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HIV Denial in the Internet Era
Tara C. Smith*, Steven P. Novella
virus (HIV), there is still denial that
the virus is the cause of acquired
immune defi ciency syndrome (AIDS).
This denial was highlighted on an
international level in 2000, when
South African president Thabo Mbeki
convened a group of panelists to discuss
the cause of AIDS, acknowledging that
he remained unconvinced that HIV was
the cause . His ideas were derived at
least partly from material he found on
the Internet . Though Mbeki agreed
later that year to step back from the
debate , he subsequently suggested
a re-analysis of health spending with a
decreased emphasis on HIV/AIDS .
HIV denial has taken root in the
general population and has shown its
potential to frustrate public education
efforts and adversely affect public
funding for AIDS research and
prevention programs. For example,
the AIDS Coalition to Unleash Power
(ACT UP) was for many years on the
front lines of AIDS education and
activism. But now a San Francisco
chapter of the group has joined the
denialist movement, stating on its Web
site that “HIV does not cause AIDS…
HIV antibody tests are fl awed and
dangerous…AIDS drugs are poison”
htm). In 2000 the chapter wrote letters
to every member of Congress asking
them to stop funding research into HIV
. ACT UP San Francisco’s position
has been condemned by other ACT UP
chapters, such as ACT UP Philadelphia
and ACT UP East Bay (http:⁄⁄www.
html). Rock stars have weighed in on
the topic. Members of the group “The
Foo Fighters” provided music for a
soundtrack of the recent documentary,
“The Other Side of AIDS” (http:⁄⁄www.
questions whether HIV is the cause of
AIDS. The band has spread its message
t may seem remarkable that, 23
years after the identifi cation of
the human immunodefi ciency
that HIV does not cause AIDS at
concerts , and it lists the HIV denial
group “Alive and Well” as a worthy
cause on its Web site (http:⁄⁄www.
As these challenges to mainstream
theories have largely occurred outside
of the scientifi c literature, many
physicians and researchers have had
the luxury of ignoring them as fringe
beliefs and therefore inconsequential.
Indeed, the Internet has served as a
fertile and un-refereed medium to
spread these denialist beliefs. The
Group for the Scientifi c Reappraisal
of the HIV/AIDS Hypothesis
(“Reappraising AIDS”) noted, “Thanks
to the ascendance of the internet,
we are now able to reinvigorate
our informational campaign” .
The Internet is an effective tool for
targeting young people, and for
spreading misinformation within a
group at high risk for HIV infection.
Two excellent online fact sheets
have been prepared to counter many
of the most commonly used arguments
to deny HIV causation of AIDS [8,9];
as such, we will not discuss these in
this article. Instead, we will review
the current intellectual strategies
used by the HIV denial movement.
Although other forms of science denial
will not be specifi cally discussed, the
characteristics described below apply
to many other forms of popular denial,
including denial of evolution, mental
illness, and the Holocaust.
Three Prominent Deniers and
One of the prominent HIV denial
groups currently is Christine
Maggiore’s “Alive and Well” (formerly
“HEAL,” Health Education AIDS
org/). Maggiore’s life story is at the
center of this group. Diagnosed with
HIV in 1992, Maggiore claims she has
since been symptom-free for the past 14
years without the use of antiretroviral
drugs, including protease inhibitors
. She has risen to prominence,
and been embroiled in controversy,
in recent years after giving birth to
and openly breast-feeding her two
children, Charles and Eliza Jane. She
had neither child tested for HIV, and
did not take antiretroviral medication
during her pregnancy or subsequent
breast-feeding . Eliza Jane died
in September 2005 of HIV-related
pneumonia , though Maggiore
remains unconvinced that HIV had any
role in her daughter’s death , and
continues to preach her message to
other HIV-positive mothers.
Peter Duesberg initiated the HIV
denial movement with a 1987 article
Funding: TCS received research start-up funding
from the University of Iowa, but received no specifi c
funding for this article.
Competing Interests: The authors have declared
that no competing interests exist.
Citation: Smith TC, Novella SP (2007) HIV denial in
the Internet era. PLoS Med 4(8): e256. doi:10.1371/
Copyright: © 2007 Smith and Novella. This is an
open-access article distributed under the terms
of the Creative Commons Attribution License,
which permits unrestricted use, distribution,
and reproduction in any medium, provided the
original author and source are credited.
Tara C. Smith is with the Department of
Epidemiology, University of Iowa College of Public
Health, Iowa City, Iowa, United States of America.
Steven P. Novella is with the Department of
Neurology, Yale University School of Medicine, New
Haven, Connecticut, United States of America.
* To whom correspondence should be addressed.
Example of a typical slogan from an HIV
The Policy Forum allows health policy makers around
the world to discuss challenges and opportunities for
improving health care in their societies.
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suggesting that HIV does not cause
AIDS . While he is no longer on
the front lines of this movement, the
arguments put forth by others trace
back to his publications.
Celia Farber is a journalist who has
spent much of her career covering HIV.
Farber is the author of a recent Harper’s
article repeating Duesberg’s claims that
HIV does not cause AIDS , and
has recently authored a book on “the
shadowy story of AIDS science” .
There are serious inconsistencies
within the broad HIV denial
movement, and the individuals
mentioned above are only the tip of
the iceberg. HIV denial groups diverge
even on the most basic tenet: does HIV
exist at all? Nevertheless, disagreements
within the movement are overlooked
for the sake of presenting a unifi ed
Conspiracy Theories and Selective
Distrust of Scientifi c Authority
That HIV is the primary cause of
AIDS is the strongly held consensus
opinion of the scientifi c community,
based upon over two decades of robust
research. Deniers must therefore
reject this consensus, either by
denigrating the notion of scientifi c
authority in general, or by arguing
that the mainstream HIV community
is intellectually compromised. It is
therefore not surprising that much of
the newer denial literature refl ects a
basic distrust of authority and of the
institutions of science and medicine.
In her book, Christine Maggiore
thanks her father Robert, “who taught
me to question authority and stand
up for what’s right” . Similarly,
mathematical modeler Dr. Rebecca
Culshaw, another HIV denier, states:
“As someone who has been raised by
parents who taught me from a young
age never to believe anything just
because ‘everyone else accepts it to be
true,’ I can no longer just sit by and do
nothing, thereby contributing to this
Distrusting mainstream medical
practitioners, many HIV deniers turn
to “alternative” medicine in search
of treatment. One such practitioner,
Dr. Mohammed Al-Bayati, suggests
that “toxins” and drug use, rather
than HIV, cause AIDS . Dr Al-
Bayati personally profi ts from his HIV
denialism: for $100 per hour, Al-Bayati
will consult “on health issues related to
AIDS, adverse reactions to vaccines and
medications, exposure to chemicals in
the home, environment or workplace”
Similarly, German vitamin supplier
and HIV denier Matthias Rath not only
pushed his vitamins as a treatment for
AIDS , but his spokesman refused
to be interviewed by Nature Medicine
about the case because he claimed the
journal is “funded to the hilt with drug
Deniers argue that because scientists
receive grant money, fame, and
prestige as a result of their research, it
is in their best interest to maintain the
status quo . This type of thinking is
convenient for deniers as it allows them
to choose which authorities to believe
and which ones to dismiss as part of a
grand conspiracy. In addition to being
selective, their logic is also internally
inconsistent. For example, they dismiss
studies that support the HIV hypothesis
as being biased by “drug money,” while
they accept uncritically the testimony of
HIV deniers who have a heavy fi nancial
stake in their alternative treatment
Portraying Science as Faith and
Consensus as Dogma
Since the ideas proposed by deniers do
not meet rigorous scientifi c standards,
they cannot hope to compete against
the mainstream theories. They
cannot raise the level of their beliefs
up to the standards of mainstream
science; therefore they attempt to
lower the status of the denied science
down to the level of religious faith,
characterizing scientifi c consensus
as scientifi c dogma . As one HIV
denier quoted in Maggiore’s book 
“There is classical science, the way
it’s supposed to work, and then there’s
religion. I regained my sanity when
I realized that AIDS science was a
religious discourse. The one thing I
will go to my grave not understanding
is why everyone was so quick to accept
everything the government said as
truth. Especially the central myth: the
cause of AIDS is known.”
Others suggest that the entire
spectrum of modern medicine is a
Deniers also paint themselves as
skeptics working to break down a
misguided and deeply rooted belief.
They argue that when mainstream
scientists speak out against the scientifi c
“orthodoxy,” they are persecuted and
dismissed. For example, HIV deniers
make much of the demise of Peter
Duesberg’s career, claiming that when
he began speaking out against HIV as
the cause of AIDS, he was “ignored and
discredited” because of his dissidence
. South African President Mbeki
went even further, stating: “In an
earlier period in human history, these
[dissidents] would be heretics that
would be burnt at the stake!” .
HIV deniers accuse scientists of
quashing dissent regarding the cause
of AIDS, and not allowing so-called
“alternative” theories to be heard.
However, this claim could be applied
to any well-established scientifi c
theory that is being challenged by
politically motivated pseudoscientifi c
notions—for example, creationist
challenges to evolution. Further,
as HIV denial can plausibly reduce
compliance with safe sex practices and
anti-HIV drugs, potentially costing
lives, this motivates the scientifi c and
health care communities to exclude
HIV denial from any public forum. (As
one editorial has bluntly phrased it,
HIV denial is “deadly quackery”) .
Because HIV denial is not scientifi cally
legitimate, such exclusion is justifi ed,
but it further fuels the deniers’ claims
Expert Opinion and the Promise of
Forthcoming Scientifi c Acceptance
Although the HIV deniers condemn
scientifi c authority and consensus, they
have nevertheless worked to assemble
their own lists of scientists and other
professionals who support their ideas.
As a result, the deniers claim that
they are just on the cusp of broader
acceptance in the scientifi c community
and that they remain an underdog
due to the “established orthodoxy”
represented by scientists who believe
that HIV causes AIDS.
In an effort to support its claim that
an increasing number of scientists
do not believe that HIV causes AIDS,
Reappraising AIDS has published a list
of signatories agreeing to the following
“It is widely believed by the general
public that a retrovirus called HIV
causes the group [of] diseases called
AIDS. Many biochemical scientists now
question this hypothesis. We propose
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that a thorough reappraisal of the
existing evidence for and against this
hypothesis be conducted by a suitable
independent group. We further propose
that critical epidemiological studies be
devised and undertaken” .
These signatories do not, however,
suggest who the “suitable independent”
group should be, since, presumably,
many scientists have already been
“indoctrinated” into believing that HIV
causes AIDS. (Indeed, many of the
signatories to this statement lack any
qualifi cations in virology, epidemiology,
or even basic biology.) They also ignore
thousands of epidemiological studies
that have already been published in the
scientifi c literature. And the signatories
fail to provide a convincing case that
there is widespread acceptance in the
scientifi c community for their marginal
Nevertheless, Farber wrote in a
1992 article that “more and more
scientists are beginning to question
the hypothesis that HIV single-
handedly creates the chaos in the
immune system that leads to AIDS”
. Similarly, a March 2006 article
appearing on the AIDS denial Web
site “New AIDS Review” claims that, in
reference to the theory that HIV causes
AIDS: “…the fabric of this theoretical
mantle is threadbare to the point
of disintegration” . Mainstream
scientists, of course, do not believe in
the imminent demise of the HIV theory;
instead they continue to produce novel
research on preventing and treating
HIV and publish thousands of papers
every year on the topic.
Further, deniers exploit the sense of
fair play present in most scientists, and
also in the general public, especially in
open and democratic societies. Calling
for a fair discussion of dissenting views,
independent analysis of evidence,
and openness to alternatives is likely
to garner support, regardless of the
context. But it is misleading for the
HIV denial movement to suggest that
there is any real doubt about the cause
Pushing Back the Goalpost
Of all the characteristics of deniers,
repeatedly nudging back the
goalpost—or the threshold of evidence
required for acceptance of a theory—is
often the most telling. The strategy
behind goalpost-moving is simple:
always demand more evidence than can
currently be provided. If the evidence
is then provided at a later date, simply
change the demand to require even
more evidence, or refuse to accept the
kind of evidence that is being offered.
In the 1980s, HIV deniers argued
that drug therapy for AIDS was
ineffective, did not signifi cantly
prolong survival, and in fact was toxic
and damaged the immune system .
However, after the introduction of a
cocktail of newer and more effective
agents in the 1990s, survival rates did
impressively increase . HIV deniers
no longer accept this criterion as
evidence for drug effectiveness, and
therefore the HIV theory of AIDS. Even
stacks of papers and books published
on the subject are not enough.
Christine Maggiore writes in her book,
“Since 1984, more than 100,000 papers
have been published on HIV. None of
these papers, singly or collectively, has
been able to reasonably demonstrate
or effectively prove that HIV can cause
HIV deniers also arbitrarily reject
categories of evidence, even though
they are generally accepted across
scientifi c disciplines. For example,
they deny inferential evidence that
HIV causes AIDS, including data
examining the closely related simian
immunodefi ciency virus (SIV) in
genomic and animal studies .
Likewise they reject correlation as
insuffi cient to establish causation
. However, multiple independent
correlations pointing to the same
causation—in this case that HIV causes
AIDS—is a legitimate and generally
accepted form of epidemiological
evidence used to establish causation.
The same type of evidence, for
example, has been used to establish
that smoking causes certain types of
What Are Their Alternatives?
After so much criticism levied upon
the prevailing theories by deniers, one
might think they would have something
to offer to replace HIV as the cause
of AIDS. However, the alternatives
they offer are much more speculative
than the mainstream theories they
decry as lacking evidence. Further,
their arguments amount to little
more than another logical fallacy,
the false dichotomy: they assume that
overturning the prevailing theory will
prove their theory correct, by default.
Interestingly, alternative hypotheses
for AIDS causation depend on where
the patient lives. In Africa, HIV deniers
attribute AIDS to a combination of
malnutrition and poor sanitation, i.e.,
they believe that AIDS is simply a re-
labeling of old diseases. In America
and other wealthy countries, they
claim AIDS is caused by drug use
and promiscuity. Duesberg has long
been an advocate of the idea that the
use of “poppers,” or amyl nitrate, is a
cause of AIDS in the gay community
. With the identifi cation of AIDS
in individuals who have never used
poppers, this hypothesis has been
widened by HIV deniers to implicate a
number of recreational drugs (cocaine,
crack, heroin, methamphetamines)
as well as prescription drugs such as
antibiotics and steroids in the etiology
of AIDS. HIV deniers have criticized
the idea that immunosuppression
due to infection with HIV could
result in all of the different infections
that characterize AIDS, and yet they
support the idea that poppers or other
drugs—including many that have not
been shown to cause severe immune
defi ciencies—could cause AIDS. In
the past decade, the very drugs used to
treat HIV/AIDS have come under fi re
by HIV deniers, who have suggested
that the medicines themselves
are a cause of AIDS (http:⁄⁄www.
Because these denialist assertions are
made in books and on the Internet
rather than in the scientifi c literature,
many scientists are either unaware
of the existence of organized denial
groups, or believe they can safely
ignore them as the discredited fringe.
And indeed, most of the HIV deniers’
arguments were answered long ago by
scientists. However, many members
of the general public do not have the
scientifi c background to critique the
assertions put forth by these groups,
and not only accept them but continue
to propagate them. A recent editorial
in Nature Medicine  stresses the need
to counteract AIDS misinformation
spread by the deniers.
While the descriptions of HIV
denialism above refer to relatively
organized campaigns, there are other
less orchestrated examples of such
denialism. A recent study, for example,
showed that a large percentage of
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African Americans are suspicious
of mainstream AIDS theories due
to a general distrust of government
authorities . Arguments by denial
groups may have played a role in the
formation of their opinion. Indeed,
the effect of denial groups on public
perception of HIV infection is an area
ripe for careful research, as this denial
can have lethal consequences. In the
recent study, stronger conspiracy
beliefs were signifi cantly associated
with more negative attitudes towards
using condoms and with inconsistent
condom use, independent of selected
partner variables, sexually transmitted
disease history, perceived risk, and
psychosocial factors .
How much of this lingering denial
is the fault of scientists and the media
for originally proclaiming AIDS a
universal “death sentence”? Even
though this idea may no longer
appear in the scientifi c literature, it
remains a public perception of the
disease. It is diffi cult to strike the
correct balance between providing
information conveying on one hand
the severity of the disease, and on
the other optimism about treatment
and advances in understanding HIV
pathogenesis (including research
about individuals who may indeed
be somewhat resistant to the virus).
Oversimplifying AIDS science to the
public lends itself to exploitation by
AIDS deniers who remain “alive and
well” years after diagnosis with HIV. Yet
these concerns must be balanced with
the desire to convey the proper gravity
of the situation and motivate those who
are known to be HIV positive to seek
treatment: a diffi cult line to walk.
This balancing act, in fact, deserves
increasing attention from medical
scientists in the age of the Internet and
a broadening gap between the practice
of science and public understanding
of science. Successful public health
education requires the presentation of
a clear and simple message supported
by a solid consensus of the medical
community. Yet the reality behind
the scenes is often quite different.
Every medical fi eld has its legitimate
controversies and complexities, and
the process of science is often messy.
Denial groups exploit the gap between
public education and scientifi c
Further, countering the
misinformation of HIV deniers needs
to be conducted in the broader societal
context of countering anti-science
and pseudoscience. The strategies of
HIV deniers, like many other denialist
movements, seek to undermine the
very philosophy of science itself, to
distort public understanding of the
scientifi c process, and to sow distrust
of scientifi c institutions. Unscientifi c
alternative medical modalities have
made signifi cant inroads into the
institutions of health care through
political means, despite a continued
lack of scientifi c legitimacy: vaccines
are characterized as dangerous instead
of life-saving; psychiatry is mocked by
celebrities and others in the public eye.
Meanwhile, many leaders in science
and business are concerned that the
United States is losing its edge as a
scientifi c powerhouse.
There remains a deep problem
of overall scientifi c illiteracy in this
country and others, creating fertile soil
for those who wish to spread scientifi c
misinformation . The scientifi c
community must collectively defend and
promote the role of science in society,
and combat the growing problem of
scientifi c illiteracy. We must all strive to
do our part to make science accessible
to the general public, and to explain
the process by which scientifi c evidence
is gathered, analyzed, and eventually
accepted, and academic institutions
should provide greater incentive
for their researchers to expend the
time and effort to do so. A solid
understanding of the scientifi c method
may not eliminate science denial, but it
may act as a buffer against the further
spread of such denialist beliefs. ?
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