In the era of haphazard proclamations that credible journalism is “fake news” and conspiracy theories sensationalizing real-world events, it is clear that information is no longer made to inform the masses, but to be shared by the masses. Newsworthy events are blown out of proportion and exaggerated to the point of near absurdity, or even worse, distorted to create a conspiracy. However, this phenomenon is not new. For decades, the AIDS epidemic has been manipulated to become the catalyst for huge conspiracies. Some conspiracies gained so much momentum in the general public that the epidemic has been considered a hoax to some, and altogether denied by others. Those who denied the epidemic’s severity spread misinformation so effectively that even those affected with AIDS believed that the scientific consensus was wrong. Even more concerning, these conspiracies were not just orchestrated by crazed internet trolls or sketchy journalists vying for clicks but by reputable scientists. By analyzing strategies used by AIDS denialists, we can hope to understand how the permeation of AIDS denialism came to be.
Acquired Immunodeficiency Syndrome (AIDS) has been thought to exist since the 1920s. According to Mann, it is thought that by 1980 the virus had spread to five continents and had infected between 100,000 and 300,000 individuals worldwide (1989). The United States’ relationship with AIDS changed in 1981 when a report detailed that five previously healthy gay men became suddenly ill with an extremely rare lung infection, Pneumocystis Carinii Pneumonia (PCP), and died (A Timeline of HIV and AIDS, 2018). After the report was published, the Centers for Disease Control (CDC) was flooded with similar reports of young gay men becoming mysteriously infected with rare cancers violent infections (Haverkos and Curran, 1982). It was clear to a plethora of healthcare professionals that an epidemic was brewing within the United States, but it would be a year until the mysterious illness would have a name, and two more years until the virus causing the illness would be identified as what we now know as HIV, or Human Immunodeficiency Virus. By the end of 1984, there had been 7,699 confirmed AIDS cases and 3,665 AIDS related deaths in the USA (Rielly, 2009).
As previously mentioned, the epidemic was not contained within the United States alone. By 1999, the World Health Organization’s World Health Report had stated that AIDS was the fourth biggest cause of death worldwide, and an estimated 33 million people were living with HIV at the time (WHO, 1999). The epidemic took the biggest toll on the continent of Africa, wherein the same WHO Health Report announced AIDS as the number one cause of death in Africa (WHO, 1999). 1999 is also the year that Thabo Mbeki—an avid AIDS denialist—became president of South Africa. In this moment, AIDS denialism both entered the mainstream and began tallying a death count. With such a strong backing to the AIDS denialism movement millions would die from a lack of medical treatment that was thought to be justified.
AIDS Denialists and Anti-Denialists
The circumstances under which the AIDS epidemic was conceived are sure to spark controversy and debate. In the United States, the early research into AIDS had split into branches with different proposals on how the HIV virus was spread, if it caused AIDS, and if there was any hope for treatment. In times of crisis, certainly there is room for dissent from scientific consensus, whether or not one is an active participant in the medical community. Dissent is a vital part of the scientific process; it is through the process of falsification that a scientific theory is developed that is closer to the truth than before. While dissent has an important place in science, it can become dangerous and irresponsible when exercised radically. The AIDS epidemic, like other medical controversies such as anti-vaccination, had retained its fair share of dissenters after scientific consensus was achieved in the medical field. The consensus states that HIV is the cause of AIDS and that HIV can be treated with medications such as standard antiretroviral therapy (ART), which can stop both symptoms and transmission of HIV. Dissenters take a number of forms within the AIDS controversy. Some deniers refute the existence of HIV at all with many considering HIV harmless and something that does not actually cause AIDS. Among these groups, AIDS is thought to be caused by HIV medication or by simple recreational drug use. With some denying that HIV is spread through sexual or blood contact, the cause of the spread of HIV is also up for debate within these communities. As we will discuss, this dissent from the scientific consensus is not due to a mere scientific rift, but rather the rejection of the science of AIDS altogether. For this reason, we will more aptly call this group denialists.
Anti-denialists are those who generally make attempts to stop the misinformation spread by denialists. Anti-denialists adhere to the scientific consensus around HIV and AIDS, arguing that the scientific evidence is undeniable. Many of those who identify specifically as anti-denialists within the controversy are scientists who have worked closely with the HIV virus or those who were once denialists themselves. These converted denialists are typically HIV-positive laymen whose lives were changed for the better once actively using HIV-specific medication for treatment.
However far HIV and AIDS related science had come, the denialism movement seemed to continue to thrive in recent years. In a survey of gay individuals during Pride parades taken in 2005, it was found that around one-third of attendees doubted that HIV causes AIDS (Meylakhs, Rykov, Koltsova, & Koltsov, 2014). Additionally, a separate study found “HIV [positive people] of African-American background … showed that one in five participants believed that there is no proof that HIV causes AIDS and that HIV medicines do more harm than good” (Meylakhs et al, 2014). If the science is clear, then why do so many individuals buy into the AIDS denialism movement? To answer this question, we must consider the tactics of legitimation employed by denialists.
Tactics of AIDs Denialism Legitimation: Inconcludability
The inconcludability tactic is commonly used in manufactured controversies to legitimate one’s claims that no one side is closer to the truth than the other. This is generally achieved by continuing to question the available data, calling for more data or research before a conclusion can be made, or referring to data taken by opponents to be flawed. This, in turn, necessitates further research on both sides. For the inconcludability tactic of legitimation to be truly effective, there must be some sort of publicly perceived “expert” on the subject in support of the dissent. The AIDS denialist movement had exactly the face of scientific dissent they needed: University of California Berkeley professor, Peter Duesberg. He is a member of the National Academy of Sciences and the first person to isolate a cancer gene, which certainly gives him scientific credibility in the eyes of the general public (Nattrass, 2007).
Where Duesberg fails in credibility is the fact that he never actually worked with HIV or AIDS during his studies, yet he was responsible for creating one of the most prevalent AIDS denialist theories in the United States. Duesberg hypothesized that HIV does not cause AIDS, and HIV is merely a harmless passenger virus or a virus that is present but has no effect on a disease (Duesberg, 2003). Based on correlational data in the 1980s that shows high recreational drug use among those in the United States who contracted the HIV virus, Duesberg claims that it is recreational drug use that is the primary cause of AIDS (Duesberg, 2003). Duesberg’s claims were refuted by the scientific community, but they found a group willing to listen within the public. Duesberg then took to the media, and according to Nattrass, “His cause was assisted substantially by The Sunday Times in London from 1992 to 1994, when the science editor ran many long pieces attempting to discredit AIDS science” (2007). Credited AIDS scientists heard of Duesberg’s hypothesis and published refutations, and although the purposes of the papers were to straighten out the facts, it was considered to the general public to be a “debate” (Cohen, 1994). As the hypothesis picked up steam, other denialists joined the movement.
Despite refutation, the scientific community failed to truly affect Duesberg in any meaningful way, as he continued to spout the same, nearly unchanged theories. Nattrass argues that Duesberg capitalized on and exploited the aspect of uncertainty within those affected by AIDS (2007). In 1999, Duesberg and other AIDS denialists were invited to join Thabo Mbeki’s Presidential Advisory Panel on AIDS (Mbeki Details Quest to Grasp South Africa’s AIDS Disaster, 2000). The numbers were split evenly between AIDS denialists and scientists who were in favor of the consensus (Mbeki Details Quest to Grasp South Africa’s AIDS Disaster, 2000). However, it was the argument of the AIDS denialists who Mbeki listened to more closely, for he doubted that the conventional wisdom (read: scientific consensus) that was being repeated to him was not enough, he demanded more research (Mbeki digs in on Aids, 2000). Mbeki had understood that AIDS may have had some connection to HIV, but he was also convinced it would not be the only factor, citing malnutrition and poverty as factors that contributed just as much to cases of extreme illness (Mbeki digs in on Aids, 2000). It is estimated that Mbeki’s AIDS denialism and subsequent policy decisions based on this ideology have caused upwards of 330,000 unnecessary AIDS-related deaths in South Africa (Ceccarelli, 2011).
Tactics of AIDs Denialism Legitimation: The Fraud Hypothesis
The fraud hypothesis is a tactic that AIDS denialists use against those who support the scientific consensus. It frames the experts as frauds who are attempting some sort of cover-up or as though they simply do not know what they are talking about. More frequently, the fraud hypothesis takes the form of labelling the pharmaceutical industry and all scientists working under pharmaceuticals as the frauds. The most popular and prevalent conspiracy theory states that the United States government invented AIDS accidentally by experimenting with vaccines on vulnerable populations (Heller, 2015). Those who tout this conspiracy frame the scientists involved with the experiments as fully knowing how severe the AIDS epidemic would become. They conclude that the scientists involved are covering-up their mistakes by blaming AIDS on some other phenomenon. Perhaps ironically, this conspiracy has two distinct versions, each with substantial, worldwide AIDS denialist followings.
The first conspiracy is known as the OPV AIDS hypothesis. The conspiracy states that the United States government was developing an oral polio vaccine (OPV) grown through chimpanzee tissue cultures, and this vaccine was then administered to a large population of Africans in the late 1950s. The timing is particularly pertinent to this conspiracy due to the fact that AIDS is believed to have originated in Africa around 1937, and blew up into a pandemic by the 1980s (Faria et al, 2014). The 1950s date of the OPV AIDS hypothesis falls neatly into when AIDS would have begun spreading consistently within Africa. This conspiracy was refuted nearly instantly, and scientists who were blamed for creating AIDS this way sued publishers of the conspiracy for defamation of character, with legal damages of just $1 (Martin, 2003). The hypothesis was considered but ultimately rejected by the whole of the scientific community for inconsistencies with the known facts and epidemiology of HIV at the time.
The second conspiracy of the same kind involves a similar story, known as the HBV theory. This conspiracy theory was started by a dermatologist, Alan Cantwell, who states that a dangerous, experimental Hepatitis B vaccine created by Dr. Wolf Szmuness was the cause of the AIDS epidemic (Cantwell, 1998). According to Cantwell, the experiments for the vaccines specifically targeted young, gay, white men in order to avoid significant legal issues. In Cantwell’s own words,
A “cohort” of over a thousand young gays was injected with the vaccine at the New York Blood Center in Manhattan during the period November 1978 to October 1979. Similar gay experiments were conducted in San Francisco, Los Angeles, Denver, St. Louis, and Chicago, beginning in 1980. The AIDS epidemic broke out shortly thereafter. (Cantwell, 1998)
Although similar to the OPV hypothesis, this conspiracy theory is evidently much more popular, even in 2018. It is easy to see why this conspiracy has stuck: much of Cantwell’s argument is factually plausible. Cantwell was correct in his assertion that Wolf Szmuness’s vaccine for Hepatitis B did in fact target young homosexuals (Altman, 1982). However Szmuness targeted young gay men because “homosexuals had been found to have a risk of developing hepatitis B that is 10 times greater than that for the population in general” (Altman, 1982). Szmuness was successful in his Hepatitis B vaccine, and no evidence has been brought forward stating that there was any connection to HIV within Szmuness’s lab. The timing of the vaccinations with the gay population and the AIDS epidemic in the United States can make believing this conspiracy tempting. Nevertheless, there is no sufficient evidence to support Cantwell’s claims.
Although not a western-manufactured conspiracy like the others, it would do the discussion of AIDS denialism a disservice if Operation INFEKTION was not, at least briefly, discussed. According to Thomas Boghardt, Operation INFEKTION was a Soviet Bloc propaganda campaign whose goal was to implicate that the United States government was solely responsible for the manufacturing and spreading of the HIV virus (2009). “Once the AIDS conspiracy theory was lodged in the global subconscience [sic], it became a pandemic in its own right. Like any good story, it traveled mostly by word of mouth, especially within the most affected sub-groups” (Boghardt, 2009). The Soviet Bloc took advantage of the nature of the human psyche by creating a conspiracy that required little effort to permeate throughout the consciousness of the world. In the Cold War era, any exclamation of fraudulence—especially directed at the United States as a global power—was a major factor in producing fear and swaying the trust of the people of the world.
Tactics of AIDs Denialism Legitimation: The Distorting Influence of Money on Research
Following the same mindset behind AIDS denialists using the fraud hypothesis to instill distrust of doctors and of entire governments for manufacturing AIDS, the tactic behind the distorting influence of money on research is to instill distrust in the entire medical establishment. This idea can be expressed more aptly by what Cohen coins as “pharmanoia”: the rising amount of distrust in the pharmaceutical industry (2006). AIDS denialists will see their dissent as bravery in combating against “Big Pharma”, and they see their offering of alternative medicines and treatments as saving those afflicted with HIV or AIDS. Surely, some distrust of pharmaceutical companies may be warranted, especially when testing medicines on vulnerable populations. Experimentation with drugs on prisoners, people of color, and gay populations was a practice common throughout history. The pharmaceutical industry can also be seen as malicious when driving prices up for life-saving medications, and in these cases, distrust is earned. However, some of the most famous AIDS-affected AIDS denialists are white, upper-middle class citizens who have no reason to fear pharmaceuticals for the reason of racial violence or price gouging. For these individuals, such as author Christine Maggiore, distrust of pharmaceuticals is rooted in misinformation about HIV treatments.
Under AIDS denialism, it is orthodox to be anti-ARV treatments and thus anti-vaccination. Indeed, AIDS research, like research for other medical issues, has to be constructed in a way that can generate profits—even if the profits are just enough to keep research efforts alive. This generally means that research is primarily aimed towards achieving a successful vaccination. According to Jon Cohen’s 2008 article in Science, vaccination efforts takes up 20% of all HIV and AIDS funding, third only to 23% in therapeutics (treatment) and 24% in training and infrastructure.
With treatment and vaccination comes the fear that because pharmaceutical companies are for profit, the treatments and vaccinations available are secretly keeping people sick and only managing symptoms to an extent that it keeps the individual coming back for more medicine indefinitely. Actually, many AIDS denialists go even farther in their assertion that the pharmaceutical industry is to be distrusted, arguing that taking HIV or AIDS medications is a death sentence, some claiming the pharmaceutical industry is committing “genocide” against HIV-infected populations (Stop AIDS Genocide By the Drug Cartel, 2005). Nattrass contests this particular fear, explaining, “Aside from there being no evidence for this, the idea is incoherent, because the profit motive driving pharmaceutical companies gives them an incentive to keep people alive on chronic therapy as long as possible, not to kill them off quickly with dangerous drugs” (2007). Despite this refutation, the fear of the pharmaceutical industry merely attempting to keep people alive and withholding a cure persists.
While an individual may need treatment for life either way, the tactic of making it look like it is the result of corporate greed may drive individuals towards alternative treatments. Alternative treatments for HIV and AIDS cover the basics, from homeopathy to changes in diet being touted as miracle cures (Natural Treatment of Immunodeficiency Disorders, 2018). Perhaps ironically, many AIDS denialists, such as the famous Christine Maggiore, generated extremely profitable business in the ‘alternative medicine’ crowd, raking in profits at the expense of individuals not getting real treatment. The alternative medicinal approach may make AIDS-afflicted individuals comfortable in the fact that they are not paying “Big Pharma” to manage their symptoms. However, this comfort is purely psychological, and potentially short-lived. It should be noted that Christine Maggiore died in 2008 at the age of 53 after being treated for pneumonia (Christine Maggiore, vocal skeptic of AIDS research, dies at 52, 2008). Many believe Maggiore was afflicted with Pneumocystis Carinii Pneumonia, an HIV-related infection, although the family has never requested an autopsy (Christine Maggiore, vocal skeptic of AIDS research, dies at 52, 2008).
Tactics of AIDs Denialism Delegitimation: Emphasize Scientific Consensus
While AIDS denialists have employed many tactics to legitimize their claims about HIV and its connection (or lack thereof) to AIDS, those who stand within the scientific consensus on the issue have employed their own tactics to delegitimize the movement by organizing campaigns to spread what they claim to be the information that is closer to the truth of the matter. This information being that 1) HIV causes AIDS; 2) HIV can be treated with ART treatments; 3) the benefits of ART use outweigh the risks; 4) it is possible to limit the spread of HIV through safe sex, safe needle use, and using ARTs while pregnant and breastfeeding; and 5) AIDS was not manufactured purposefully by any group (Centers for Disease Control and Prevention, 2018). Arguably the best tactic for delegitimizing the AIDS denialist movement that anti-denialists have is emphasizing the scientific consensus.
Denialists—intentionally or not—misinterpret the science behind HIV and AIDS. According to an interview with Tara Smith, a professor of Public Health at Kent State,
They say HIV was never isolated. We give them excellent electron micrographs of the virus. They say “OK, it’s a virus, but it doesn’t cause disease.” They say that Koch’s postulates haven’t been proven to conclusively show HIV causes AIDS. We give them examples of medical workers who were accidentally exposed to the virus and later developed AIDS. They say they must have undisclosed drug addictions or other causes for the immune decline. They never accept the science—they just keep changing the target of their disbelief. (Anders, 2015)
Indeed, the straight refusal to believe science by AIDS denialists is more often than not including some misreading or misrepresentation of science. Nattrass cites the misuse of the Padian study, in which low transmission rates of HIV were found after sexual contact (2007). However, the same study had individuals counseled to practice safe sex, including advice to use condoms (Nattrass, 2007). This fact is forgotten by AIDS denialists and the study is still touted as “proof” that sex does not cause HIV to spread, and thus, in their eyes, the scientific consensus must be wrong, or lying.
However, AIDS denialists have always been a minority, and the scientific community has overwhelmingly sought to educate the public about what are known to be the facts. AIDTruth.org, a website started in 2006, began as a response by doctors and research scientists who worked closely with HIV and AIDS research to refute the massive amount of misinformation spread online. Where journals and magazines were once the avenue in which dissent and debate around scientific controversies occurred, websites are now the primary way in which the general public acquires their information. According to the findings of Eysenbach and Kohler, individuals seeking online health information inspect the first ten search results 97% of the time (2002). It is then essential for anti-denialist efforts to exist online, and AIDSTruth.org became a primary source for debunking common misconceptions and reframing the arguments made by AIDS denialists. The website makes the science behind the scientific consensus on HIV and AIDS accessible to the general public in a straightforward way. As of 2015, AIDSTruth.org announced it would no longer be actively maintaining its website, instead taking the form of an archive of all its articles (AIDSTruth: Our work is done, 2015). According to the post, the team behind the website “believe [sic] that AIDS denialism died as an effective political force” (AIDSTruth: Our work is done, 2015). This is largely because the work behind emphasizing the scientific consensus has been generally a success.
In 2000, one year after Mbeki became president of South Africa and put together his Presidential Advisory Panel on HIV and AIDS, the Durban Declaration was signed by over 5,000 doctors and scientists. The declaration stated that HIV was without a doubt the cause of AIDS. The declaration required signatories to have either a doctorate degree or medical doctorate degree, and those who had possible conflicts of interest, meaning those working in commercial industries, were asked not to sign (The Durban Declaration, 2000). The Durban Declaration was a direct response to doubters and stark AIDS denialists, and it brought enlightenment to those who were unsure about where scientific community stood on the HIV issue.
Although we have discussed at length the tactics used by AIDS denialists to convince the general public to adhere to its doctrines, the AIDS denialist movement is, fortunately, smaller than ever before. South Africa—once the AIDS denialist capital of the world thanks to the propaganda spouted by President Mbeki—is now the epicenter of AIDS treatment initiatives and anti-stigma campaigns (A Timeline of HIV and AIDS, 2018). As of 2017, it is estimated that nearly 21 million HIV positive individuals are on antiretroviral treatment, and almost three quarters of HIV positive pregnant women have used antiretroviral treatment to prevent passing on HIV to their children (WHO).
Nowadays, the AIDS denialism movement continues to inhabit online forums that generally target those already predisposed to support conspiracy theories. It no longer lives in the greater public debate, nor any country’s government. While the AIDS denialist movement is largely defeated, this does not mean we should stop studying just how it came to be in the first place. Now more than ever, it is vital to remain vigilant about what information we consume, who is disseminating it, and who stands to profit from our ignorance. The tactics above are still popular strategies for those who wish to spread “fake news” or insidious conspiracies, so allow the story of AIDS denialism to serve as a cautionary tale.
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