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Debunking the HIV/AIDS denialism that delayed us from moving forward

August 3, 2018

Nations pay a high price for denialism. This is the story of HIV denialism, once practiced by countries and a few scientists.

 

The Cost of HIV denialism

 

Denialists refute objective, verifiable facts. Writing for Psychology Today, Dr. Saul Levine, asserts that denialists are not mentally ill. Instead, they strongly “adhere to their false credos in spite of clear evidence to the contrary which is presented to them, especially if based on scientific findings.” Denialism can have catastrophic consequences. More than 330, 000 people are estimated to have died prematurely of HIV/AIDS between 2000 and 2005, because of the delayed rollout of antiretroviral therapies (ARTs; see infographic for major reasons) in South Africa.

 

Scientific Denialism: Why HIV is Not Like Any Other Microbe

 

Scientists are not immune from denialism. In this case, facts can be taken out of context to support unverified hypotheses. Scottish virology professor, Dorothy Hunter, described how Robert Koch’s postulates to identify the causative agent of a disease, widely accepted in microbiology, were used to bolster an argument that HIV was not linked to AIDS. This argument can be rebutted as follows:

  • Postulate 1: A pathogen has to be absent in the tissues of healthy animals and present in the case of diseased hosts

    • This rule does not apply to every microbe

      • HIV can linger undetected in different parts of the body of apparently healthy individuals, announcing itself only when a weakened immune system is measurable, in the form of lower CD4 T-cell counts

      • HIV also enables a gamut of other potential pathogens to flourish in the body

  • Postulate 2: A pathogen should be isolatable and grown in pure culture

    • HIV is not cultivable in standard microbiological media

  • Postulate 3: A pathogen should be able to cause disease when injected to a healthy animal

    • Because HIV does not fulfill the postulate 2 requirement, evidence has to be obtained indirectly via tests such as immunological screening for HIV

  • Postulate 4: The pathogen should be retrievable from an inoculated animal and shown to be identical to the initial isolate

    • Because HIV does not fulfill the previous requirements, evidence of a causal link came from indirect routes

      • Accidental infections of workers with a pure clone of HIV (workers subsequently presented with markedly lower CD4 T-cell counts) and retrieval of the same clone from their blood samples provided key evidence of a cause-effect relationship

Coming to Grips with HIV/AIDS in Southern Africa and Elsewhere

 

Public health experts in Southern Africa have reason to cheer over the regional 2018 HIV/AIDS report card. Due to an intensified ART rollouts augmented by patient support, South Africa has reduced its rates of new infections by 44%. Three-quarters of HIV-positive persons residing in one of its neighboring countries, Namibia, have such low levels of virus in their bodies, that healthcare professionals consider them to be “virally suppressed.” Globally, new HIV infections have been reduced by 47% from its peak in 1996. In 2017, 59% [44% to 73%] of all people living with HIV were accessing treatment.

 

Celebration at this good news has to be tempered with caution. According to UNICEF, about 9.6 million young people between the ages of 15 and 24 years old, may become newly infected with HIV in sub-Saran Africa (between 2017 and 2050)  and two-thirds of them will likely be girls and young women. In other regions of Africa, more men and boys are dying of AIDS-related illnesses. The major reason? People are not getting tested for HIV and therefore remain unaware of their HIV-status. In the USA, where blacks represent about 12% of the population, but accounted for 41% of people living with an HIV infection in 2011, much work remains to be done in this subpopulation and other marginalized groups.

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