Document:Bauer Preface

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2007

An alien observer might well by puzzled over the discrepancy between the actual facts about HIV and AIDS and the conventional wisdom about them.

For instance, the accepted view incessantly urges "safe sex", particularly the use of condoms, on the grounds that HIV/AIDS is sexually transmitted. In point of fact, however, studies that note different degrees of condom use find that it makes no difference; and observations of actual sexual transmission find it negligibly small: unprotected heterosexual intercourse between an HIV-positive partner and an HIV-negative one results in the latter seroconverting – becoming positive – only about 1 time in 1,000, according to studies not only in the United States, but also in Thailand, Haiti, and Africa, where, according to official pronouncements, heterosexual intercourse is the chief mode by which HIV is supposed to spread. These studies (cited in Chapter 2) are all in respected and freely available scientific periodicals. Like all such articles, they are indexed, so most of them will immediately turn up in any search for information about sexual transmission of HIV.

A second instance is the press release of June 2005 from the Centers for Disease Control and Prevention (CDC) announcing that "for the first time" the number of HIV-positive Americans had passed the million mark (CDC 2005). Equally authoritative estimates, most of them from the CDC itself, had estimated about 1 million Americans as being HIV-positive ever since testing began: "In 1986...between 1 and 1.5 million persons were infected" (MMWR 1987a). In 1987 (MMWR 1987b), "The estimate obtained by incorporating these revision into the 1986 calculation... – 945,000 to 1.41 million – differs little from the earlier figure." "In mid-1988 it was estimated that 1.5-2 million Americans had been infected," according to Donald Francis, AIDS Adviser, California Department of Health Services, and Richard Kaslow, Chief of Epidemiology and Biometry, National Institute of Allergy and Infectious Diseases (Kaslow & Francis 1989, 93). In 1989, "Currently about 1 million persons in the United States are infected with human immunodeficiency virus (HIV)" (CDC 1989). For 1993, in a policy forum in Science it was estimated that > 1 million in North America were HIV-positive (Merson 1993, fig. 1). "In 2003, more than 1 million persons in the United States were estimated to be living with human immunodeficiency virus (HIV) infection" (Glynn & Rhodes 2005). There is no basis in fact for saying, in 2005, "for the first time".

Looking further into the sequence of events, the alien observer might note that Kaposi's sarcoma, one of the original "signature" diseases of AIDS, is now known not to be caused by HIV. Yet this accepted fact has not inspired widespread questions about how HIV and AIDS are connected, or whether they are connected at all.

How could such discrepancies between fact and conventional wisdom persist for so long? The observer, by delving into the histories of human understanding of science and medicine, might come to see that the high technical capability had brought with it bureaucratic organization; and bureaucratic management could not cope with the fact that progress means continually abandoning established theories.

The alien would realize, too, that there is a marked discrepancy between conventional wisdom and best knowledge not only as to HIV/AIDS but also about science and medicine as a whole. Humankind still tends to see the history of science as one of unwavering progress, even though its specialists know better: the historians, sociologists, and philosophers of science know that the histories of science and of medicine are histories of errors corrected, often errors that the orthodoxy defended to the bitter end.

Unaware of those histories, the media, policy makers, and public simply accept what the leading institutions of medical science happen to say at a given time, finding it inconceivable that they could be wrong over anything so significant. All official organizations and most of the prominent non-governmental organizations and charities, international as well as national, promulgate the belief that HIV is sexually transmitted and causes AIDS. Funding sources support only work premised on that view. Scientific and medical journals rarely publish any doubts over the matter, despite a sizable body of competent people who persist in trying to publish dissenting claims.

Once aware of the contemporary state of human understanding of science and medicine and their histories, the alien observer would then be less surprised to find that disagreements over matters of science and medicine display the least enlightening, most dysfunctional features of polemics: evasion of substantive points, distortion of opponents' positions, and argument ad hominem – attacking the person rather than the position taken by that person.

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With the appearance of AIDS in the early 1980s, there soon came fear as well. People were dying unexpectedly and in painful ways for unknown reasons. And then the cause turned out to be justifiably fear-inspiring: a new virus of unprecedented type, known nowadays as the human immunodeficiency virus, HIV. There were fears that it might be spread by touch, in saliva and other body fluids, possibly even through the air like influenza. It was assumed that medical personnel would be at particular risk. The virus would certainly be transmitted through the blood supply, via infected needles, and – the greatest worry for everyone – through sexual intercourse. There was an atmosphere approaching panic: HIV-positive children were excluded from schools, dentists wore protective clothing, and police and other public servants avoided contact with blood (for example, Garrett 1994, 328).

The body's immune system, which normally produces antibodies that neutralize invaders, produced antibodies that did not neutralize this invader. Once HIV-positive, one remained permanently so and capable of infecting others. The new virus destroyed the immune system itself, thus producing the effect for which AIDS is named: Acquired Immune Deficiency Syndrome. As the immune system deteriorated, fewer and fewer infections could be fought off, and death came inevitably from the "opportunistic" infections that took advantage of the weakened immune system. The time between contracting the virus and the appearance of actual symptoms of illness appeared at first to be a matter of months, but soon the estimates were lengthened to a few years, then to the current nine or ten years. Once actual symptoms appeared, however, death followed inevitably and fairly rapidly. ^[1]

The first cases of AIDS had been noticed in the gay communities of a few large cities, and soon after that among injection drug users. The natural fear had been that the whole population was at risk; obviously, no sexually transmitted infection could long remain isolated in just a few groups that are in social and sexual contact with the rest of the population, even if it is only occasional contact. Yet no epidemic of AIDS has swept the general population in the quarter-century since the first cases appeared. By and large, everyone now realizes that the only non-drug-abusing heterosexual people who appear to be at risk of AIDS are in sub-Saharan Africa and the Caribbean. The fear, so widespread in the 1980s, has largely dissipated. In 1995, Americans still ranked HIV/AIDS as the nation's most urgent health problem; but by 2006, only 17 percent of Americans did so (Newsweek, 15 May 2006, sidebar, p. 37). The AIDS quilt "fades to obscurity...from large to largely forgotten" (Zarembo 2006).

Though the panic is gone (or has been fobbed off to Africa), the conventional and official wisdom, what everyone knows and hears, has not really changed. There is an endless repetition by official institutions and the mass media of sound bites and urban legends that bear dire warnings:

• AIDS is an equal-opportunity disease. Everyone is at risk, everyone should always use condoms, everyone should get tested.
• Magic Johnson was infected through heterosexual playing around.
• A Florida dentist infected five of his patients and caused the death of an innocent virgin.
• Ryan White, a child who became infected via blood products administered for his hemophilia, died at an early age after being shunned and driven from school. His name was immortalized in a Congressional law that made treatment for HIV/AIDS available for all Americans.
• Africa is in crisis because of HIV/AIDS.

Anyone who questions the orthodox view that HIV causes AIDS is interrupted, challenged, bombarded with rhetorical questions based on shibboleths like these, which form the common knowledge about HIV/AIDS: How could everyone be wrong about this? What about the nurses and doctors who got AIDS from accidental needle-sticks? And so forth.

Urban legends like these are among the reasons why the claims of HIV/AIDS theory have not yet succumbed to critiques by the so-called "HIV/AIDS dissidents," in books by Peter Duesberg (1996), Robert Root-Bernstein (1993), John Lauritsen (1990, 1993, Lauritsen & Wilson 1986, Lauritsen & Young 1997), Neville Hodgkinson (1996), Joan Shenton (1998), Christine Maggiore (2000), and others as well, and the continuing journalism of Celia Farber (Farber 2006a, Farber 2006b), and many others. Nevertheless, these dissidents have pointed out that:

• "AIDS" is not a well-defined disease entity;
• HIV has never been isolated in pure form, so that the "HIV tests" have never been validated – indeed, one can question the very existence of HIV;
• antiretroviral treatments have never been proven in properly controlled trials to effect clinical improvement or better health, let alone extended life;

and much else that speaks against HIV/AIDS theory. These discussions usually involve technicalities of virology and immunology and epidemiology, perhaps further reason why the weight of these arguments has not swung the scales in the public arena.

The salient and apparently novel insight embodied in Part I of this book is this: The data from two decades of HIV tests show that what is being detected is not an infectious agent. Thus the theory that HIV causes AIDS is incompatible with the findings published in mainstream journals and official reports.

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In much of this book, instead of the commonly used phrase, "the prevalence of HIV,", I use the neologism "F(HIV)" to stand for specifically "the frequency of positive HIV-tests", thereby avoiding the implication that a positive test necessarily signifies the presence of a proven-to-exist virus, HIV. I also prefer "seroconverting" or "newly becoming HIV-positive" to avoid describing the phenomenon as "becoming infected". Indeed, the phrase "prevalence of HIV" has often been used unjustifiably, when the tests were actually for antibodies to HIV; it was merely assumed that a positive antibody test marked active infection, even when tests for the virus itself were negative, which has happened quite often.

However, as several readers of various drafts of this book have observed, my usage is not entirely consistent. In part this is because in so much of the literature, including some citations used here, the frequency of positive tests is referred to loosely as "prevalence of HIV" and seroconversions as "new incidence" or just "incidence" of HIV. In other part it is because strictly consistent usage would be too unwieldy; for example, instead of saying, "HIV does not cause AIDS," I would have to say, "HIV, the generally-thought-to-exist-virus, or at any rate whatever it is that HIV tests detect, does not cause AIDS." One possible device would be to always place scare quotes around "HIV" to emphasize the doubts about it, but that would soon become tiresome. Instead, perhaps these remarks can serve to place virtual scare quotes around all subsequent references to HIV.

When reporting statistics and whenever the exact ones do not add to the meaning, I will round off to some reasonable number of significant digits, for example, 23,500 in lieu of 23,527.

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Part I of this book shows the inadequacy of the received view, whose essence is this:

• Something unprecedented became apparent around 1980.
• The responsible agent was infectious and entered the United States in one or more distinct locations a number of years before 1980.
• It subsequently spread from one or more gay communities through chains of sexual contact and needle-sharing contacts, and via blood products, across the country and into at least some heterosexual communities.

It follows that HIV tests ought to show HIV spreading over the years from the first AIDS epicenters – Los Angeles, New York, and San Francisco – into the rest of the country. F(HIV) should have been increasing in the country as a whole. There should be patters typical of venereal diseases.

Instead, the accumulated data of 20 years of HIV tests, covering between ¼ and ½ of the adult US population, reveal that what is being measured is not epidemic; it has not come from nowhere to infect a rapidly increasing number of people. Rather, it is something endemic, that has been here at about the same level and distributed in about the same manner since well before testing began. Therefore it could hardly have been responsible for unprecedented and localized but widely scattered outbreaks beginning around 1980. Moreover, F(HIV) and AIDS are not correlated chronologically, geographically, in their relative presence in men and women, or in their relative presence among black and white Americans (Chapter 9).

The assertion that HIV does not cause AIDS reopens the pressing questions of what does cause AIDS. Chapter 10 reviews a variety of suggestions: direct harm to immune systems from "recreational" and other drugs; immune systems succumbing to an unusual range and succession of challenges, chiefly infections and antibiotic treatments; perhaps undiagnosed or inadequately diagnosed syphilis in some cases, or possibly autoimmune reactions. New research is needed to test these suggestions, in part because the picture has been so muddied by changing criteria for diagnosing AIDS in the United States (see Chapter 1, How AIDS has changed). AIDS in Africa, on the other hand, is almost certainly an entirely different matter than AIDS – the original 1980s AIDS – in the United States.

Further research is also needed to better define what tests for "HIV" really detect (Chapter 8). Of immediate importance is to discover what it is that distinguishes those HIV-positive people who never become ill from those HIV-positive people who do become ill; and why – seemingly – such a high proportion of gay men become HIV-positive.

Part II of the book points out that it is far from unprecedented for the medical-scientific establishment to go wrong on so major a matter. Consider that bacteria are now recognized as the cause of many ulcers, and prions rather than a lentivirus as the cause of mad-cow disease. Consider the wrong presumptions of an infectious agent for any number of conditions, including vitamin deficiency diseases. In historical context, the false equation of HIV = AIDS is no startling oddity.

It is popularly assumed that science and medicine have been getting better and better, less and less likely to go wrong. The truth is different and almost the opposite, insofar as the correction of missteps is concerned. Yes, improving research methods and their applications have accomplished wonders and promise many more; but the very organization and integration that have made these wonders possible have also brought deleterious side-effects that seem inseparable from bureaucracy. Institutional conflicts of interest compound what were already increasing problems of individual conflicts of interest in academe, medicine, and science. The manner in which HIV/AIDS theory got on the wrong track and stayed there (Part III) is a cogent illustration of the dilemmas faced by knowledge-seeking in the 21st century. In a nutshell, the intellectual free market that gave rise to modern science, starting in earnest roughly in the 17th century in Western Europe, was created by individual knowledge-seeking scientific entrepreneurs; it has morphed, most notably during the second half of the 20th century, into knowledge monopolies and research cartels dominated by commercial, official, and academic bureaucracies, in which the search for truth does not necessarily take priority over profit-seeking, institutional jockeying for political and social preferment, and public relations.

There seems to have been no concerted analysis of the accumulated results of HIV tests before those I began to publish in 2005 (Bauer 2005, 2006a, b). Any such analysis quickly turns up patterns that are unlike those of venereal diseases. How could that have been missed by the very researchers who had obtained those data?

That researchers often do not pick up contradictions to accepted theory, or do not pick up on them as clues, is in fact part of the normal course of science, at least according to Thomas Kuhn, who also introduced the concept of paradigm shifts in scientific revolutions. Historians and sociologists of science have noted that needed modifications of accepted theories sometimes come from outsiders rather than from specialists inside the discipline concerned. The possibility that a widely accepted belief could turn out to be wrong is not often at the forefront of the mind of a working scientist.

My own interest in HIV/AIDS grew out of long-standing fascination with scientific unorthodoxies. Philosophy of science has called it "the demarcation issue", trying to find criteria that distinguish genuine science from non-science or from pseudo-science. How to identify potentially valid novelties among a host of seemingly wild claims?

After two decades of teaching chemistry, carrying out research specifically in electrochemistry, I joined the fledgling field of "science studies", or "science and technology studies", which was emerging in the 1970s as an interdisciplinary venture among engineers, scientists, historians of science, sociologists of science, philosophers of science, political scientists, and others. It was because of my interest in scientific unorthodoxies that I came to read, and sometimes to write reviews of, books by people who doubted or denied that HIV causes AIDS. I was led to the analysis of data from HIV tests through astonishment over a sentence in Harvey Bialy's scientific biography of Peter Duesberg, published in 2004: the "US Armed Forces find that, just as in Africa, the distribution of HIV antibody is gender-neutral among the presumably fit adolescents wanting to enlist" (Bialy 2004, 184).

Why I found this sentence astonishing, what questions I was inspired to ask, and what I learned in the process of trying to get the answers, is the subject of the chapters that follow.

References

Footnote

1. ↑  Unlike bacterial diseases, diseases caused by viruses cannot be defeated by antibiotics. Viruses have coats of protein over small sections of DNA that carry information for reproducing themselves, but viruses do not have the machinery to actually accomplish that reproduction; they need to enter living cells and misappropriate their machinery. Drugs cannot distinguish virus-infected from non-infected cells, so the only protection is vaccination, which trains the immune system to recognize a virus and eliminate it before cells are infected.
   HIV is a retrovirus, particles of RNA covered by protein. These cannot directly command the reproducing machinery of cells they infect. First, the RNA needs to be "translated" into DNA and integrated into the cell's own DNA by enzymes called reverse transcriptases. Then, when the cell does its normal reproducing, the foreign retroviral DNA also reproduces.
   The first antiretroviral drugs tried against HIV stopped cell reproduction indiscriminately, killing normal as well as infected cells. The later "protease inhibitors" aim to prevent formation of the proteins thought to be HIV's protective coat and thereby stop creation of new particles of retrovirus, but like the earlier antiretrovirals, the protease inhibitors are not selective, and they interfere with the production of essential proteins as well as retroviral ones. For these reasons, side effects of antiretroviral treatment are common and notably unpleasant.
   A further complication is that HIV is thought to be a lentivirus, a "slow virus" that does its damage only years after it has infected a host. Exactly how that could happen remains to be understood.

© 2007 by Henry Bauer