Dangerous Thinking

There's a dangerous group of "thinkers" out there who call themselves AIDS "dissidents". These "dissidents" put forth the statements that HIV does not cause AIDS, that unprotected sex is not the cause of the AIDS epidemic in Africa and a whole host of other dangerous beliefs that, if they gain acceptance, could truly cause the number of AIDS cases to explode. These people advocate the belief that AIDS is caused by malnutrition, illegal drug uses, overuse of antibiotics, use of glutocosteroids, parasites, repeated STDs and/or other "body stressers" like poverty. They claim that there's a huge conspiracy between the government, drug manufacturers and the medical profession to use minorities as guinea pigs. So in case you ever run into one of these sorts, pay careful attention so you can refute them without breaking a sweat.

First, their main thrust is to argue against what they say the medical community (including pharmaceutical companies) is pushing: that HIV=AIDS (or that HIV causes AIDS). While it may be true that in the early stages of investigating the mysterious deaths that began plaguing the gay community and IV drug-users in the late 1970s/early 1980s doctors might have said that HIV caused the deaths, no one is teaching that now. (Although that is what some may understand it to mean.) AIDS stands for "acquired immunodeficiency syndrome". That last word— syndrome— is extremely important. The most commonly recognized syndrome among Americans (because most don't realize AIDS is a syndrome) is Downs syndrome. Downs syndrome, as with all syndromes, is a general description of a medical condition in which all those who have the syndrome have at least one characteristic in common. In the case of DS, it is the presence of an extra chromosome. The various other traits— mental retardation, mobility, coordination, speech, physical appearance, etc.— will all vary greatly. But everyone with DS has one thing in common: they have that extra chromosome. AIDS is no different. It is a general description of a medical condition in which all those who have AIDS have two things in common: they all have the HIV virus and they all have the presence of at least one of more than two dozen diseases that are relatively rare in those with healthy immune systems. The various other traits— such as which of these opportunistic diseases will actually end their life— varies greatly. But until they have the presence of the HIV virus and at least one of these diseases, they do not have AIDS. HIV, therefore, doesn't cause AIDS, it is a symptom of AIDS.

Their second big argument is that blacks and Hispanics are being targeted for HIV testing. They say this indicates that those who are saying that being HIV+ is necessary before one can get AIDS are racist. It has nothing to do with the color of their skin, per se, but with the cultural attitudes. The machismo of the Hispanic males (and I spent ten years in Denver where there is a large Hispanic population— one of the largest outside the states that actually border Mexico) often means that he has many sexual partners. Both blacks and Hispanics are statistically known to be less likely to use condoms, therefore they are at greater risk of contracting a sexually transmitted virus. Part of that is economics: condoms cost money that many blacks and Hispanics often don't have to spend on prevention of pregnancy. Birth control is not usually covered under health insurance plans (although Viagra is. Go figure.), but a pregnancy is.

Additionally, in Africa, where the disease is running rampant, many of these cultures don't even talk about sex. There are some tribes that don't even have words for someone's genitalia or the act of sex, therefore teaching someone to use condoms and to avoid risky sexual behavior becomes almost impossible when their culture refuses to discuss sex and their language has no words for it. In addition, there is not the access to condoms or educational material on how to stop the transmission of HIV. Much of the spread of HIV is due to the vast number of truckers and other transportation people who travel from one part of the continent to the other, sleeping with hookers along the way. Hookers who have HIV. Then they take it home to their wives. Again, it's all cultural differences, lack of education and lack of access to condoms, although most health care workers in Africa doubt that condoms would be used even if they were available because of the cultural and language differences. I believe there was an excellent article in National Geographic on the spread of HIV in Africa. I highly recommend reading it.

Third, they say that the media and the medical community are teaching that everyone is at risk (ie, there are no "high risk" behaviors), but then use the low rate of infection among "non-drug using white monogamous/non-sexually active heterosexuals" as proof that poverty (which is more prevalent in Africa and among blacks and Hispanics in the US) is the main root cause of AIDS. So they're citing statistics from those who engage in no high-risk activities, while at the same time denying these high risk activities are relevant. When it's pointed out to them that the spread of HIV in Africa is due in large part to unprotected sex with multiple partners who also have unprotected sex with multiple partners (these latter being for the most part hookers), they again toss out accusations of racism by saying that you're suggesting that blacks have sex like wild animals.

They then point to the high infection rate among blacks in Africa vs. whites in the US as further proof of racism. What they don't comprehend is that the vast majority of people in Africa are black. HIV, in Africa, began among the blacks. Probably among black heterosexuals, whereas in the US it began among gays and IV drug users. The very simple fact of the matter is that it's not a conspiracy or racism: it's nothing but statistics, probabilities and mathematics. Because most of the people in Africa are black, probabilities are higher that HIV infection began in the black population. Since most are heterosexual, probabilities are higher that it began among heterosexuals. And since most people have multiple sex partners (and that does not mean at the same time) it means that most of the people having HIV in Africa will be black heterosexuals who have had multiple sex partners in the course of their life. Thus, HIV infection rates are following the same pattern they did in the US: they're hitting hardest where they hit first.

Additionally, you can't simply go by the number of infected persons in certain categories: you must use percentages. Because the heterosexual population is anywhere from ten to thirty times bigger than the gay population (depending on whose statistics you use), you'd expect it to take longer to infect the same percentage of the heterosexual community IF none of the other variables changed. But these have changed: now that we know what behaviors put us at risk, those populations not already infected can slow down the rate of infection by not participating in risky behavior, therefore it will take even longer to reach that same percentage of infection present within the gay community. If you're having difficulty understanding this concept, think of it this way. Let's take two groups of people: one group has one hundred people in it and one group has 1000, which is roughly the same proportions of the gay to straight communities. Now, one person from each group takes one minute to tell two people the same thing and those two people each take one minute to tell two more people, etc. In the group that has 100 people, it will take six minutes before the entire group knows. (1+2+4+8+16+32+37=100) In the group with 1000 people, it will take 9 minutes for the entire group to find out (1+2+4+8+16+32+64+128+256+491=1000) using the same "rate" of discovery— a three minute difference. (This analogy isn't entirely accurate since with HIV, some who are infected have sex with others who are already infected, unlike the example where everyone who was told had not been told by someone else.) Now, let's say that after the fifth telling, we "slow down" the "rate" of discovery to two minutes. In the group of 100 people, that means we're adding an extra two minutes to the total time. But in the group of 1000 people, we're adding an extra five minutes, so we've doubled the time difference that it takes before 100% of the people know. Therefore, AIDS "dissidents" who claim that the fact that it's not spreading as quickly in white heterosexual populations is proof of a conspiracy are simply wrong.

These "AIDS dissidents" use what, on the surface, look like convincing arguments. Like the one about how the Japanese, who are the largest group to frequent Thailand's sex parlors have and have regularly scheduled bus tours to Nevada brothels, have one of the lowest reported incidences of AIDS in the world. They will quote a bunch of statistics and cite sources that taken together might convince most people. I'm not most people. It didn't convince me and it took me all of about 20 seconds to come up with an alternative explanation. I'm going to put it here so you too can use it if they try to convince you.

The number of cases cited are reported cases based on the cause of death listed on the death certificate. Cultures in the orient place a great deal of weight on family social standing and family members are under tremendous pressure not to tarnish the family name or reputation. People who get HIV/AIDS have very compromised immune systems and quite often die of one of the co-morbid diseases that come with a lowered immunity, like pneumonia. Even in the US, there are lots of people whose death certificates don't bear testimony to being HIV positive: their cause of death is listed as pneumonia or cancer, another co-morbid disease with HIV. Therefore, the rate appears low because most deaths from AIDS are not reported as being from AIDS. There is no requirement that one's HIV status be printed on the death certificate. If there were, my guess is that the number of AIDS deaths in Japan would skyrocket overnight.

They also argue that the number of deaths from AIDS among heterosexuals in the US is nothing like once predicted. The same kind of thinking can apply here: so many in the US still see HIV and AIDS as the "gay disease" or as "proof" that someone is shooting up drugs. Families, especially those in the Bible belt, often don't put AIDS as the cause of death on the birth certificate and don't broadcast their loved ones HIV status because they don't want it known that their loved one was gay or using IV drugs. Parents don't put it on their children's death certificates so that people don't realize that their child was sexually active at such a young age or that the child got HIV from one of the parents. The shame and stigma associated with HIV+ status in the US is a sad reminder of how much emphasis and importance Americans place on what others think about them and how it will look to the neighbors.

Another favorite, but false, argument is that the presence of the HIV antibody means that your body has fought and won the battle against the virus. Such a statement is blatantly false. The presence of antibodies means that your body has fought or is fighting an infection of some sort or that you have been vaccinated against the disease for which the antibodies have been found. I've never had TB but you'll find TB antibodies in my blood because I've had several TB tine tests.

They also like to use the argument that the drugs used to treat HIV are poisonous and, when used long term, will probably kill those taking them. No one is debating this fact. But what they seem to forget is that the same can be said of early cancer treatments and early chemotherapy. Yet today, in some cancer treatments like leukemia, death rates have been almost halved due in large part to the advancements made by studying the treatments of earlier victims. HIV treatments are becoming less toxic as well and will continue to do so as time goes by.

Don't let "AIDS dissidents" scare you into believing that the entire medical community the world over is in a giant conspiracy to kill blacks and other minorities or to make money for the drug companies. I have yet to figure out why they are doing what they're doing, but the fact that they're doing it at all is bad enough. To suggest that there are no high-risk activities that put an individual at greater risk of contracting HIV is irresponsible at best and criminal at worst.

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