Debunking Denialism

Defending science against the forces of irrationality.

Category Archives: HIV/AIDS Denialism

When HIV/AIDS Activism Goes Wrong

13 Comments Posted by on December 10, 2012

virus

A few days ago, a guest post by HaifischGeweint appear on the Crommunist blog over at the Freethought Blogs network. It is about the stigma attached to individuals with HIV/AIDS and focuses on laws requiring individuals that are HIV positive to let their sexual parters know before engaging in sex. HaifischGeweint appears to label these laws “institutionalized HIV/AIDS discrimination”.

Just so there are no misunderstandings

Just to make sure that we are reducing the risk of misunderstandings, let us get some things clear. HaifischGeweint clearly states that he or she “very strongly disagree with engaging in unprotected sex without first having an honest conversation about STIs and safer sex (no matter what your status)”. HaifischGeweint is also careful to point out that he or she “cannot stand by someone who lies about their status when asked about it or who (regardless of their status) deliberately avoids getting tested and/or practising [sic] safer sex. Full stop.”

Second, people with HIV/AIDS experience a lot of stigma. A lot of people just assume that HIV+ individuals have been sexually promiscuous without using protection, even if the HIV infection was the result of rape, having sex with a long-term partner that cheated on you or getting contaminated blood during surgery. We should do everything within reason to work together against irrational stigma against people with HIV/AIDS. But no matter how noble the goal is, we should not promote scientific falsehoods in order to achieve it (see below).

HIV, sex and informed consent

I am not going to spend a whole lot of text on the main issue here, because there are other serious problems with the blog post (see below), but I think it is clear that informed consent is important when it comes to sex (and most other serious human activities). In a perfect world, everyone would get tested, ask their partner about sexually transmitted infections and tell them if they have any as well as use protection. Unfortunately, this is a fantasy. It does not exist, and it does not appear to be reachable within the foreseeable future. So how should society protect people from being at uninformed risk of being infected by HIV? One avenue is via the legal system, where a person with HIV/AIDS is punished when he or she has sex with another person who has been denied informed consent. Should the punishment be 25 years in prison if there was no intention? That seems a bit excessive, but then again, I am not a legal scholar.

I find it quite ironic that HaifischGeweint seems to put a lot of responsibility onto the other person to ask about HIV status compared with the responsibility of the person with HIV telling about his or her status. In reality, how much different, in terms of emotional difficulty, is it to say that one has HIV compared with answering “Do you have HIV?”? Although I do not know for sure what the difference is in terms of emotional impact, I think it is safe to say that both are emotionally difficult. But let’s flip the situation over. Imagine having HIV and that your partner has another sexually transmitted infection that will substantially decrease your health and quality of life as well as the capacity of your immune system. Surely, you would want him or her to tell you? So the value of informed consent really goes both ways. This would lead me to conclude that both the person with HIV/AIDS and the other person both have a moral responsibility to have an open and honest conversation about sexually transmitted infections before having sex.

So what is the main problem? Read more of this post

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How HIV/AIDS Denialists Abuse Bayes’ Theorem

11 Comments Posted by on August 16, 2012

Image by Matt Buck, under Attribution-ShareAlike 2.0 Generic.

bayestheorem in neon

Note: Snout (Reckless Endangerment) has made some good arguments in the comment to this post. The gist is that HIV/AIDS denialists overestimate the false positive rate by assuming that the initial test is all there is, when in fact, it is just the beginning of the diagnostic process. Snout also points out that it is probably wrong to say that most people who get tested have been involved in some high-risk behavior, as a lot of screening goes on among e. g. blood donors etc. I have made some changes (indicated by del or ins tags) in this post because I find myself convinced by the arguments Snout made.

There have already been several intuitive introductions to Bayes’ theorem posted online, so there is little point in writing another one. Instead, let us apply elementary medical statistics and Bayes’ theorem to HIV tests and explode some of the flawed myths that HIV/AIDS denialists spread in this area.

The article will be separated into three parts: (1) introductory medical statistics (e. g. specificity, sensitivity, Bayes’ theorem etc.), (2) applying Bayes’ theorem to HIV tests to find the posterior probability of HIV infection given a positive test result in certain scenarios and (3) debunking HIV/AIDS denialist myths about HIV tests by exposing their faulty assumptions about medical statistics. For those that already grasp the basics of medical statistics, jump to the second section.

(1) Introductory medical statistics

A medical test usually return a positive or a negative result (or sometimes inconclusive). Among the positive results, there are true positives and false positives. Among the negative results, there are true negatives and false negatives.

True positive: positive test result and have the disease.
False positive: positive test result and do not have the disease

True negative: negative test result and do not have the disease.
False negative: negative test result and have the disease.

For the purpose of this discussion, + will indicate a positive test, - will indicate a negative test, HIV will indicate having HIV and \neg HIV will indicate not having HIV.

P(A) is the probability of an event A, say, the probability that a fair dice will land on three. Conditional probabilities, such as P(A \mid B) , represents the probability of event A, given that event B has occurred. If A and B are statistically independent events, then P(A \mid B) = P(A) , if P(B) \neq 0 (because the definition of P(A \mid B) has P(B) in the denominator).

Let us define some conditional probabilities that are relevant for HIV tests and Bayes theorem: Read more of this post

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No Sanctions for HIV/AIDS Denialist Marco Ruggiero

4 Comments Posted by on July 31, 2012

Previously, I have written about how the University of Florence has launched an inquiry into the activities of HIV/AIDS denialist Marco Ruggiero, a professor who held courses actively promoting that HIV is not the cause of AIDS at the university. He also promotes a pseudoscientific yogurt treatment of HIV/AIDS and supervised degree projects by students that also denied the link between HIV and AIDS that were clearly plagiarized.

ruggiero

Yesterday, an article about the decision written by science journalist Zoë Corbyn was posted on the Nature News Blog entitled “Greater oversight but no sanctions for Italian AIDS contrarian“. The general gist of the story is that no sanctions will be leveled at Ruggiero, that his future teachings will be supervised more strongly, that his clinical experiments with the yogurt treatment has been reported to the Italian medical board.

Ruggiero sees it as a victory for his position when he claims that “The University of [Florence] has demonstrated it is an institution where the freedom of research and teaching is guaranteed”. This is of course nonsense as university teachings in science should be based on evidence.

The HIV Forum, who notified the university about Ruggiero, also claims a modest victory because “Our target was not the career of someone, but the consistency of what is taught at the University of Florence with what thirty years of scientific research tells us about HIV,” and “[The result confirms] freedom of research and teaching must ‘move with the scientific method’.”

I think the special commission had a tight rope to talk on. Clearly, the university cannot go around teaching that HIV does not cause AIDS, but sanctions on Ruggiero could create another martyr and strengthen conspiracy theories. I will try to keep myself updated on the decision by the Italian medical board.

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HIV/AIDS Denialist Marco Ruggiero under Investigation

8 Comments Posted by on March 22, 2012

In a previous entry about Ruggiero called HIVforum.info takes on Italian HIV/AIDS denialist Marco Ruggiero, I explained how an Internet forum populated by HIV+ Italians and other individuals alerted me to the fact that Ruggiero, a professor at the University of Florence, not only where propagating an alternative medicine treatment for HIV/AIDS in the form a yogurt, but was also teaching elective courses containing parts that explicitly tried to teach that HIV was not the cause of AIDS.

Now, according to a Nature News article by Zoë Corbyn called Inquiry launched over AIDS contrarian’s teaching the University of Florence has launched an investigation into “the teaching activities of an academic who assisted on a course that denies the causal link between HIV and AIDS, and supervised students with dissertations on the same topic”.

I first found out about the dissertations by the students from reading the Reckless Endangerment blog written by Snout. I particularly found two articles, HIV/AIDS denialism at the University of Florence and More pseudoscholarship from the Italian Journal of Anatomy and Embryology especially helpful and informative.

The Nature News article continues:

The Italian university’s internal ‘special commission’ will examine the “teaching behaviour and responsibility” of molecular biologist Marco Ruggiero, a university spokesman told Nature.

The move follows a letter to the institution’s rector, Alberto Tesi, by an Italian campaign group called the HIV Forum, which represents people infected with HIV and others concerned about the disease. It calls on him to disassociate the university from the “science and activities” of Ruggiero, who, the group says, is “internationally known” for denying the widely accepted link between HIV and AIDS, and promotes a potential cure for HIV involving an enriched probiotic yoghurt for which there is no proven evidence.

Tesi replied on 29 February to announce the special commission. This “will examine whether professor Ruggiero’s conduct complies with the institutional guidelines on teaching contents and adherence to the objectives of the official curriculum of biological sciences”, says university spokesman Duccio Di Bari, who adds that any misconduct would be dealt with internally.

This is also a great example of what Internet activism potentially can result in. Besides supervising dissertations promoting HIV/AIDS denialism and promoting a treatment lacking scientific evidence, the inquiry will focus on the elective courses he handled: Read more of this post

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Why HIV/AIDS Denialist Henry Bauer Fails to Understand Risk

Leave a Comment Posted by on February 24, 2012

Henry Bauer is the gift that just keeps on giving. He fails to understand the basic biology of viruses. He does not understand that birth rates can mask the results of HIV/AIDS. He does not understand that the difficulty of making an HIV vaccine lies in its high mutation rate or that HIV tests are extremely accurate.

A study, Scherzer et. al. (2012), was recently published online ahead of print. By studying almost 11000 HIV positive subjects undergoing combined antiretroviral therapy, they showed an association between the use of a specific type of antiretroviral medication (called tenofovir) and an increased risk for certain events associated with kidney disease. However, the researchers concluded that

Despite tenofovir’s association with progressive kidney disease, it is an important component of effective antiretroviral therapy that may be required in many patients to control viral load. The balance between its efficacy and probable adverse effects requires further study.

In other words, tenofovir has side effects, but you also have to look at the side effects of not taking the drug in question. Let’s see how Bauer put a spin these results. In the blog post What’s next for the HIV/AIDS vigilantes at Treatment Action Campaign?, Bauer quotes an article from the website of the University of California, San Francisco called Tenofovir, Leading HIV Medication, Linked with Risk of Kidney Damage. However, he chops up the quotes and forgets to quote the researchers saying that:

Shlipak noted that HIV, itself, increases the risk of kidney damage, while modern antiretroviral treatments clearly reduce that overall risk. “Patients need to be aware of their kidney disease risks before they start therapy, and this should influence the medications that they choose in consultation with their doctor,” he said. “For an otherwise healthy patient, the benefits of tenofovir are likely to exceed the risks, but for a patient with a combination of risk factors for kidney disease, tenofovir may not be the right medication.”

In other words, HIV/AIDS itself increases the risk of kidney damage, which is reduced by the use of modern ARVs. So in other words, the risk of kidney damage from treatment must be balanced against the risk of kidney damage from not being treated. Otherwise you will perform an irrational risk analysis as there is really no such thing as “no risk”, only “risk compared with what”.

To be fair, Bauer does mention that HIV is believed by researchers to increase the risk of kidney damage, but he scoffs at this and rejects it by saying that “HIV itself is blamed by HIV/AIDS believers for every ill that antiretroviral drugs bring”. However, it has been clearly shown that HIV does cause renal failure.

United States Department of Veteran Affairs explains that 30% of HIV/AIDS patients have abnormal renal function and that risk factors include low CD4 count and unsuppressed viral load. Also, the incidence of HIV-associated nephropathy has declined since the advent of cART.

This clearly demonstrates how Bauer cherry picks the research to support his denialist beliefs. Those studies that appears to support his position (like this one about Tenofovir) is accepted without skepticism, whereas studies that contradicts his position (such as those showing that HIV can lead to kidney damage) is rejected out of hand.

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HIVforum.info takes on Italian HIV/AIDS denialist Marco Ruggiero

27 Comments Posted by on February 16, 2012

Marco Ruggiero is a professor of molecular biology at the University of Florence. He is also an HIV/AIDS denialist that promotes pro-biotic yogurt as a cure for AIDS. He is also a coauthor of the pseudoscientific junk paper published in an obscure Italian journal with an impact factor of below 0.5

A few days ago, I received a message from a user called Dora from the discussion forum HIVforum.info. Dora said that they had “sent a letter to the provost of the University of Florence, asking for an open dissociation of his Institution from denialist Professor Marco Ruggiero theories and practices” and that they sent “a similar letter [...] to many Italian infectious diseases experts, to the scientific board of the Italian Journal of Anatomy and Embryology, who recently published a paper of Duesberg and Ruggiero denying HIV–AIDS link , to activists, politicians, media and institutional agencies”.

Dora asked me to link to the English version of the letter to maximize the circulation of their message. The ongoing forum conversation can be found here (it is in Italian, so use Google translate service).

The gist is that Ruggiero is attempting to teach a course at the University of Florence called “The revolution of immunotherapy: perspectives on cancer and AIDS cure”. According to screenshots taken of the course description, it will be taught that “the HIV role in AIDS pathogenesis; association but not causation” and that clinical trials have supposedly eliminated HIV infection. This would be enormously damaging and they contacted Professor Marco Linari, President of the undergraduate degree in Biological Science at the University of Florence and they have apparently got him on their side now.

I wish them good luck in their attempts to get him investigated and disciplined or ousted. Academic freedom is one thing, but trying to sneak in HIV/AIDS denialist junk into undergraduate biology classes, even if elective, is insane.

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Dismantling the HIV/AIDS Denialist Henry Bauer’s Central Falsehoods

2 Comments Posted by on February 3, 2012

Why am I picking low-hanging fruit?

Henry Bauer is professor emeritus in chemistry and science studies at Virgina Tech, he has done very little scientific research, no scientific research on retroviruses, believes in the existence of the Loch Ness monster, considers homosexuality an “aberration or illness” (although he has apparently a more generous view these days) and is a former editor of the woo-woo journal called Journal of Scientific Exploration. This hardly sounds like a formidable adversary. However, Bauer is one of the most prolific HIV/AIDS denialists and those supporting science-based medicine should strive to defend rational science from the pseudoscientific falsehoods that Bauer keeps peddling.

I have in many previous articles shown that his claims fall incredibly short of scientific accuracy, but now it is time to release the sharks with frickin’ laser beams on their heads and focus our rational and science-based thinking on his central falsehoods that he lists on the about page of his WP blog. In the end, none shall survive. Read more of this post

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Nathan Geffen on AIDS Deaths in South Africa

Leave a Comment Posted by on January 18, 2012

I have already provided a thorough coverage of the flawed Duesberg paper in irresponsible and obscure journal Italian Journal of Anatomy and Embryology, we can now add a piece written by Nathan Geffen, working with the Treatment Action Campaign in Cape Town, South Africa. He published the article What do we know about AIDS deaths in South Africa? at AIDSTruth.org (perhaps among the best available resources for combating HIV/AIDS denialism online). In it, he showed that two of the main claims made by the recent Duesberg paper is fatally flawed.

The first argument, that the population has increased, can be swiftly dealt with.

The annual number of births in South Africa over the last two decades has been between 1 and 1.2 million. By the best estimate the number of deaths rose between 1997 and 2006 from about 400,000 to about 650,000 annually. This rise in deaths, as I explain below is entirely consistent with our large HIV epidemic, but it is still far below the number of births: hence South Africa’s population has risen.

So the population growth in South Africa is due to high birth rates, not with the scientifically flawed claim that there is no HIV/AIDS epidemic. Geffen also shows that there is plenty of evidence for an HIV/AIDS epidemic, but that the death rates from HIV/AIDS are partially obscured by stigma and partly attributed to the availability of ARVs.

Geffen concludes by asking what we all what to know:

All of the above is of course ignored by Duesberg et al. But it is well known to experts on the South African epidemic. This raises a perplexing question: who were the peer reviewers of the Duesberg et al. article? It is very unlikely that any genuine expert in AIDS statistics would have given their paper the go-ahead.

To be honest, a few seconds spent on Google would have revealed that the “arguments” put forward by Duesberg et. al. were merely rehashing of the same old scientifically flawed claims that have been debunked for decades.

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The Breathtaking Inanity of Henry Bauer’s HIV/AIDS Denialist Balderdash

3 Comments Posted by on January 16, 2012

I have picked apart the flawed claims made by the HIV/AIDS denialist Henry Bauer a few times before and found them wanting, basically rehashing the same old debunked canards that denialists have repeated to themselves and anyone who wants to listen for decades. However, a recent blog entry by Bauer called Evidence-based medicine: No HIV/AIDS epidemic was so full of mind-numbing falsehoods and error that I just had to write a refutation.

So once more unto the breach…

The scientific evidence supports HIV as the cause of AIDS

—> Not only does Bauer think that there is no evidence that HIV causes AIDS, he also thinks that the evidence is stacked against this model. What is more, despite the fact that HIV has been isolated and probably visualized with electron microscopy, he actively believes that HIV as a virus does not even exist.

—> Nothing can be proven with absolute mathematical certainty in science, but a strong case can be made if multiple, independent lines of evidence all converge on the same general conclusion. This is what we find for the model that HIV causes AIDS.

—> The National Institute of Allergy and Infectious Diseases lists a lot of this evidence, including established epidemiological association, isolation, transmission pathogenesis, infection by HIV as a uniquely strong predictor for development of AIDS, the vast majority of AIDS-defining illnesses occur in patients with HIV, death rates are higher among HIV+ individuals than HIV- ones, HIV can be detected in AIDS patients, correlation between high HIV virus, viral antigens and viral genetic material one the one hand and increase risk of developing AIDS, efficacy of ARVs specific for blocking HIV replication improves prognosis for HIV patients, individuals with a lower viral load as a result of medication are less likely to progress to full-blown AIDS, AIDS patients have HIV antibodies, low prevalence of HIV antibodies correlate with extreme rarity of AIDS, HIV is similar to other viruses of the same type that causes immunodeficiency in their natural hosts etc. (NIAID, 2010)

—> None of these findings mathematically prove that HIV must cause AIDS, but the combined weight of the independent evidence strongly favors it. Those that reject the scientific conclusion that HIV causes AIDS must not just rationalize away each piece of evidence, but they must find another model on which the evidence is more likely.

—> The bottom line is that the HIV causes AIDS model predicts the evidence with a much higher probability than the notion that HIV does not cause AIDS.

Drop in lifespan reveals the severe impact of the HIV/AIDS pandemic

—> Bauer repeats the old canard that HIV/AIDS is not an epidemic since the population growth in certain African countries are positive.

—> This is a flawed argument, because high birthrates compensates. The severe impact of HIV/AIDS can be seen by looking at changes in average lifespan over time. As discussed in a previous blog entry, Kalichman (2009, pp. 77-78) points out that countries in southern Africa, including South Africa, have seen a massive decrease in life expectancy over the years that correspond to the occurrence of AIDS pandemic. He writes that: “Life expectancy in many countries that were improving during the post-colonial years of the 1960s and 1907s began to erode in the 1980s and 1990s, and life expectancy in many countries is now worse than even during the 1950s, the last full decade of colonialism. The reason why some countries afflicted by AIDS sustain positive population growth is simply due to high birth rates.”

Failure to provide ARVs South Africans caused 340000 deaths

––> Researchers at Harvard School of Public Health concludes in Chigwedere et. al. (2008) that over 330000 individuals with HIV/AIDS died earlier than needed because the previous President of South Africa, Thabo Mbeki, and his government refused to let his people have access to antiretrovirals. They believed that it was just a western pharmaceutical plot to destroy the future of the country and instead, he suggested garlic and lemon as treatment (Kalichman, 2009). How can Henry Bauer claim that there is no HIV epidemic? Read more of this post

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Debunking the new Duesberg HIV/AIDS Denialist “paper” in IJAE

6 Comments Posted by on January 11, 2012

Peter Duesberg is the among the forefathers of the HIV/AIDS denialist movement. They reject the notion that HIV causes AIDS, despite being contradicted by a massive amount of scientific evidence and has held on to this view for three decades.

Duesberg has recently got an article called “AIDS since 1984: No evidence for a new, viral epidemic – not even in Africa” published in the obscure Italian Journal of Anatomy and Embryology. This is after getting rejected from four other journals and having gotten a previous version of the article pulled from the journal Medical Hypotheses, itself a crank journal.

One of the co-authors is Henry Bauer. He is a homophobic professor emeritus in chemistry and science studies at Virgina Tech. He is also, apparently, a world-renowned proponent of the existence of the Loch Ness monster. I kid you not. He was also an editor of the woo-woo journal Journal of Scientific Exploration. All of these three journals mentioned have an impact factor well below 1, making them shoddy and unreliable at best.

The Duesberg et. al. (2011) paper itself is just a rehashing of the same old falsehoods that HIV/AIDS denialists have peddled for many decades Read more of this post

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