the HIV-AIDS Hypothesis Available: http://www.virusmyth.net/aids/reappraising. Accessed 14 November 2006.
8. National Institute of Allergy and Infectious Diseases (2003) The evidence that HIV causes AIDS. Available: http://www.niaid.nih.gov/factsheets/evidhiv.htm. Accessed 17 July 2007.
9. AIDS Truth (2007) Debunking AIDS denialist myths. Available: http://www.aidstruth.org/debunking-denialist-myths.php. Accessed 17 July 2007.
10. Maggiore C (1997) What if everything you thought you knew about AIDS was wrong? Studio City (CA): Health Education AIDS Liaison. 126 p.
11. Gerhard S (2001) HIV-positive women birthing outside the system. Mothering Magazine. Available: http://www.healtoronto.com/mothering1001a.html. Accessed 17 July 2007.
12. Ribe J (2005) Autopsy report of Eliza Jane Scovill. Available: http://www.ratbags.com/rsoles/comment/maggiorecoroner.pdf. Accessed 17 July 2007.
13. ABC News (2005) Did HIV-positive mom’s beliefs put her children at risk? Available: http://abcnews.go.com/Primetime/print?id=1386737. Accessed 17 July 2007.
14. Duesberg P (1987) Retroviruses as carcinogens and pathogens: Expectations and reality. Cancer Research 47: 1199â€“1220. Find this article online
15. Farber C (2006) Out of control: AIDS and the corruption of medical science. Harper’s Magazine. Available: http://www.harpers.org/archive/2006/03/0080961. Accessed 17 July 2007.
16. Farber C (2006) Serious adverse events: An uncensored history of AIDS Hoboken (NJ): Melville House. 345 p.
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