Those of us in the skeptical community are no strangers to whacko medical theories. It seems every week there is another quack promoting a new "naturalistic" diet or treatment. By far, though, the brunt of a skeptic's time is dealing with denialism – groups of individuals denying that contemporary medical practices don't work or are even dangerous. In the last few years, the anti-vax denialists have been in the media spotlight due to their elaborate campaigns and the outspoken celebrities like Jenny McCarthy who have taken up the anti-vax fight. But there is another camp of deniers festering away in the underbelly of alternative medicine. These people are the AIDS deniers; people who claim that AIDS is not caused by the HIV virus, but rather that it is actually caused by drug use. Some even go so far as to claim that HIV does not exist! Given the horrifying prevalence of AIDS in third world nations and even its alarming proliferation in developed nations, increasing support for AIDS denialism is not simply worrying but outright dangerous.
AIDS denialism has been known to me for some time, having learned about it from reading about Nobel Prize winner Kary Mullis, who is one of AIDS denialism's best known proponents. Though, given Mullis' colorful personality I figured he was just a lone crank. It was not until this past week when a good friend of mine, SofiaRune, began to get comments on a Youtube video she produced about debunking the link between HIV infection rates and male circumcision. A user by the name of "mykoolaidtastesfunny" made a variety of claims about how AIDS and HIV are not linked, and how HIV has not been shown to exist. He also posted a video by a variety of AIDS "skeptics" repeating his points. Immediately we began to investigate these claims. In the following series of posts, I'll address the claims of the AIDS "skeptics". In Part I, I will focus on the video that started it all…
Mullis and More: A Menagerie of Morons
The video that was posted is as follows:
Note that I will only critique the claims made by the scientists in this video. It's not worth my time to debunk the two journalists in the video since they are not the ones making any scientific claims (especially the first one, Neville Hodgkinson, who's entire argument boils down to "I spent a week in the lab of an unnamed German scientist and he showed my unexplained data which I now believe".)
Kary Mullis: Mullis is a man known to virtually everyone in biology. His claim to fame is winning the Nobel Prize in Medicine and Physiology for the development of PCR. However, as a perfect example that even eminent scientists can hold completely insane beliefs, Mullis also believes in astrology, denies anthropogenic global warming, and believes he has conversed with an alien in the form of a glowing raccoon. He is also completely convinced that he will die in the presence of redwood trees, and is thus completely reckless when redwoods are not around, going so far as to ski down the centre of a highway far from the sight of a redwood. In the video, Mullis recalls the tale of applying to a grant from the NIH and needing to find a source for the claim that AIDS is caused by HIV. He claims that he did a search through the literature but look as he may, he could not find one. Furthermore, he claims to have asked Luc Montagier (one of the co-discoverers of HIV, along with Robert Gallo) and Montagier was unable to provide him with any sources. Shocked that there was no source for the HIV/AIDS link, Mullis became a skeptic and has denied a relationship between the two ever since. Whether or not this story is true, I have no way of telling. But it is possible to do a search of the literature to see if there are any papers showing the link between HIV and AIDS. And does Mullis' claim stand up to scrutiny?Hell no.
A very preliminary search on PubMed allowed us to find 6 different papers1 which show a link between infection with HIV and AIDS, more than enough necessary to support the claim that AIDS is caused by HIV. All of these papers were published between the years of 1985 and 1993, so many – if not all of them – were available to Mullis at the time he was writing his grant application2. Either Mullis is incapable of doing a cursory search of scientific literature, or he isn't being entirely honest with his story. I'm inclined to believe the latter.
But I'm feeling generous. Let's give him the benefit of the doubt; maybe some of these papers had yet to be published, and perhaps he didn't have access to the journals the other papers had been published in. Perhaps Mullis could be excused for being skeptical at the time. But what about now? Those papers, and many others, are now readily available. Arguing that there was no evidence available two decades ago doesn't mean much today. Saying "Oh HIV doesn't cause AIDS because I did a search of the literature twenty years ago and found no proof" is akin to arguing that evolutionary theory is flawed because Darwin's original work from 150 years ago wasn't entirely accurate. Such an argument completely ignores scientific findings and advances made since then. This argument fails because there ARE papers that show AIDS is caused by HIV, those papers have been published as far back as 1983, and such papers continue to be published. Someone hand the deniers a copy of "Searching PubMed for Dummies".
Rodney Richards: Richards is a biochemist who founded the biotech company AMGen (though, I am assuming this is true – the only references to him I could find on Google all come from AIDS denial websites…). Richards begins talking about Peter Duesberg, the granddaddy of the AIDS denial movement (more on him later). He recalls his time at AMGen when Duesberg was invited to give a seminar. According to him, Duesberg's talk was boycotted by the other scientists working at AMGen. He notes that he thought this was odd and it prompted him to "go to the library". What did he find in his research? He doesn't say. Richards actually does not make an argument at all. He just says "that was 12 years ago and I've been studying this issue ever since". What Richards is doing is a subtle argument from authority; he is basically saying "I'm a scientist who has studied AIDS for 12 years, and I don't believe in it, therefore you can be confidant that HIV does not cause AIDS". He doesn't need to present an argument because his sycophants will simply hide behind his status as a scientist with a PhD.
He also implies that the truth about AIDS is being covered up by some scientific conspiracy, a notion that is common with alt-med movements. Such an argument, however, is laughable, considering that in the past, the editor-in-chief of Science has explicitly stated his support for Duesberg's right to air his views and to do his research, going so far as to voice his support for Duesberg's grant applications3 (he was not, of course, agreeing with Duesberg's views). It is not surprising, though, that scientists don't want to listen to Duesberg's claims. For scientists, the issue is settled – AIDS is caused by HIV. There is ample evidence built up over the last 30 years that shows this to be the case. It is the same reason why evolutionary biologists don't invite creationists to speak at evolutionary biology conferences; their claims are not supported by the scientific evidence and are a waste of time to deal with. This should not be confused with some sort of conspiracy to silence the anti-AIDS crowd. They have every right to express their views – and maybe when they have some real evidence, we'll listen.
Christian Fiala: As I watched Fiala's portion of the video I quickly began to ask myself "How on Earth did this man ever get a PhD?" Fiala's argument is so incredibly wrong that it is hard to believe that his segment isn't satire. In case you didn't catch his argument due to a massive brain haemorrhage from stupid overload, it goes like this: HIV spread to the heterosexual population in the 80s from the homosexual population. This is unlikely, he says, because the virus' method of transmission is predetermined and does not change easily. How did the virus know, he muses, that the risk group was almost all affected and it had to "break out" into a new population? Fiala claims that transmission from the homosexual population to the heterosexual population would require the virus to gain some sort of sentience and realize it needs to move out. This is impossible so, he claims, the appearance of AIDS in heterosexuals could not have been caused by HIV.Are you done laughing?
The virus, of course, does not need to have some kind of sentient knowledge of its situation to transfer from one population to the other. In fact, we know EXACTLY how the virus moved into the heterosexual population. Blood samples used for blood transfusion are now closely screened for HIV, but back in the 80s, before we really knew much about the virus, it wasn't. Many members of a subset of the homosexual community were frequent blood donors, and their samples would have all been tainted. For people with haemophilia, blood transfusions can be an important life saving procedure, and in many instances, blood from HIV positive samples was used. It wasn't long until AIDS began to show up in haemophiliacs, and then in the general population. At no point did the virus knowingly decide to move into another population, and at no point did the mode of transmission change. The movement of the virus through populations is well known and well documented, so Fiala's argument falls flat on its face.
Peter Duesberg, Kingpin of Denial: Rodney Richards, in his video appearance, mentions a man by the name of Peter Duesberg. Anyone who looks into the AIDS denialist issue is bound to come across references to him; his name has practically become synonymous with the AIDS "skeptic" movement. In 1987, Duesberg published a paper in the journal Cancer Research4 where he claimed that HIV is simply a harmless passenger virus5. At that time, there was much not known about how the HIV virus causes AIDS, and Duesberg could perhaps be excused for being skeptical at the time. Nevertheless, the uncertainty in what mechanism the HIV virus utilized was dwarfed by the voluminous epidemiological data that suggested HIV as the cause. In the years following, the precise molecular mechanism of HIV's virulence has been elucidated, and there really is no longer any cause for skepticism. Duesberg nonetheless clings to his beliefs.
So what does Duesberg attribute AIDS to, if not to HIV? He and his followers believe that AIDS is actually caused by drug use – particularly intravenous drugs and nitrite inhalants – as well as malnutrition. There are many reasons why this cannot be the case. If AIDS is caused by drug use, then why is it that all drug users do not contract AIDS? And of the subset of drug users that do get AIDS, why do they all test positive for HIV? Why do we only find HIV in people who have AIDS or eventually progress to AIDS, if it is just a harmless virus with no real pathology? Why does AIDS pass from mother to child if it is not due to a transmissible pathogen? Surely newborn infants are not heavy drug users. These questions need to be addressed by Duesberg if he wishes his ideas to have any kind of validity, and to date, neither Duesberg nor his followers have been able to adequately provide a response.
Why does Duesberg continue to be a boil on the face of AIDS research if his ideas are patently ridiculous? Perhaps it is due to the false sense that his ideas are taken seriously by other members of the scientific community. Many AIDS "skeptics" will frequently cite numbers of scientists that supposedly support Duesberg. But these are often lists of scientists that do NOT believe Duesberg is correct on the AIDS/HIV issue; they merely support his right to investigate the issue and to voice his opinions. The credibility of his scientific views is falsely inflated this way.
These are the prominent faces in the AIDS denialist world. Continuing on into Part II, I'll look at Koch's Postulates, how they relate to AIDS, and how they confirm that HIV really is the cause.
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- Those papers are as follows:-Fauci A.S. "Multifactorial nature of human immunodeficiency virus disease: implications for therapy". Science 1993.262:1011-1017.
-Weiss R.A. "How does HIV cause AIDS?" Science 1993.260:1273-1278.
-Gallo R.C., Satin P.S., Gelmann E.P., Roberto Gumff M. "Isolation human T-cell leukemia virus in acquired immune deficiency syndrome (AIDS)". Science 1983. 220:865-867.
-Gallo R.C. et al "Frequent detection and isolation of cytopathic retroviruses (HTLV-III) from patients with AIDS and at risk from AIDS". Science 1984. 224:500-503.
- Schechter M.T. et al "HIV-1 and the aetiology of AIDS". British Columbia Centre for Excellence in HIV AIDS, Vancouver, Canada, Lancet 1993. 341:658-659.
- Weiss R.A., Jaffe H.A. "Duesberg, HIV and AIDS". Nature 1990. 345:659-660.
- Actually, with a little math, we can see that all of these papers were available to Mullis, at least at the time his clip was filmed. As you will see in the clip with Rodney Richards, Richards claims that he has been researching AIDS and HIV for 12 years. Robert Gallo's papers which linked HIV with AIDS was published in 1983. If Richards began his research that very same year, then his clip was filmed 12 years later, in 1995 (that is, of course, the earliest it could have been filmed – it may have been filmed at an even later point). It is not unreasonable to think that Mullis' part was filmed around the same time. So, at the very earliest, Mullis' clip was filmed in 1995, after all of the papers had been published. He has no excuse for making the claims he does.
- Cohen J. "The Duesberg phenomenon". Science. 1994 (Issue 266, 1642-1644)
- Deusberg P. "Retroviruses as carcinogens and pathogens: Expectations and reality". Cancer Research Issue 47 (1987)
- Gallo has actually challenged Duesberg to infect himself with HIV, if he really believes so strongly that it is harmless. Duesberg has, of course, backed down from this challenge, saying he could never get the proper approval of an ethics board to do it.
31 comments:
Great post! Revealing the insanity behind AIDS Denialism is the best way to keep people from falling into the false hope and lies that AIDS deniers spread. Not sure where you found that picture of Mullis in his panties, but that is what I mean by revealing!
What is it about the Nobel and AIDS? Luc Montagnier is the latest Prize winner to lend a hand to denialism. He has made some strange comments about HIV and is studying homeopathy and other oddities. What is up with that?
Thanks! Debunking the nonsense deniers espouse is definitely the best way to help make sure more people aren't hurt by them. It's unfortunate that the general public lacks the critical thinking skills necessary to see the flaws in their arguments, which makes it all the more neccessary that we keep it up.
As for Montagnier and his newfound love for all things homeopathic, it confounds me how someone who is rational in all other respects can be so completely irrational when it comes to homeopathy. He's a striking example of why the Argument from Authority fails; even Nobel laureates can be kooks!
I'm not surprised that HIV denialists gravitated toward SofiaRune's dismissal of the high-quality empirical work showing that circumcision decreases HIV transmission risk. By sarcastically questioning the scientific consensus ("let's assume that correlation and causation are the same thing"? No; let's do a set of large, experimental trials that prove the causal effect is real and very large) she gives fuel to their view that the science of HIV is far more unsettled than it really is.
Male circumcision definitely needs further study, mainly in terms of implementation. Mockery has no place in that discussion, nor does ignoring the data.
Umm, excuse me, but Dr. Fiala is RIDICULING the idea of a sentient virus.
Since his real views are absolutely nothing like what you've described and you didn't bother to do any actual fact-checking (or thinking, or listening), I have to assume the rest of your rebuttal is total crap too.
http://vorige.nrc.nl/international/Opinion/article1984104.ece/AIDS_are_we_being_deceived
http://www.altheal.org/statistics/fiala.htm
Joyce
Please.
Consider for a moment the sane world in which most of us live.
Does it really matter if Fiala said exactly one thing or another about the virus?
Dr. Fiala is an AID Denier and there is no sense quibbling over the details of what he may have said at one point or another. AIDS Denialists change their tune and change their facts. It is called moving the goal posts, misstating reality, etc. We could spend a lifetime ‘debating’ what an AIDS denialist may have meant at one time or another. Have you ever challenged the delusions of a person with schizophrenia? It is not a very productive use of time.
In case you have any doubt about whether Fiala is an AIDS Denier…read about the Rethinking AIDS Society…he sits on the Board of Directors. Also, check out his 2008 article “Aids: are we being deceived?” in which he says.. “We are still being told that Africa suffers a devastating AIDS epidemic. The gigantic numbers of infections yield gigantic amounts of public funds for research and thus researchers. What scientific judgement can we expect from experts who stand for a broad-based conviction that guarantees their income?”
When Einstein said "The important thing is not to stop questioning", I doubt he meant questioning reality.
Seth Kalichman
http://denyingAIDS.blogspot.com
@joyce: I think you missed the point about Fiala entirely. Yes, he is ridiculing the idea of HIV gaining sentience, and that is the basis for his argument in the video clip. He is saying "The HIV virus would have to somehow KNOW it needs to spread into another population. Isn't this absolutely ridiculous?! There is no way it could have happened! So HIV didn't spread and cause AIDS in other populations." What he has done is create a giant strawman argument. Of course the idea is ridiculous! Too bad for him the idea is also incorrect.
It's sort of like creationists claiming evolution is false because we dont find any "Crocoducks" in the fossil record. They ridicule the idea of such creatures, and claim that since they cannot have possibly existed, evolution is false. It's a strawman argument.
Whether Fiala still uses this argument, I don't know. I was only concerned with addressing his argument as presented in the video.
Seth: I challenge you to cite a single example where Dr. Fiala has ever "changed his tune" or "changed his facts." Anyway, I can tell by your insults that you don't know him and know little if anything about him, so your remarks have zero credence.
CWGK: Dr. Fiala is using the sentience point as a satirical analogy - obviously he's not saying that's the actual scientific argument employed by AIDS scientists. Also, it should be self-evident that his brief comments in that video clip lack context and shouldn't be judged so superficially. As far as I understand his views, his underlying premise here is that while HIV transmission has always been by sexual means (or blood), and researchers have always predicted an epidemic spreading into heterosex populations, that's only happened in Africa. So he challenges the alleged heterosex spread of HIV in Africa in part because he believes there's no credible explanation for why it would happen in Africa and nowhere else (except for the belief that African sexuality is uniquely promiscuous, which he rejects as racist and unwarranted). Hence his satirical analogy to a sentient virus that has decided to selectively infect black heterosexuals in Africa but not elsewhere for the most part.
Note that I'm not claiming he's right. I'm just reporting his point of view to the best of my knowledge.
@Joyce:
Whether Fiala's comments in the video are out of context, and whether or not he actually professes these views is irrelevant in the scope of what I have written. His comments in the video were presented (not by Fiala himself, but by another AIDS denier)as evidence that HIV does not cause AIDS. I have debunked the argument in this context.
As for the situtation in Africa being due to a "unique promisquity", I would not argue that, but I would argue that the AIDS epidemic in Africa does persent a (largely) unique case. Much of the spread of AIDS in Africa can be attributed to many factors that are not present in other parts of the world. We only began to really understand HIV and AIDS when it was just beginning to become an issue in the Western world, but by that time, it had already become epidemic in parts of Africa. We utilized our knowledge - and continue to do so - to prevent the same sort of outbreak here. Furthermore, it is only in Africa where you have authority figures in both the government and in the clergy telling the public that condoms help spread AIDS instead of prevent it. Africa also lacks the AIDS awareness and prevention programs that are available elsewhere. Given these factors, it is not surprising that the spread of AIDS to the heterosexual population occured in Africa much more easily than it did in other places.
And to claim that AIDS has not spread to heterosexuals in other places is just plain nonsense. It has not become an epidemic as it has in Africa (for the above reasons), but it has become a problem in heroin users and was for a time an issue in the haemophiliac population - populations I am sure are not entirely composed of homosexuals.
So if Fiala's argument is actually that HIV cannot cause AIDS because 1)it's only spread into the heterosexual population in Africa and nowhere else, and that 2)there is no reason for this discrepency, then he really shows his ignorance of the situtation in Africa. For someone who works in Uganda, I would expect better of him.
In your original post, you certainly did not "debunk the argument" and your only "context" was to label Fiala as a "denialist." You used that as a pretext to dismiss his views without having to refute them or even find out what they were. You used it as an entitlement to ridicule him and insult him personally.
Accusations of "denialism" say far more about the fears and weakness of the accuser than the accused. It's just a weasel word used by bullies and cowards.
I gave you a couple of links to Dr. Fiala's work. Instead of passing judgment based on your simplistic speculations about his views and findings, why don't you just read them yourself? It seems like you might be capable of taking off the ideological blinders for a moment - unlike Kalichman, who arrogantly and obliviously gave me the same link to Fiala's article that I had just posted myself. (Bizarrely, Kalichman quotes a couple of Fiala's excellent and damning points without offering any refutation - it's as if he believes anything Fiala says is automatically silly and false simply because he sees Fiala as a "denialist." How pathetic and laughable!)
Regarding the possible factors you list to help explain the heterosex spread of HIV in Africa, good. I'm glad you're thinking beyond the common assumption that it's because of a unique African promiscuity, and you even state that you wouldn't argue that. Aren't you treading on dangerous ground though, by agreeing with a "denialist?" Because if a "denialist" might have a point about one thing, it means they might have other points worth listening to. It means you can't completely dismiss them out of hand, as Kalichman does.
I'm sure we agree that not every aspect of science and research is 100% accurate and beyond question, that scientists can make mistakes, and that the science of HIV/AIDS is not exempt from error. The sad thing is, even if most aspects of HIV/AIDs science are correct, many valid scientific critiques and questions that would help improve the accountability and robustness of the science get sidelined simply because they're perceived as coming from "denialists," or never get broached at all out of fear of being accused of denialism. Subjecting dissenting scientists to personal attacks is an abuse of science that can only slow progress and reinforce wrong directions, and probably cost lives.
Fiala is on the board of Rethinking AIDS, one look at their website is sufficient to determine whether anything he says should be taken seriously. The fake "documentary" film House of Numbers, which this clip is an extra from, was funded by Rethinking AIDS, then they lied about it:
http://www.tig.org.za/Minutes_RA2006.htm
http://www.guidestar.org/FinDocuments//2006/311/688/2006-311688738-0314e401-F.pdf (see page 11)
http://www.rethinkingaids.com/Content/QA/tabid/160/Default.aspx
There's a very straightforward potential explanation for why the efficiency of heterosexual transmission of HIV is increased in Africa: activated CD4 T cells are more easily infected, and background levels of CD4 T cell activation (including genital tract CD4 T cell activation) are higher on the African continent compared to elsewhere. There is strong evidence that the same mechanism underlies the consistently observed 2-3 fold increase in risk of HIV acquisition associated with HSV-2 infection; there are higher levels of activated, susceptible CD4 T cells in the genital tract engaged in the local surveillance of HSV-2.
http://www.ncbi.nlm.nih.gov/pubmed/20588163
http://journals.lww.com/aidsonline/Fulltext/2000/09290/Immune_activation_in_Africa_is.3.aspx
http://journals.lww.com/aidsonline/Fulltext/2006/01020/Herpes_simplex_virus_2_infection_increases_HIV.11.aspx
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2723183/?tool=pubmed
Thanks rj. Re Fiala and Rethinking AIDS, you don't have a point. Guilt by association is not an argument, it's a logical fallacy (as is ad hominen). I find it suspicious that pseudoscientific tactics are frequently required to defend HIV/AIDS science from the "denialists."
Second, the sources you gave indicate only that Rethinking AIDS once attributed Leung's funding to "private sources." That's not a lie, it's an omission. It's unfortunate they didn't mention their contribution, on the other hand, where's the crime exactly? Leung surely had a variety of private funding sources as it costs far more than $25,000 to make a film, and I don't see the relevance of the sources since the film should be judged on its own merits. Instead, it's usually dismissed with "denialist" type accusations like yours. Another example of a pseudoscientific response - and worse than unconvincing to people on the fence like me. You know, almost everything people like Kalichman and John Moore say makes me more sympathetic to HIV "denialism" because such tactics point to scientific weakness, not strength.
I've seen the film and it's a very well done documentary. Interviewing people who don't agree with the establishment doesn't make it "fake," it just makes it unpopular with the establishment. I don't agree with everything in the film and am skeptical about other things in it, but I've yet to see a worthwhile rebuttal to it (see further note below). It's almost all just defensive ad hominen like yours, or it's complaints about being taken "out of context" - another meaningless accusation that avoids having to address the real issues. Besides, Leung has openly released his full extended interviews, so the out-of-context claim is BS as well as weak.
As far as I know, there's been just one real attempt to rebut the film by Jeanne Bergman: http://www.aidstruth.org/features/2009/real-answers-fake-questions-“house-numbers”. However, it's too brief to properly address the film's claims (much of what she says doesn't really address the underlying arguments by HIV dissenters; her only point that satisfies me is the one on the use of risk factors in testing and diagnosis). She also makes a number of inaccurate statements and baseless assertions, she confuses and conflates HIV and AIDS, and like most orthodox believers, she repeatedly uses unsupported words like "conclusive" and "overwhelming" as props for the faith. If this is the best that the AIDS establishment can do, I'm justified in taking the film seriously.
Thanks for your interesting points on heterosex transmission of HIV in Africa. I'll pass those on to Dr. Fiala. I'm not a scientist, but what occurs to me on reading the abstracts is that these findings seem consistent with the hypothesis that HIV is a marker of immune dysfunction/activation, rather than the cause of AIDS itself. Further, your second link says: "Immune activation in African residents is environmentally driven and not genetically predetermined." This does not explain the higher rate of HIV infection in American blacks, and it also implies that HIV is just one factor in causing AIDS, and/or that environmental factors could reduce HIV infection or even clear it.
Pointing out the fact that Fiala is on the board of an organization that promotes outrageous misrepresentations and lies about the scientific literature is not guilt by association, it's just guilt.
The film House of Numbers interviews people whose organization funded it, without disclosing that fact, or even disclosing that they're all members of the same organization. This is a fundamental breach of documentary filmmaking ethics, which renders the film not a documentary but AIDS denial propaganda.
"these findings seem consistent with the hypothesis that HIV is a marker of immune dysfunction/activation"
Only a lot of that activation is HIV-specific e.g.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC356973/?tool=pubmed
and when HIV is suppressed, activation declines precipitously in close parallel e.g.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1951290/?tool=pubmed
http://www.liebertonline.com/doi/abs/10.1089/aid.2010.0200
Environmental immune activation doesn't cause AIDS, immune activation caused by HIV infection does. See this recent review for a broader discussion of biological factors and racial disparities in HIV prevalence:
http://www.ncbi.nlm.nih.gov/pubmed/21223426
It's much better to read papers rather than abstracts.
http://www.nashvillescene.com/nashville/controversy-lingers-after-premiere-of-nashville-directors-aids-documentary/Content?oid=120095
"'I didn't imagine the intense polarities that existed before the movie came out," says Leung, 29, via cell phone from a Starbucks in New York during a visit to his fiancée. 'I was a little taken aback. All I did was put up information as spoken.'
'Nobody was taken out of context,' Leung says. 'There was no hidden agenda.'"
http://www.tig.org.za/Minutes_RA2006.htm
“Motion on Funding: Bob Leppo moved that RA board authorize the RA foundation to make grants for a wider range of purposes, including films and video. Seconded by Charles Geshekter. Funding for each project would still have to be approved by a 2/3 majority of the board. Board members involved in a project would recuse themselves from such decisions. Unanimous agreement.
Roberto Giraldo moved that the RA foundation make grants for Brent Leung’s film based on available funds. Seconded by Christine Maggiore. Unanimous agreement.”
rj - I don't know anything about what the RA Board did so I can't speak to that, although I doubt you have the full or accurate story. Regardless, the film still stands on its own, and you seem to be using the issue about the funding as a way to avoid dealing with the film itself. Dismissing the film as "denialist" and hurling insults and accusations at the RA group is not a rebuttal - it simply arouses suspicion that maybe those "denialists" are really on to something. Arrogant bluster usually hides fear and doubt.
As for heterosexual transmission of HIV in Africa and higher prevalence in African blacks, Dr. Fiala says your argument amounts to "nonsense" because demographics and population growth contradict the existence of any HIV epidemic in Africa to begin with, at least in Uganda and South Africa. Besides the 2 links I gave in my first comment, he also gave me this one: http://www.bmj.com/content/327/7408/184.2/reply
I'll let him speak for himself, here's his email to me:
"Uganda was the first country hit by HIV/Aids, so we can oversee the longest time period. HIV/Aids was studied very well, HIV prevalence was quite high in the 90s, we can observe 'natural' disease progression as no drugs were available until recently, there has been little migration and no major event which would have had an impact on HIV. So where are we with HIV and Aids prevalence: HIV prevalence rose to around 16% in the general population in the 90s, then it came down. The increase of HIV was attributed to heterosexual activity. The reduction of HIV prevalence was attributed to ABC interventions. However all indicators of sexual activity remained stable over the last 30 years: age at first intercourse, age at first birth, number of children per woman. In other words there is no indicator that sexual activity changed over time or had anything to do with the dramatic rise and fall of HIV prevalence."
"Aids prevalence: Aids is diagnosed in Uganda based on the Bangui definition. This is a highly unspecific way to make a diagnosis. The number of Aids patients diagnosed and reported over the years is insignificant.
Then 'underreporting' is said to be widespread. Maybe. But no facts or proof is given. In any case there are no signs of increased mortality as a consequence of 16% of the general population being sentenced to premature death. On the very contrary: annual population growth rate rose from a record 2.5% to 3.4%. One of the highest growth rates in the world.
In other words, while PLFA (People living from Aids) claimed that Uganda was the first victim of a global Aids pandemic with an unprecedented mortality, in fact the biggest problem of Uganda is the unprecedented population increase. This increase is the result of a stable and high fertility combined with a stable or slightly reduced mortality."
"Last, all this development took place without any drugs being taken by the population. In essence, if HIV would be really more easy to be transmitted because of 'activated CD4 T cells', than we would expect a continuous prevalence. But even if one would accept that HIV is spread more frequently heterosexually, there is no indicator for a negative impact on the health status and survival."
"Concerning the claim of heterosexual transmission of HIV: frequently HIV and syphilis are tested in the same patients. And there is a strong negative correlation between these two, both over time and in geographical distribution. This can be found not only in Uganda, but also in South Africa and Thailand. Negative correlation means those regions with the highest HIV prevalence have the lowest syphilis prevalence and vice versa."
Fiala either can't express himself clearly in English or is totally barking mad. Take your pick.
You struggle to think how anyone could come up with such a series of random speculations and attempt to join them up into a hypothesis.
Well, to answer your questions Jonny, Dr. Fiala is German-speaking and lives in Austria, and if it's a "struggle" for you to understand his overview, I suggest looking at his more detailed research and evidence in the links I provided, e.g.: http://altheal.org/statistics/fiala.htm
How many references does Fiala make to the published scientific literature in that document? I count one cite, to a study in JID. The rest is woeful extrapolation and speculation about Newsweek articles and surveillance reports. And it is apparently on this basis that he offers the blithely stated lie that "there is no indicator for a negative impact on the health status and survival."
See here for many studies of the impact of untreated HIV infection on mortality:
http://journals.lww.com/aidsonline/toc/2007/11006
Including these from Uganda:
http://journals.lww.com/aidsonline/Fulltext/2007/11006/Survival_of_HIV_infected_treatment_naive.3.aspx
Survival of HIV-infected treatment-naive individuals with documented dates of seroconversion in Rakai, Uganda
http://journals.lww.com/aidsonline/Fulltext/2007/11006/HIV_1_disease_progression_and_mortality_before_the.4.aspx
HIV-1 disease progression and mortality before the introduction of highly active antiretroviral therapy in rural Uganda
And prior published studies:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(94)90133-3/abstract
Two-year HIV-1-associated mortality in a Ugandan rural population
http://journals.lww.com/aidsonline/Fulltext/1997/05000/An_HIV_1_natural_history_cohort_and_survival_times.11.aspx
An HIV-1 natural history cohort and survival times in rural Uganda.
So you have data like this:
“The age-standardized mortality rates per 1000 person-years for the prevalent, incident, and negative cases were 156.5 [95% confidence interval (CI), 115.8-211.4], 35.0 (95% CI, 16.4-75.0) and 13.5 (95% CI, 7.3-25.1), respectively.”
Versus the statement: "there is no indicator for a negative impact on the health status and survival."
Heterosexual transmission has been documented in multiple studies, in Uganda and elsewhere, and the risk is consistently associated with STDs and HIV viral load levels. Against this, Fiala offers two surveillance reports on HIV and syphilis prevalence and says “The conclusion of these observations is obvious: HIV can not be heterosexually transmitted”(!). He does this because he thinks “one would expect a correlation of both diseases in geographical distribution and any change over time.” But syphilis is treatable and protective immunity leads to fluctuations in prevalence (e.g. see http://www.nature.com/nature/journal/v433/n7024/full/nature03072.html).
And look at table 3 here, from which Fiala carefully selected the 2000 data for the purposes of his specious propaganda: http://www.unwembi.co.za/doh/aids/syph-f.html
Then look at the fluctuations in syphilis prevalence both by region and time.
rj:
OBVIOUSLY this is just a big scientific conspiracy. I mean, clearly all of those studies are mere fabrications in order to make Fiala and other HIV denialists looks crazy because scientists have nothing better to do.
Seriously though I was going over Ms. Joyce's sources... it's interesting how most of it comes from 1990 or earlier... biiig surprise.
Also a note to the anonymous person who tried to make it out as if I was fudging information: I'm sorry you have difficult listening but when I said "let's assume correlation equals causation" I was actually referring to the "observational studies" which deemed the correlation between HIV infection rate and circumcision to be good evidence that circumcision prevents HIV infection. None of the information in that video is my opinion. I got it from peer-reviewed scientific literature which is sourced in the description bar... though I'm not surprised you couldn't be bothered to check it out. Good work. :P
Here are just s few of the published studies on heterosexual HIV transmission, see Pubmed for more: http://www.ncbi.nlm.nih.gov/sites/entrez
http://content.nejm.org/cgi/content/abstract/331/6/341
A longitudinal study of human immunodeficiency virus transmission by heterosexual partners.
N Engl J Med. 1994 Aug 11;331(6):341-6.
http://content.nejm.org/cgi/content/abstract/342/13/921
Viral load and heterosexual transmission of human immunodeficiency virus type 1.
N Engl J Med. 2000 Mar 30;342(13):921-9.
http://www.journals.uchicago.edu/JID/journal/issues/v181n4/991196/991196.html
Virus load and risk of heterosexual transmission of human immunodeficiency virus and hepatitis C virus by men with hemophilia.
J Infect Dis. 2000 Apr;181(4):1475-8.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2748905/
Virologic and immunologic determinants of heterosexual transmission of human immunodeficiency virus type 1 in Africa.
AIDS Res Hum Retroviruses. 2001 Jul 1;17(10):901-10.
http://www.ncbi.nlm.nih.gov/pubmed/11323041
Probability of HIV-1 transmission per coital act in monogamous, heterosexual, HIV-1-discordant couples in Rakai, Uganda.
Lancet. 2001 Apr 14;357(9263):1149-53.
http://jid.oxfordjournals.org/content/188/10/1492.long
Human immunodeficiency virus acquisition associated with genital ulcer disease and herpes simplex virus type 2 infection: a nested case-control study in Rakai, Uganda.
J Infect Dis. 2003 Nov 15;188(10):1492-7. Epub 2003 Oct 28.
http://www.ncbi.nlm.nih.gov/pubmed/2502150
Transmission of HIV to heterosexual partners of infected men and women.
AIDS. 1989 Jun;3(6):367-72.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1835678/
Risk factors for male to female transmission of HIV. European Study Group.
BMJ. 1989 Feb 18;298(6671):411-5.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1881972/
Effect of serotesting with counselling on condom use and seroconversion among HIV discordant couples in Africa.
BMJ. 1992 Jun 20;304(6842):1605-9.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1881672/
Comparison of female to male and male to female transmission of HIV in 563 stable couples. European Study Group on Heterosexual Transmission of HIV.
BMJ. 1992 Mar 28;304(6830):809-13.
http://www.ncbi.nlm.nih.gov/pubmed/8097789
Man-to-woman sexual transmission of HIV: longitudinal study of 343 steady partners of infected men.
J Acquir Immune Defic Syndr. 1993 May;6(5):497-502.
http://www.ncbi.nlm.nih.gov/pubmed/7744488
Male-to-female transmission of HIV in a cohort of hemophiliacs--frequency, risk factors and effect of sexual counseling.
Infection. 1995 Jan-Feb;23(1):29-32.
http://www.annals.org/cgi/content/full/125/4/324
Heterosexual transmission of HIV in Haiti.
Ann Intern Med. 1996 Aug 15;125(4):324-30.
http://journals.lww.com/aidsonline/Fulltext/1997/09000/Biological_correlates_of_HIV_1_heterosexual.2.aspx
Biological correlates of HIV-1 heterosexual transmission.
AIDS. 1997 Jul 15;11(9):1089-94.
http://journals.lww.com/aidsonline/Fulltext/1999/06180/Rates_of_HIV_1_transmission_within_marriage_in.12.aspx
Rates of HIV-1 transmission within marriage in rural Uganda in relation to the HIV sero-status of the partners.
AIDS. 1999 Jun 18;13(9):1083-9.
http://journals.lww.com/jaids/Fulltext/1999/06010/Heterosexual_Transmission_of_HIV_1_Is_Associated.7.aspx
Heterosexual transmission of HIV-1 is associated with high plasma viral load levels and a positive viral isolation in the infected partner.
J Acquir Immune Defic Syndr. 1999 Jun 1;21(2):120-5.
http://journals.lww.com/jaids/Fulltext/2001/07010/Mismatched_Human_Leukocyte_Antigen_Alleles_Protect.10.aspx
Mismatched human leukocyte antigen alleles protect against heterosexual HIV transmission.
J Acquir Immune Defic Syndr. 2001 Jul 1;27(3):277-80.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC135722/
Molecular epidemiology of human immunodeficiency virus type 1 transmission in a heterosexual cohort of discordant couples in Zambia.
J Virol. 2002 Jan;76(1):397-405.
Good point...AIDS Denialists can only cite work from before 1990. They are stuck in the 80's. It is sad that anyone would believe people like Duesberg and Fiala.
Choice...It is not that Fiala has changed his tune. He has consistently been a nut case. His words speak for themselves.
Seth Kalichman
http://denyingaids.blogspot.com
"Reality is that which, when you stop believing in it, doesn't go away." Philip K. Dick
Besides, the transmission of HIV from a homosexual to a heterosexual population does not necessarily have to have been by blood transfusion only. I don't believe that the shudders between the homo- and heterosexual populations need be so watertight as is assumed by attributing it solely to blood transfusion, I mean, Homosexuals CAN have sex with heterosexuals and vice versa - and they do I am sure. This may not be the primary reason for the spread from the former group to the latter, but I think it has taken place and could added to it nevertheless.
You're all complaining that Dr. Fiala's citations (http://www.altheal.org/statistics/fiala.htm) come from the 1990s. But the link I provided was to an older version of his presentation, from around 2003, and he uses the most recent data from 2000-01. Further, if you're dismissing his work based on the age of his citations, this obviously means that newer data must exist to refute his older data, but inexplicably, none of you provided it! In my view, this means that you've engaged in yet another obfuscating tactic to avoid having to deal with the evidence (who are the "denialists"?), and second, that newer data probably don't even exist and therefore Dr. Fiala's theory stands unrefuted. Thanks for confirming that for me.
Here's an updated version of Dr. Fiala's presentation given in 2009 at the RA conference (video): http://ra2009.org/media/qtdownload/RA_6_Fiala.mov
(Btw, I note that Kalichman appears to be the master of obfuscation here, as he claims that Fiala and "denialists" only cite work from BEFORE 1990 - a demonstrably false statement that reveals Kalichman's fundamental dishonesty in his attacks against "denialists".)
rj says: "But syphilis is treatable and protective immunity leads to fluctuations in prevalence (e.g. see http://www.nature.com/nature/journal/v433/n7024/full/nature03072.html)."
I don't understand what your point is. HIV is considered treatable too, people's susceptibility varies, and there are lots of fluctuations in HIV prevalence. The estimated numbers vary from place to place and from time to time. Your link talks about a rare endogenous factor in syphilis transmission, but doesn't dispute that syphilis is sexually transmitted.
rj says: "And look at table 3 here, from which Fiala carefully selected the 2000 data for the purposes of his specious propaganda: http://www.unwembi.co.za/doh/aids/syph-f.html Then look at the fluctuations in syphilis prevalence both by region and time."
The table at that source shows a steady overall decline in syphilis prevalence, just as Dr. Fiala said. Of course there are some regional fluctuations - just like with HIV infection. Also, newer data from South Africa continue to show the same overall pattern - a continued decline of syphilis in recent years, although much decreased compared to the 90s. There are some small fluctuations in the most recent years, but HIV rates have gone up and down a bit too, while remaining high and relatively stable. http://www.unaids.org/fr/dataanalysis/epidemiology/countryestimationreports/file,29278,fr..pdf
So the data still show a strong inverse correlation between HIV infection and syphilis infection. Dr. Fiala showed the same thing happened in Thailand, which you don't address.
rj, none of your links (your 12:40pm post Feb 6) address Dr. Fiala's other contention that AIDS is a collection of previous diseases, relabelled AIDS. Of course people are dying in Africa, but he believes it's from the same old causes as before - malnutrition, diarrhea, TB, parasites, malaria, etc. These all affect the immune system, so ill people would tend to test positive if HIV is an effect, rather than a cause, of a compromised immune system. I've noticed that the majority of HIV research, including your long list of links on sexual transmission (your 1:08pm post), simply assumes HIV is the cause of AIDS, rather than a symptom of a weakened immune system, or just one contributing cause among others. It seems to me that much of the data out there could be interpreted to support either of the latter hypotheses, and I don't see data showing that correlation definitely equals causation in the case of HIV and AIDS, or that HIV is definitely the only cause of AIDS.
Also, I'm a bit surprised that many of the studies you gave me (first batch) show long-term survival in a significant number of HIV positives without the use of ARVs. I thought HIV was a death sentence, and an especially quick one without drugs? I couldn't see that any of these studies adjusted for other factors, such as better healthcare or nutrition, presence of other diseases, etc., which would also affect peoples' survival rate. (Some found increasing mortality with age, but we don't need a study to prove that!) With a healthy environment and lifestyle, people can even clear HIV infection naturally. http://www.youtube.com/watch?v=WQoNW7lOnT4. Where are the studies showing that ARVs work better at prolonging life than a healthy lifestyle?
As for the 2nd batch of studies on sexual transmission, since sero-conversion between discordant couples seems relatively uncommon and difficult, how can the researchers know for sure that sero-conversions were actually the result of unprotected sex and not due to other factors? E.g., how do they know that consistent condom use reduces the risk of AIDS, when the type of people willing and able to use condoms consistently might differ significantly in other ways from those who can't? (I.e., lack of self-discipline probably correlates to poorer health, which would increase the risk of immune dysfunction and HIV positivity.)
Also, many of the studies you provide talk about other factors that influence transmission, including viral load, stage of HIV infection, presence of other STDs, genital ulceration, menstruation, "genetic variation at the human leukocyte antigen (HLA) loci", "variability in infectivity of the index case", and "susceptibility of the contact." I don't understand how the alleged causal factor of unprotected sex can be teased out from the multitude of other factors in a meaningful way that would allow one to conclude that HIV is primarily sexually transmitted in Africa.
"Dr. Fiala's other contention {is} that AIDS is a collection of previous diseases, relabelled AIDS."
Dr Fiala is simply wrong. AIDS is a single disease (of the immune system). The "collection of previous diseases" are AIDS-indicating. They are signifiers, not the thing that is signified. This is Semiotics 101, and is not that difficult.
"...so ill people would tend to test positive if HIV is an effect, rather than a cause, of a compromised immune system."
"Ill people" do not tend to test test HIV positive, unless they have the underlying immunodeficiency characteristic of HIV/AIDS. If you are trying to reverse the cause-effect relationship between HIV and AIDS then you have to address the the most basic rule of cause and effect - that causes always precede their effects. HIV negative people do not develop the illnesses that would be AIDS-defining in the absence of a positive HIV test, and then subsequently seroconvert for HIV: the sequence is always the other way around.
"Also, I'm a bit surprised that many of the studies you gave me (first batch) show long-term survival in a significant number of HIV positives without the use of ARVs. I thought HIV was a death sentence, and an especially quick one without drugs?"
The median "latency" between HIV infection and AIDS of about ten years has been known since the late 1980s, and essentially replicated in literally dozens of large natural history studies. Median means that half of people take longer than 10 years to develop AIDS. Why is this news to you more than 20 years after it was first established?
Snout, AIDS is not a single disease of the immune system. It is an immune deficiency SYNDROME marked by the presence of several symptoms, diseases, and conditions, out of a wide variety of possible ones. Which ones are expressed in a particular AIDS patient largely depends upon the geographical region and risk group. Here is a 2009 CDC list of opportunistic infections and other conditions that are "AIDS-defining" - www.cdc.gov/hiv/topics/treatment/MMP/pdf/MMP_2009_MRA_SPIF_v400_Jan5_2009.pdf (see page 4)
Every single one of these is its own illness or condition that can and does occur apart from HIV infection, and has treatment protocols that differ from HIV/AIDS. The problem is, AIDS can't even be properly defined - many different definitions are in use, and the WHO official case/clinical definitions are not used much in developing countries, e.g., parts of Africa still rely on the old Bangui definition to diagnose people. If AIDS can't be properly defined, it means it can't be properly diagnosed either. Except with an HIV test of course, but HIV itself (and the reliability of tests and what they are actually measuring) are the main bone of contention for the "denialists."
Regarding the reversal of cause and effect, I want to think about that some more, but it seems to me that there's a basic circularity built into the definition of HIV/AIDS, making your cause-and-effect a self-fulfilling prophecy. Being HIV positive has been made a necessary condition for AIDS, so by definition, unless the presumed "cause" is detected, there is deemed to be no "effect". But people can have symptoms that look just like AIDS and not be HIV positive, so they would not be diagnosed with AIDS (e.g., idiopathic cd4 lymphocytopenia, but it could just be a bad case of the flu). Conversely, many people have remained HIV positive and healthy for 15-30 years or more without drugs, so where is the effect for them? (long-term non-progressors).
Further, I often see claims that large numbers of people are HIV positive but don't know it (e.g., 1 in 5 in the US, roughly 200,000 people: http://news.change.org/stories/one-in-five-people-living-with-hiv-dont-know-it). But if HIV invariably leads to AIDS, this would mean that 1000's of Americans would be developing full-blown AIDS every year, before ever having had an HIV test. Which would make it difficult if not impossible to distinguish cause from effect - if you don't simply "assume" the HIV has been there awhile. (If you do, you're just self-fulfilling the prophecy of "HIV causes AIDS".) By the way, where ARE all those full-blown AIDS patients with no prior HIV test? They must make up at least 20% of all new AIDS cases - maybe up to a third in developing countries.
Joyce, a "disease" is a distinct abnormal physiological state causing distress and/or dysfunction. A "syndrome" is a collective noun for a group of phenomena that tend to occur together. In medicine, the word "syndrome" implies a common pathophysiological aetiology - that is, a single underlying disease state.
You seem to be implying that "syndromes" and "diseases" are mutually exclusive categories. They are not. All diseases have their own characteristic syndrome, and in practice the term "syndrome" is often used interchangeably with the term "disease".
The disease "AIDS" refers to the abnormal state of immunological function (the signified) rather than to the opportunistic diseases or haematological tests that are used to define that state (the signifiers).
You are also confusing an epidemiological surveillance case definition with a diagnosis made in clinical practice to guide treatment. They are used for completely different purposes. The so-called "Bangui definition" is a very early and now outdated example of the former, used to provide very rough (and perhaps questionable) AIDS prevalence estimates where HIV testing was unavailable and diagnostic methods for AIDS-defining illnesses were rudimentary, but has never been used to guide an individual's clinical treatment.
To reverse the HIV to AIDS causation, you need to find a significant series of people who developed AIDS-defining clinical conditions such as PCP or cerebral toxoplasmosis or end-organ CMV disease prior to seroconverting for HIV. Where HIV status is known before the onset of these diseases, seroconversion always precedes them, not follows them. Although such opportunistic diseases can occasionally occur in HIV negative people with other causes of severe cell-mediated immunosuppression, this is rarely, if ever, followed by HIV seroconversion.
And yes, there are still thousands of Americans each year whose HIV is first diagnosed when they present to hospital with life-threatening AIDS-defining opportunistic diseases. This is very unfortunate, because such diseases are now largely preventable with timely diagnosis of HIV and antiretroviral treatment.
ARV drugs do not cure people of the HIV virus or AIDS, they only make people sick. Most people do not realize that ARV drugs actually feed the HIV virus so that the virus doesn’t go into full blown AIDS and consume the entire body. Thus, ARV drugs keep one alive but at the expense of immense pain and suffering, feeding the virus their happiness and energy. Listen to the audios to see how Aids is being cured without drugs.
http://www.merkaba.org/audio/aids.html/
@nath99
What evidence do you have that ARVs dont work? Claiming that ARVs actually keep HIV active is a pretty bold statement, so I hope you have some scientific evidence to back it up.
Also, the page you linked me to does not work. This "Merkaba Technique", though, seems to me to be nothing but mysticism, Again, it comes down to evidence. What evidence is there that Merkaba actually works?
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