AIDS denialism

HIV/AIDS denialism is the belief, despite conclusive evidence to the contrary, that the human immunodeficiency virus (HIV) does not cause acquired immune deficiency syndrome (AIDS). Some of its proponents reject the existence of HIV, while others accept that HIV exists but argue that it is a harmless passenger virus and not the cause of AIDS. Insofar as they acknowledge AIDS as a real disease, they attribute it to some combination of sexual behavior, recreational drugs, malnutrition, poor sanitation, haemophilia, or the effects of the medications used to treat HIV infection (antiretrovirals).

The scientific consensus is that the evidence showing HIV to be the cause of AIDS is conclusive and that HIV/AIDS denialist claims are pseudoscience based on conspiracy theories, faulty reasoning, cherry picking, and misrepresentation of mainly outdated scientific data. With the rejection of these arguments by the scientific community, HIV/AIDS denialist material is now targeted at less scientifically sophisticated audiences and spread mainly through the Internet.

Despite its lack of scientific acceptance, HIV/AIDS denialism has had a significant political impact, especially in South Africa under the presidency of Thabo Mbeki. Scientists and physicians have raised alarm at the human cost of HIV/AIDS denialism, which discourages HIV-positive people from using proven treatments. Public health researchers have attributed 330,000 to 340,000 AIDS-related deaths, along with 171,000 other HIV infections and 35,000 infant HIV infections, to the South African government's former embrace of HIV/AIDS denialism. The interrupted use of antiretroviral treatments is also a major global concern as it potentially increases the likelihood of the emergence of antiretroviral-resistant strains of the virus.

History

A constellation of symptoms named "gay-related immune deficiency" was noted in 1982. In 1983, a group of scientists and doctors at the Pasteur Institute in France, led by Luc Montagnier, discovered a new virus in a patient with signs and symptoms that often preceded AIDS. They named the virus ''lymphadenopathy-associated virus'', or LAV, and sent samples to Robert Gallo's team in the United States. Their findings were peer reviewed and slated for publication in ''Science''.

At a 23 April 1984 press conference in Washington, D.C., Margaret Heckler, Secretary of Health and Human Services, announced that Gallo and his co-workers had discovered a virus that was the "probable" cause of AIDS. This virus was initially named HTLV-III. In the same year, Casper Schmidt responded to Gallo's papers with "The Group-Fantasy Origins of AIDS", published in the ''Journal of Psychohistory''. Schmidt posited that AIDS was not an actual disease, but rather an example of "epidemic hysteria", in which groups of people subconsciously act out social conflicts. Schmidt compared AIDS to documented cases of epidemic hysteria in the past which were mistakenly thought to be infectious. (Schmidt himself later died of AIDS in 1994.)

In 1986, the viruses discovered by Montagnier and Gallo, found to be genetically indistinguishable, were renamed HIV.

In 1987, molecular biologist Peter Duesberg questioned the link between HIV and AIDS in the journal ''Cancer Research''. Duesberg's publication coincided with the start of major public health campaigns and the development of zidovudine (AZT) as a treatment for HIV/AIDS.

In 1988, a panel of the Institute of Medicine of the U.S. National Academy of Sciences found that "the evidence that HIV causes AIDS is scientifically conclusive." That same year, ''Science'' published Blattner, Gallo, and Temin's "HIV causes AIDS", and Duesberg's "HIV is not the cause of AIDS". Also that same year, the Perth Group, a group of denialists based in Perth, Western Australia, led by Eleni Papadopulos-Eleopulos, published in the non-peer-reviewed journal ''Medical Hypotheses'' their first article questioning aspects of HIV/AIDS research, arguing that there was "no compelling reason for preferring the viral hypothesis of AIDS to one based on the activity of oxidising agents."

In 1989, Duesberg exercised his right as a member of the National Academy of Sciences to bypass the peer review process and published his arguments in ''Proceedings of the National Academy of Sciences of the United States of America'' (''PNAS'') unreviewed. The editor of ''PNAS'' initially resisted, but ultimately allowed Duesberg to publish, saying, "If you wish to make these unsupported, vague, and prejudicial statements in print, so be it. But I cannot see how this would be convincing to any scientifically trained reader."

In 1990, the physiologist Robert Root-Bernstein published his first peer-reviewed article detailing his objections to the mainstream view of AIDS and HIV. In it, he questioned both the mainstream view and the "dissident" view as potentially inaccurate.

In 1991, The Group for the Scientific Reappraisal of the HIV-AIDS Hypothesis, comprising twelve scientists, doctors, and activists, submitted a short letter to various journals, but the letter was rejected.

In 1993, ''Nature'' published an editorial arguing that Duesberg had forfeited his right of reply by engaging in disingenuous rhetorical techniques and ignoring any evidence that conflicted with his claims. That same year, Papadopulos-Eleopulos and coauthors from the Perth Group alleged in the journal ''Nature Biotechnology'' (then edited by fellow denialist Harvey Bialy) that the western blot test for HIV was not standardized, non-reproducible, and of unknown specificity due to a claimed lack of a "gold standard".

On 28 October 1994, Robert Willner, a physician whose medical license had been revoked for, among other things, treating an AIDS patient with ozone therapy, publicly jabbed his finger with blood he said was from an HIV-infected patient. Willner died in 1995 of a heart attack.

In 1995, The Group for the Scientific Reappraisal of the HIV-AIDS Hypothesis in 1991 published a letter in ''Science'' similar to the one they had attempted to publish in 1991. That same year, Continuum, a denialist group, placed an advertisement in the British gay and lesbian magazine ''The Pink Paper'' offering a £1,000 reward to "the first person finding one scientific paper establishing actual isolation of HIV", according to a set of seven steps they claimed to have been drawn up by the Pasteur Institute in 1973. The challenge was later dismissed by various scientists, including Duesberg, asserting that HIV undoubtedly exists. Stefan Lanka argued in the same year that HIV does not exist. Also that year, the National Institute of Allergy and Infectious Diseases released a report concluding that "abundant epidemiologic, virologic and immunologic data support the conclusion that infection with the human immunodeficiency virus (HIV) is the underlying cause of AIDS."

In 1996, the '' British Medical Journal'' published "Response: arguments contradict the "foreign protein-zidovudine" hypothesis" as a response to a petition by Duesberg: "In 1991 Duesberg challenged researchers… We and Darby et al. have provided that evidence". The paper argued that Duesberg was wrong regarding the cause of AIDS in haemophiliacs.
In 1997, The Perth Group questioned the existence of HIV, and speculated that the production of antibodies recognizing HIV proteins can be caused by allogenic stimuli and autoimmune disorders. They continued to repeat this speculation through at least 2006.

In 1998, Joan Shenton published the book ''Positively False – Exposing the Myths Around HIV and AIDS'', which promotes AIDS denialism. In the book, Shenton claims that AIDS is a conspiracy created by pharmaceutical companies to make money from selling antiretroviral drugs.

In 2006, Celia Farber, a journalist and prominent HIV/AIDS denialist, published an essay in the March issue of '' Harper's Magazine'' entitled "Out of Control: AIDS and the Corruption of Medical Science", in which she summarized a number of arguments for HIV/AIDS denialism and alleged incompetence, conspiracy, and fraud on the part of the medical community. Scientists and AIDS activists extensively criticized the article as inaccurate, misleading, and poorly fact-checked.

In 2007, members of the Perth Group testified at an appeals hearing for Andre Chad Parenzee, asserting that HIV could not be transmitted by heterosexual sex. The judge concluded, "I reject the evidence of Ms Papadopulos-Eleopulos and Dr Turner. I conclude… that they are not qualified to give expert opinions."

In 2009, a paper was published in the then non-peer-reviewed journal ''Medical Hypotheses'' by Duesberg and four other researchers which criticized a 2008 study by Chigwedere et al., which found that HIV/AIDS denialism in South Africa resulted in hundreds of thousands of preventable deaths from HIV/AIDS, because the government delayed the provision of antiretroviral drugs. The paper concluded that "the claims that HIV has caused huge losses of African lives are unconfirmed and that HIV is not sufficient or even necessary to cause the previously known diseases, now called AIDS in the presence of antibody against HIV." Later that year, the paper was withdrawn from the journal on the grounds of it having methodological flaws, and that it contained assertions "that could potentially be damaging to global public health". A revised version was later published in ''Italian Journal of Anatomy and Embryology''.

US courts

In 1998, HIV/AIDS denialism and parental rights clashed with the medical establishment in court when Maine resident Valerie Emerson fought for the right to refuse to give AZT to her four-year-old son, Nikolas Emerson, after she witnessed the death of her daughter Tia, who died at the age of three in 1996. Her right to stop treatment was upheld by the court in light of "her unique experience". Nikolas Emerson died eight years later. The family refused to reveal whether the death was AIDS related.

South Africa

In 2000, South Africa's President Thabo Mbeki invited several HIV/AIDS denialists to join his Presidential AIDS Advisory Panel. A response named the Durban Declaration was issued affirming the scientific consensus that HIV causes AIDS:

The declaration has been signed by over 5,000 people, including Nobel Prize winners, directors of leading research institutions, scientific academies and medical societies, notably the US National Academy of Sciences, the US Institute of Medicine, Max Planck institutes, the European Molecular Biology Organization, the Pasteur Institute in Paris, the Royal Society of London, the AIDS Society of India and the National Institute of Virology in South Africa. In addition, thousands of individual scientists and doctors have signed, including many from the countries bearing the greatest burden of the epidemic. Signatories are of MD, PhD level or equivalent, although scientists working for commercial companies were asked not to sign.

In 2008, University of Cape Town researcher Nicoli Nattrass, and later that year a group of Harvard scientists led by Zimbabwean physician Pride Chigwedere, each independently estimated that Thabo Mbeki's denialist policies led to the early deaths of more than 330,000 South Africans. Barbara Hogan, the health minister appointed by Mbeki's successor, voiced shame over the studies' findings and stated: "The era of denialism is over completely in South Africa."

In 2009, Fraser McNeill wrote an article arguing that South Africa's reluctance to openly address HIV/AIDS resulted from social conventions that prevent people from talking about causes of death in certain situations, rather than from Mbeki's denialist views. Similarly, political scientist Anthony Butler has argued that "South African HIV/AIDS policy can be explained without appeals to leadership irrationality or wider cultural denialism."

In July 2016 Aaron Motsoaledi, the Health Minister of South Africa, wrote an article for the Centre for Health Journalism in which he criticised past South African leaders for their denialism, describing it as an "unlucky moment" in a country which has since become a leader in treatment and prevention.

Denialists' claims and scientific evidence

The term "HIV/AIDS denialism" denotes the rejection of the mainstream scientific view that AIDS is a medical condition that is brought about by HIV infection. The use of the term encompasses the denial of the existence of the virus (HIV denialism), the denial of the causation of AIDS by HIV (that is, the proposed link between the virus and the syndrome), and the denial of the effects on the human body that are ascribed to HIV (that is, the description and characterization of the virus). In a framework incorporating the second denial and/or the third, criticism of the current scientific view has variously been rested on the claim that HIV has not been adequately isolated, that HIV does not fulfill Koch's postulates

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