The answer is quite simple, but required some of the most sophisticated science and epidemiology to investigate. Despite the definitive proof of HIV being the cause of AIDS, a large denialist movement persists…
First, why am I so sure about HIV causing AIDS? Well, we know more about the HIV/AIDS connection than just about any other disease on Earth. No one really questions the connection between influenza virus and the flu, or Plasmodium and malaria, or really about any other infectious disease whose agent has been discovered.
Some basics
HIV is a human retrovirus isolated from every AIDS patient who has been tested. After inoculation of the virus, it rapidly travels to lymph nodes and infects white blood cells. It replicates rapidly and prolifically, and shortly after infection is present in high amounts in the blood. Many patients experience acute retroviral syndrome at this point.
The immune system then begins to regain some measure of control, and the amount of virus in the blood drops rapidly, but remains detectable. After several years, the virus has mutated sufficiently to escape the body’s immune defenses, and immune cells, especially CD4 cells, begin to die. Even before their numbers drop, the immune system has begun to malfunction. When their numbers reach certain critical levels, infections that don’t normally hurt healthy persons begin to attack.
A common myth is that HIV has never been isolated from the blood of AIDS patients. This could not be a more vicious lie. I have personally tested hundreds of AIDS patients and specifically measured the amount of HIV in their blood. We also measure antibodies produced by the patient in reaction to the infection…this is useful, but it is not the only way to detect potential infection.
Since the mechanism of the virus’ attack on the immune system is so well known, specific drugs have been developed to prevent different steps in this process. They work. With the invention of protease inhibitors, AIDS wards literally closed down as patients became healthier and returned to a somewhat normal life.
So who doesn’t get it?
What is it about AIDS that attracts denialists, conspiracy theorists, and nut jobs?
I have a few admittedly amateur ideas.
First, sex is involved, and whenever sex and sin enter into an issue, all hell breaks loose. However, no one disputes that Neisseria gonnorheaea causes gonorrhea, so that can’t be all there is.
Second, the disease disproportionately affects the poor, at least world-wide. This attracts quite a few conspiracy theorists, but dysentery and malaria also affect the poor disproportionately, so that’s not the whole picture either.
Third, it takes a long time between infection and the onset of AIDS. This is also not unique to HIV, however the idea crops up quite a bit in the conspiracy literature.
So who and what is behind this movement? It isn’t always clear, but there are some broad trends.
Scientist denialists
One of the first and most enduring HIV denialists is Peter Deusberg. He is a PhD virologist, who has done some brilliant work. This does not preclude him being wrong, and his errors have been discussed elsewhere at length. Perhaps he suffers from a common ailment of the brilliant scientist–forgetting one can be wrong, and holding too strongly to a mistaken idea, despite having failed to prove your point.
Amateur denialists
The web is rife with amateur denialists, these days mostly in blogs. They appear to be quasi-professionals who lack the ability or patience to understand the science involved, or are simply paranoid conspiracy theorists. Most also hold to other, unrelated conspiracies. So to be a little uncharitable, I think many of them just want to be in on “the big secret”, even if it is a lie.
Political denialists
These reside mostly in Southern Africa, an area completely devastated by AIDS. Perhaps they are just broken by their experiences of colonial oppression. Who knows? But they often reference American denialists. The scariest fact here is that they actually control AIDS strategy in Africa, and so hold the lives of millions in their hands.
Solutions
As usual, the only solution is education. Education in the basic sciences comes first, so that people can understand the issues involved. Removing from public office those who would question scientific truth is another step. But moralism in the U.S. pervades all aspects of AIDS education, and interferes with a broad, comprehensive approach to education, prevention and treatment. I’m not hopeless, because scientific facts will not change. I only hope political courage will.
