AIDS reappraisal

Overview
The AIDS reappraisal movement or AIDS dissident movement, also referred to as AIDS denialism, is a loosely connected group of individuals who dispute the scientific consensus that the human immunodeficiency virus (HIV) is the cause of acquired immune deficiency syndrome (AIDS). Dissidents argue that the consensus that HIV causes AIDS has resulted in inaccurate diagnoses, psychological terror, toxic treatments, and a squandering of public funds, as well as an unprecedented deviation from scientific method and standards.

The scientific community considers the causative role of HIV to be substantiated by research; dissident arguments are considered by the scientific community to be the result of cherry-picking and misrepresentation of predominantly outdated scientific data, with the potential to endanger public health by dissuading people from utilizing proven treatments.

Timeline

 * 1983: A group of scientists and doctors at the Pasteur Institute in France, led by Luc Montagnier, discovers a new virus in a patient with signs and symptoms that often precede AIDS. They name their discovery lymphadenopathy-associated virus, or LAV, and send samples to Robert Gallo's team in the United States.


 * 1984: On April 23, at a Washington press conference held two weeks before the relevant papers are published, Margaret Heckler, then Secretary of Health and Human Services, announces that Gallo and his co-workers have discovered a virus that is the "probable" cause of AIDS. This virus is initially named HTLV-III.


 * 1984: Casper Schmidt responds to Gallo's papers by writing "The Group-Fantasy Origins of AIDS", which is published by the Journal of Psychohistory. He posits that AIDS is an example of "epidemic hysteria" in which groups of people are subconsciously acting out social conflicts, and compares it to documented cases of epidemic hysteria in the past which were mistakenly thought to be infectious. Schmidt himself died of AIDS in 1994.


 * 1986: The viruses discovered by Montagnier and Gallo, having been found to be genetically indistinguishable, are renamed HIV.


 * 1987: Peter Duesberg questions the HIV theory of AIDS for the first time in his paper "Retroviruses as Carcinogens and Pathogens: Expectations and Reality", published in the journal Cancer Research. This publication coincides with the start of major public health campaigns and the promotion of AZT as a treatment.


 * 1988: The Perth Group, led by Eleni Papadopulos-Eleopulos, publishes their first article questioning aspects of the mainstream ideas about HIV and AIDS. They conclude that there is "no compelling reason for preferring the viral hypothesis of AIDS to one based on the activity of oxidising agents."


 * 1990: Robert Root-Bernstein publishes his first peer-reviewed article detailing his objections to the mainstream view of AIDS and HIV, entitled "Do we know the cause(s) of AIDS?" In it, he questions both the mainstream view and the dissident view as potentially inaccurate.


 * 1991: The Group for the Scientific Reappraisal of the HIV-AIDS Hypothesis, comprised of twelve scientists, doctors, and activists, submits a short letter to various journals; the letter is rejected. Another similar letter would be published 4 years later in the journal Science.


 * 1994, 28 October: Robert Willner, a physician whose medical license was revoked for, among other things, treating an AIDS patient with ozone therapy, publicly jabs his finger with blood he says is from an HIV-infected patient. Willner died the following year of a heart attack.


 * 1995: The dissident group Continuum places an advertisement in The Pink Paper offering a £1,000 reward to "the first person finding one scientific paper establishing actual isolation of HIV" (according to their specific set of rules).


 * 1996: Various scientists, including Duesberg, dismiss the Continuum challenge, asserting that HIV doubtlessly exists.


 * 2000: South Africa's President, Thabo Mbeki, invites several dissidents to join his Presidential AIDS Advisory Panel. The scientific community responds with the Durban declaration, a document affirming that HIV causes AIDS, signed by over 5,000 scientists and physicians.


 * 2006: Celia Farber, a journalist and prominent AIDS dissident, publishes an essay in the March issue of Harper's entitled Out of Control: AIDS and the Corruption of Medical Science, in which she summarizes a number of arguments for AIDS reappraisal and alleges incompetence, conspiracy, and fraud on the part of the mainstream medical community.


 * 2007: Eleni Papadopulos-Eleopulos, having testified at an appeals hearing for Andre Chad Parenzee that HIV is harmless, is found by the court "not qualified to express opinions about the existence of HIV, or whether it has been established that it causes AIDS."

The AIDS dissident community
People critical of the mainstream view of AIDS include HIV-positive persons, government employees, scientists, doctors and activists in several countries.

Probably the most famous and influential AIDS dissident scientist is Peter Duesberg, professor of molecular and cell biology at the University of California, Berkeley, who has been contesting the mainstream view of AIDS causation since 1987. Other scientists include David Rasnick (who worked with proteases and is co-holder of several patents on protease inhibitors similar to those used in the treatment of AIDS) and Rodney Richards (who worked at Amgen during the development of some of the first commercial HIV antibody tests). Nobel Prize winner Kary Mullis, inventor of PCR, has expressed sympathy for dissident theories.

Other notable AIDS dissidents include Australian academic Hiram Caton, journalist Celia Farber and activist Christine Maggiore. Nate Mendel, bassist with the rock band Foo Fighters, has expressed support for AIDS dissident ideas and organized a benefit concert in January 2000 for the AIDS dissident organization Alive & Well AIDS Alternatives.

Organizations of AIDS dissidents include the Perth Group and the Group for the Scientific Reappraisal of the HIV-AIDS Hypothesis.

Former dissidents
Several prominent scientists once associated with AIDS reappraisal have since changed their views and accepted that HIV plays a role in causing AIDS, in response to an accumulation of newer studies and data. Robert Root-Bernstein, author of Rethinking AIDS: The Tragic Cost of Premature Consensus and formerly a critic of the HIV/AIDS paradigm, has since distanced himself from the AIDS dissident movement, saying, "The denialists make claims that are clearly inconsistent with existing studies. When I check the existing studies, I don’t agree with the interpretation of the data, or, worse, I can’t find the studies [at all]."

Joseph Sonnabend, who until the late 1990s regarded the issue of AIDS causation as unresolved, has reconsidered in light of the success of newer antiretroviral drugs, stating, "The evidence now strongly supports a role for HIV... Drugs that can save your life can also under different circumstances kill you. This is a distinction that denialists do not seem to understand." Sonnabend has also criticized AIDS dissidents for falsely implying that he supports their position, saying:

Both Sonnabend and Root-Bernstein now favor a less controversial hypothesis, suggesting that cofactors in addition to HIV are necessary to cause AIDS.

Walter Gilbert, winner of the 1980 Nobel Prize in Chemistry, once expressed skepticism about the role of HIV in AIDS. Like Sonnabend, he has since changed his mind in response to the effectiveness of antiretroviral treatment.

Nonetheless, as of November 2006, some dissident websites continue to claim that Root-Bernstein, Sonnabend and Gilbert deny the role of HIV in AIDS.

Death of HIV-positive dissidents
In 2007, aidstruth.org, a website run by HIV researchers to counter dissident claims, published a partial list of AIDS dissidents who had died of apparently AIDS-related causes. For example, the magazine Continuum, run by HIV-positive dissidents, shut down when its editors all died of AIDS-related causes. It was noted that in every case, the AIDS dissident community has attributed the deaths to unknown causes, secret drug use, or stress.

Points of contention
Although members of the AIDS dissident community are united by their disagreement with the concept that HIV is the cause of AIDS, the specific positions taken by various groups differ.

Dissident arguments have centered around claims that HIV does not exist or has not been adequately isolated, that the virus does not fulfill Koch's postulates, that HIV testing is inaccurate, or that antibodies to HIV neutralize the virus and render it harmless. Suggested alternative causes of AIDS include recreational drugs, malnutrition and the very antiretroviral drugs used to treat the syndrome.

Such claims have been examined extensively in the peer-reviewed medical and scientific literature; a scientific consensus has arisen that dissident claims have been convincingly disproved, and that HIV does indeed cause AIDS. Accumulating evidence of the significant benefits of modern anti-HIV medication is seen as further confirmation of HIV's role in AIDS.

Impact beyond the scientific community
The concept that HIV causes AIDS is widely regarded as proven in the scientific community. However, the AIDS dissident movement has had a significant impact outside of scientific spheres, making the debate a civil and political as well as a scientific and public health issue.

Impact in North America and Europe
Skepticism about HIV as the cause of AIDS began almost immediately after the discovery of HIV was announced. One of the earliest prominent skeptics was the journalist John Lauritsen, who argued in his writings for The New York Native that AIDS was in fact caused by amyl nitrite poppers, and that the government had conspired to hide the truth.

The publication of Peter Duesberg's first AIDS paper in 1987 fueled further support for dissident theories. Shortly afterwards, the journal Science reported that Duesberg's remarks had won him "a large amount of media attention, particularly in the gay press where he is something of a hero." However, Duesberg's support in the gay community dried up as he made a series of statements perceived as homophobic; in an interview with the Village Voice in 1988, Duesberg stated his belief that the AIDS epidemic was "caused by a lifestyle that was criminal twenty years ago."

In the following few years, others became skeptical of the HIV theory as researchers initially failed to produce an effective treatment or vaccine for AIDS. Journalists such as Neville Hodgkinson and Celia Farber regularly promoted dissident ideas in the American and British media; several television documentaries were also produced to increase awareness of the alternative viewpoint.

With the introduction of highly active antiretroviral therapy (HAART) in 1996-1997, the survival and general health of people with HIV improved significantly. The positive response to treatment with anti-HIV medication is regarded as further proof of HIV's causative role in AIDS, and has led several prominent AIDS dissidents to accept the causative role of HIV. Today, AIDS dissident arguments are widely regarded as pseudoscience, on par with Lysenkoism. Nevertheless, these theories continue to exert a significant influence in some communities; a survey conducted at minority gay pride events in four American cities in 2005 found that 33% of attendees doubted that HIV caused AIDS.

AIDS activists have expressed concern that dissident arguments about HIV's harmlessness may be responsible for an upsurge in HIV infections. According to Stephen Thomas, director of the University of Pittsburgh Center for Minority Health:

Impact in South Africa
The government of South African President Thabo Mbeki has been sympathetic to the views of AIDS dissidents in the past; critics charge that dissident influence has been responsible for a slow and ineffective governmental response to the AIDS epidemic.

Durban Declaration
In 2000, when the International AIDS Conference was held in Durban, President Mbeki convened a Presidential Advisory Panel containing a number of AIDS dissidents, including Peter Duesberg and David Rasnick. The Advisory Panel meetings were closed to the general press; an invited reporter wrote that Rasnick advocated that HIV testing be legally banned and denied that he had seen "any evidence" of an AIDS catastrophe in South Africa, while Duesberg "gave a presentation so removed from African medical reality that it left several local doctors shaking their heads."

In his address to the International AIDS Conference, Mbeki reiterated his view that HIV was not wholly responsible for AIDS, leading hundreds of delegates to walk out on his speech. Mbeki also sent a letter to a number of world leaders likening the mainstream AIDS research community to supporters of the apartheid regime. The tone and content of Mbeki's letter led diplomats in the U.S. to initially question whether it was a hoax.

Mainstream AIDS scientists and activists were dismayed at the president's behavior and responded with the Durban declaration, a document affirming that HIV causes AIDS, signed by over 5,000 scientists and physicians.

Criticism of governmental response
South African health minister Manto Tshabalala-Msimang has also attracted heavy criticism, as she has often promoted nutritional remedies such as garlic, lemons and olive oil to people suffering from AIDS,  while emphasizing possible toxicities of antiretroviral drugs, which she has referred to as "poison". The South African Medical Association has accused Tshabalala-Msimang of "confusing a vulnerable public". In September 2006, a group of over 80 scientists and academics called for "the immediate removal of Dr. Tshabalala-Msimang as minister of health and for an end to the disastrous, pseudoscientific policies that have characterized the South African government's response to HIV/AIDS." In December 2006, deputy health minister Nozizwe Madlala-Routledge described "denial at the very highest levels" over AIDS. She was subsequently fired by Mbeki.

Mbeki's government has been widely criticized for delaying the rollout of programs to provide antiretroviral drugs to people with advanced HIV disease and to HIV-positive pregnant women. The national treatment program began only after the Treatment Action Campaign (TAC) brought a legal case against Government ministers, claiming they were responsible for the deaths of 600 HIV-positive people a day who could not access medication. South Africa was one of the last countries in the region to begin such a treatment program, and roll-out has been much slower than planned.

At the XVI International AIDS Conference, Stephen Lewis, U.N. special envoy for AIDS in Africa, attacked Mbeki's government for its slow response to the AIDS epidemic and reliance on dissident theories:

In 2002, Mbeki requested that AIDS dissidents no longer use his name in dissident literature, and requested that dissidents stop signing documents with "Member of President Mbeki's AIDS Advisory Panel".

In early 2005, former South African president Nelson Mandela announced that his son had died of complications of AIDS. Mandela's public announcement was seen as both an effort to combat the stigma associated with AIDS, and as a "political statement designed to... force the President [Mbeki] out of his denial."

Harm allegedly caused by dissident views
Many AIDS experts and activists have alleged that the AIDS reappraisal movement endangers lives by persuading people to abandon safer sex or forego HIV testing and treatment. In particular, the Durban declaration stated that:

In response to such accusations, the dissident Perth Group has denied encouraging unsafe sex or drug use; indeed, they contend that passive anal sex and drug use increase risk of AIDS and should be avoided. Duesberg argues that although HIV itself is harmless, HIV-infected people are treated with medications which he claims cause AIDS; therefore, he argues, condom use will "protect people who have an average of 1,000 sexual contacts with HIV-positives from infection, and thus from AIDS caused by anti-HIV medication."

Related Chapters

 * HIV and AIDS misconceptions

Mainstream

 * National Institute of Allergy and Infectious Diseases (NIAID) Focus on the HIV-AIDS Connection: Resources and Links
 * Series of articles in Science magazine examining dissident claims
 * HIV Denial in the Internet Era, from PLoS Medicine, August 2007
 * AIDS Treatment News Denialist Series
 * AVERT.org: Evidence that HIV causes AIDS
 * AEGiS: News and Views on AIDS Causality
 * AidsTruth.org

Dissident

 * Group for the Scientific Reappraisal of the HIV/AIDS Hypothesis
 * Virusmyth
 * Peter Duesberg website
 * The Perth Group

Aids-Dissident Científicos disidentes sobre la hipótesis que correlaciona VIH con SIDA Aidoso-retaksado Hypothèses alternatives sur la responsabilité du VIH dans le SIDA Ipotesi alternative sull'AIDS エイズ否認主義 Reavaliação da AIDS Альтернативные теории ВИЧ-инфекции и СПИДа 艾滋病重估运动