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Questioning the HIV-AIDS hypothesis: 30 years of dissent

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Since 1984, when the hypothesis that HIV-causes-AIDS was announced, many scholars have questioned the premise and offered alternative explanations. Thirty years later, competing propositions as well as questioning of the mainstream hypothesis persist, often supported by prominent scientists. This article synthesizes the most salient questions raised, alongside theories proposing non-viral causes for AIDS. The synthesis is organized according to four categories of data believed to support the HIV-AIDS hypothesis: retroviral molecular markers; transmission electron microscopy (EM) images of retroviral particles; efficacy of antiretroviral drugs; and epidemiological data. Despite three decades of concerted investments in the mainstream hypothesis, the lingering questions and challenges synthesized herein offer public health professionals an opportunity to reflect on their assumptions and practices regarding HIV/AIDS.
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PUBLIC HEALTH
OPINION ARTICLE
published: 23 September 2014
doi: 10.3389/fpubh.2014.00154
Questioning the HIV-AIDS hypothesis: 30 years of dissent
Patricia Goodson*
Department of Health & Kinesiology, Texas A&M University, College Station, TX, USA
*Correspondence: pgoodson@hlkn.tamu.edu
Edited by:
Sanjay P. Zodpey, Public Health Foundation of India, India
Reviewed by:
Lalit Raghunath Sankhe, Grant Government Medical College, India
Preeti Negandhi, Indian Institute of Public Health Delhi, India
Keywords: HIV, AIDS, dissent, causation, multifactorial causality
Since 1984, when the hypothesis that
HIV-causes-AIDS was announced, many
scholars have questioned the premise and
offered alternative explanations. Thirty
years later, competing propositions as well
as questioning of the mainstream hypoth-
esis persist, often supported by prominent
scientists. This article synthesizes the most
salient questions raised, alongside theories
proposing non-viral causes for AIDS. The
synthesis is organized according to four
categories of data believed to support the
HIV-AIDS hypothesis: retroviral molecular
markers; transmission electron microscopy
(EM) images of retroviral particles; efficacy
of anti-retroviral drugs; and epidemiologi-
cal data. Despite three decades of concerted
investments in the mainstream hypothe-
sis, the lingering questions and challenges
synthesized herein offer public health pro-
fessionals an opportunity to reflect on
their assumptions and practices regarding
HIV/AIDS.
“The HIV/AIDS hypothesis is one hell
of a mistake, wrote Kary Mullis in 1996
[(1), p. 14]. Mullis Nobel Laureate in
Chemistry, 1993 – and other distinguished
scientists have claimed the HIV-causes-
AIDS hypothesis is false,unproductive, and
unethical. They have done so since 1984,
when the hypothesis was proposed. Thirty
years after countless studies, resources, and
attempts to cure have been poured into the
HIV-AIDS hypothesis, it may be fruitful
to ask: What happened to those views and
voices that once disagreed? Have the past
three decades, with their scientific, tech-
nological, and public health developments,
been sufficient to convince critics of the
hypothesis’ value? Have these advances
been able to silence the questioning?
Here, I synthesize the main criticisms
aimed at the HIV-AIDS hypothesis, along-
side select unorthodox
1
theories propos-
ing non-viral cause(s) for AIDS, to argue:
far from being condemned to extinction,
competing explanations for, and thorough
questioning of the mainstream premise
persist. Perhaps better known by the lay
public than by health professionals, many
explanations are, in fact, attracting a grow-
ing number of sympathizers. To support
the argument, I employ historical research
and data synthesis methods. I utilize, as
data, trade and professional publications
in tandem with authoritative scientific
sources.
It is important to note that my purpose
is not to review the state of the science
regarding HIV/AIDS,nor to persuade read-
ers to reject the mainstream hypothesis.
Instead, I aim to expose readers to the per-
sisting controversies, and to motivate them
to raise questions of their own. Ultimately,
then, this article invites the public health
workforce to reflect on prevailing assump-
tions and practices regarding HIV-AIDS.
Reflecting on assumptions and practices
represents a central task for public health
professionals; a vital step to ensure their
(our) practice continually grounds itself in
the most rigorous ethical standards (3).
HIV-CAUSES-AIDS: HOW VALID ARE
THE DATA?
In 1984, Margaret Heckler (then Secretary
of the Department of Health and Human
Services) announced a retrovirus was the
“probable cause” of the alarming immune
system collapse emerging in the US since
1981 (4). When scientists identified anti-
bodies to a retrovirus known as LAV, or
HTLV-III, in 48 persons (from a sample
of 119, with and without immune defi-
ciency symptoms), the retrovirus became
the culprit of what would be perceived as
“the most urgent health problem facing the
country” in recent history [(5, 6), p. 1].
The announcement intended to assure
the public: the mystery surrounding this
apparently contagious and decidedly fatal
illness later labeled AIDS for acquired
immune deficiency syndrome was solved.
The newly identified virus – soon renamed
HIV, for human immunodeficiency virus –
was, almost certainly, responsible for debil-
itating people’s immune system and mak-
ing them vulnerable to infections which,
before AIDS, were either rare or not par-
ticularly dangerous. Now, however, infec-
tions such as Kaposi’s Sarcoma and Pneu-
mocistis carinii Pneumonia had morphed
into vicious killers (4, 6). By identify-
ing the perpetrator, scientists’ attention
and government resources could then
focus on treatment, cure, and vaccine
development.
Yet almost immediately, scientists who
knew a great deal about retroviruses and
immunology began to voice misgivings
regarding the HIV-causes-AIDS hypothe-
sis, and to question it. They highlighted the
difficulties, flaws, and contradictions they
saw in the hypothesis, and offered alter-
native explanations. Many of the original
misgivings have survived, and others have
been raised, in the past three decades.
1
In this article, I will use the terms unorthodox, non-orthodox, non-mainstream, and alternative, to refer collectively to those who disagree with the prevalent view, and
to their propositions (despite their variability). I will favor the term “unorthodox” for it carries the notion of intention or willful deviation from the norm and connotes
a power differential in which one set of theories (the orthodox or mainstream) dominates another what Delborne calls “the epistemological tyranny of the intellectual
majority” [(2), p. 510].
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Goodson HIV/AIDS: 30 years of dissent
In this paper, therefore, I summarize
some of these difficulties, and present what
critics propose as alternative causes of
AIDS. I organize the challenges put forth
by unorthodox scholars into four cate-
gories of data that support the HIV-AIDS
hypothesis
2
: (1) retroviral molecular mark-
ers; (2) transmission electron microscopy
(EM) images of retroviral particles; (3) effi-
cacy of anti-retroviral (ARV) drugs; and
(4) epidemiological data (7, 8). Because
these data are proffered as solid evidence
for HIV’s role in causing AIDS,it is useful to
examine how critics question the evidence
in each category, specifically.
RETROVIRAL MOLECULAR MARKERS
Mainstream scientists and physicians claim
the molecular evidence for HIV-as-the-
cause-of-AIDS is irrefutable (8, 9) and
comprises: (a) HIV antibodies and (b) viral
load. As incontrovertible as these mole-
cular markers appear to be, unorthodox
scientists have meticulously examined each
one and detected significant problems in
both (7).
HIV antibodies
The first available tests to screen blood
banks for HIV detected HIV antibod-
ies (10). Physicians still use these tests
when screening blood for infection and,
since 2004, direct-to-consumer home tests
have become available for identifying anti-
bodies to HIV using only a saliva sam-
ple (e.g., OraQuick) (11). Yet, from the
time the first tests appeared, scientists in
both orthodox and unorthodox camps
reiterated that, according to established
immunology principles, antibodies to a
virus indicate the immune system has acted
to control the invading virus. Antibodies
point to previously occurring infection and
do not signal active infection. In 1984,CDC
scientists (mainstream) wrote:
A positive test for most individuals in
populations at greater risk of acquir-
ing AIDS will probably mean that the
individual has been infected at some
time with HTLV-III/LAV [the names
originally used for HIV]. Whether
the person is currently infected or
immune is not known, based on the
serologic test alone [(12), p. 378].
It is not only this simple argument anti-
bodies suggest the immune system has con-
trolled the invading agents – that unortho-
dox scientists have debated. The tests them-
selves remain the target of critic’s intense
scrutiny. For instance, in 1996 Johnson
reported 60-plus factors capable of caus-
ing a false-positive result on tests for HIV
antibodies [either an ELISA or a western
blot (WB) test] (13). Because they react to
these factors, the tests may not be detect-
ing HIV at all. Worthy of notice, among
the list, are elements ubiquitous among all
populations such as the flu, flu vaccina-
tions, pregnancy in women who have had
more than one child, tetanus vaccination,
and malaria (an important element to con-
sider in the case of the AIDS epidemic
in Africa). Supporting each factor, John-
son provides scientifically valid evidence –
published in reputable peer-reviewed jour-
nals such as AIDS, the Proceedings of the
National Academy of Sciences of the United
States of America, The Lancet, the Cana-
dian Medical Association Journal, and the
Journal of the American Medical Association
(JAMA) (13).
Celia Farber’s book, Serious Adverse
Events: An Uncensored History of AIDS
(14) an exposé of the epidemic’s eth-
ically questionable history contains an
interesting appendix authored by Rodney
Richards. Richards who helped to develop
the first ELISA test for HIV outlines
the evolution of CDC’s stances regard-
ing the role of antibodies, infection, and
HIV tests. First, the CDC aligned itself with
the traditional view of antibodies signal-
ing past/prior infection (as evidenced in the
quote above, from 1984). In 1986, the CDC
moved toward a qualified claim, stating:
. . . patients with repeatedly reac-
tive screening tests for HTLV-III/LAV
antibody . . . in whom antibody is also
identified by the use of supplemental
tests (e.g., WB, immunofluorescence
assay) should be considered both
infected and infective [(15), p. 334].
Finally, in 1987, CDC adopted a non-
qualified claim that antibodies signify
active infection and/or illness: The pres-
ence of antibody indicates current infec-
tion, though many infected persons may
have minimal or no clinical evidence of
disease for years [(16, 17), p. 509].
A more specific measure than the ELISA
test, the WB detects antibodies by identify-
ing proteins believed to be associated with
HIV, and only with HIV. A person under-
goes a confirmatory WB after a prior ELISA
screening test reacts positively (but it is
important to remember: over 60 conditions
can yield a false-positive ELISA) (13, 18).
Critics of the orthodox view decry the
lack of standardized criteria for a positive
result in a WB, across countries, world-
wide (19). Bauer (Table 1), in a 2010 arti-
cle titled “HIV tests are not HIV tests”
claims,“no fewer than five different criteria
have been used by different groups in the
United States” [(18), p.7]. Moreover adds
Bauer – included in the contemporary cri-
teria for a positive WB are p41 and p24,
protein–antigens “found in blood platelets
of healthy individuals.”This means some of
the biological markers being used to “flag”
the presence of HIV are not“specific to HIV
or AIDS patients [and] p24 and p41 are
not even specific to illness.” In other words,
healthy persons may test positive on a WB
but not carry HIV at all [(18), p. 6].
An example may clarify: if tested in
Africa, a WB showing reactivity to any two
of the proteins p160, p120, or p41, would
be considered positive for HIV. In Britain,
the test would be positive only if it showed
reactivity to one of these three proteins,
together with reactions to two other pro-
teins, p32 and p24 (see mention of p24,
above, as occurring in healthy individuals).
Therefore, someone whose test reacts to
p160 and p120 would be considered HIV-
positive in Africa, but not in Britain. A
test reaction to p41, p32, and p24 would
be considered positive in Britain, but neg-
ative in Africa, leading author Celia Farber
to comment: . . . a person could revert
to being HIV-negative simply by buying a
plane ticket from Uganda to Australia [or
in our example, from Uganda to London
(14), p. 163].
According to critics, a definitive answer
regarding which protein–antigens are spe-
cific to HIV and HIV alone can only come
from successful virus isolation and purifi-
cation. Isolating and purifying “would be
required to verify that all of these proteins
2
I am indebted to E. de Harven (7) for suggesting these categories.
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Goodson HIV/AIDS: 30 years of dissent
Table 1 | Credentials and professional experience of select critics of the HIV-AIDS hypothesis.
Name (alphabetical order by
last name)
Credentials
Henry Bauer, Ph.D. Professor Emeritus of Chemistry and Science Studies
Dean Emeritus of Arts and Sciences
Virginia Polytechnic Institute and State University (Virginia Tech)
James Chin, MD, MPH
a
Chief of Infectious Disease Section, California State Department of Health Services, Berkeley, CA, USA (1970s–1987)
Former Chief of Surveillance, Forecasting and Impact Assessment (SFI), Unit of the Global Program on AIDS (GPA) of
the World Health Organization Editor: APHAs “Control of Communicable Diseases Manual”
Ettiene de Harven, MD Emeritus Professor of Pathology: University of Toronto, ON, USA
Specialized in electron microscopy at the “Institute du Cancer” in Paris
Published first images of budding virus through EM (1960)
Member: Sloan Kettering Institute, New York, NY, USA in 1968
Former President: The Electron Microscopy Society of America (in 1976)
Former President: Rethinking AIDS
Peter Duesberg, Ph.D. Professor of Molecular and Cell Biology: The University of California, Berkeley, CA, USA
Isolated the first cancer gene and mapped the genetic structure of retroviruses (1970)
Member: National Academy of Sciences (since 1986)
Outstanding Investigator Award – National Institutes of Health 1986
Heinrich Kremer, MD Founder and Senior Consultant: Cell Symbiosis Therapy Academy® (based on his work on NO and its association with
chronic inflammatory and degenerative disease)
Collaborating Member: Study Group for Nutrition and Immunity (Bern, Germany)
Extensive clinical work with youth drug addiction
Kary Mullis, Ph.D. Nobel Laureate – Chemistry – 1993
Developed: polymerase chain reaction
Founder and Chief Scientific Advisor: Altermune
David Rasnick, Ph.D. Biochemist with >25 years of work with proteases and protease inhibitors
Former President: Rethinking AIDS: the group for the scientific reappraisal of the HIV hypothesis
Former President: international coalition for medical justice
a
Chin agrees with the mainstream hypothesis that HIV is the cause of AIDS. His critique centers on the collection and interpretation of the epidemiological data for
HIV/AIDS, in the US and world-wide.
actually originate from HIV particles” [(7),
p. 70]. Attempts at purifying have been
made (20, 21), but have been criticized for
their ambiguous findings (22), or for their
use of cultured samples (see discussion
below on EM images). To date, the issue of
HIV isolation in purified samples has not
been addressed to critics’ satisfaction (23).
Viral load
The expression “viral load” refers to the
quantity of virus found in HIV-infected
blood. According to the mainstream per-
spective, information on viral load helps
monitor the infections progress, “decide
when to start treatment, and determine
whether or not . . . HIV medications are
working” (24).
The technique for measuring viral load
is known as RNA PCR ribonucleic acid
polymerase chain reaction (25). Main-
stream scientists regard this test as the most
specific documentation of HIV’s presence
in a persons body. It is often used when the
ELISA and WB tests are negative, because
PCR can detect the virus’ genetic material
(or its RNA/DNA fragments), before the
human body has had a chance to recognize
the virus, produce antibodies in defense,
and react positively in an antibodies-only
test (26).
Despite its enhanced specificity, many
mainstream scientists and practitioners
recommend caution when using PCR for
screening or diagnosing infection (27). For
instance, authors of a study published in
JAMA in 2006, in which PCR was used
with a sample of almost 3,000 people, con-
cluded: “The PCR assay is not sufficiently
accurate to be used for the diagnosis
of HIV infection without confirmation
[(28), p. 803].
PCR technology evolved quickly since
it was introduced in 1983 (25). Although
being employed, mostly, for assessing viral
load (less for screening and diagnosis), it
should give us pause to learn, however, that
Dr. Kary Mullis the scientist who won
the 1993 Nobel Prize for inventing the PCR
test and whose quote introduced this arti-
cle (Table 1) has strongly opposed using
the technique for determining the amount
of virus circulating in plasma. Lauritsen
explains:
Kary Mullis . . . is thoroughly con-
vinced that HIV is not the cause of
AIDS. With regard to the viral-load
tests, which attempt to use PCR for
counting viruses, Mullis has stated:
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Goodson HIV/AIDS: 30 years of dissent
“Quantitative PCR is an oxymoron.”
PCR is intended to identify substances
qualitatively, but by its very nature
is unsuited for estimating numbers.
Although there is a common misim-
pression that the viral-load tests actu-
ally count the number of viruses in
the blood, these tests cannot detect
free, infectious viruses at all; they can
only detect proteins that are believed,
in some cases wrongly, to be unique
to HIV. The tests can detect genetic
sequences of viruses, but not viruses
themselves [(29), p. 3].
If to this picture we add human
endogenous retroviruses (or HERVs) (30)
as potential confounders, the genetic
sequences detected in a PCR test may not
be those from an exogenous virus, at all,
and may explain the test’s substantial false-
positive rates (18, 27). HERVs consist of
retrovirus-like particles produced by host
cells that are stressed or dying. In other
words, when various infections assail the
body, and certain cells experience stress or
die in large numbers, they can manufacture
by-products similar to retroviruses. These
by-products can be reactive when test-
ing for HIV antibodies, protein antigens,
and viral loads (31). Culshaw summarizes
it well:
A retrovirus is nothing more than
RNA with an outer protein shell. The
shell enables it to bind to cells of
the type it infects, and once it gains
entry, the outer coating disappears
and the RNA is transcribed to DNA
and incorporated as provirus into
the host cell’s own genome. It is for
this reason that retroviruses are called
enveloped viruses, and it is also the
reason that it is very difficult to distin-
guish between exogenous retroviruses
(those that originate outside the body
from a foreign invader) and endoge-
nous retroviruses (those that are man-
ufactured from our own retroviral-
like genetic sequences under condi-
tions of cellular stress, including dis-
eases) . . . Much of the genetic material
attributed to HIV is in fact DNA or
RNA from [these] decaying cells (. . .)
Human beings are filled with such
endogenous retroviruses [(32), pp. 53,
55–56].
TRANSMISSION ELECTRON MICROSCOPY
IMAGES OF RETROVIRAL PARTICLES
Although it seems intuitive that pho-
tographing HIV would provide undeni-
able evidence of its presence in the host’s
plasma, the reality is much more complex.
Adequately interpreting images obtained
through EM is, even for the most skilled
scientists, challenging. EM generates highly
amplified images of cells and viral parti-
cles. An electron-microscope uses “beams
of electrons focused by magnetic lenses
instead of rays of light” to produce images
magnified up to 10,000,000× (a light
microscope has difficulty exceeding 2000×
magnification) (33).
The first images of what researchers
believed to be HIV particles budding out
of human cells were published in the jour-
nal Science, in 1983, by the French team
that co-discovered HIV (headed by Luc A.
Montagnier) (34). These images, and the
computer graphics based on them, were
printed in textbooks and articles discussing
AIDS, extensively. Despite their popular-
ity, the images were obtained from a “pre-
AIDS” patient (not a patient with AIDS),
and the sample furnishing the images had
not been purified according to standard
procedures (35).
It would be 14 years later, in 1997, when
EM images from purified samples were
produced (20).Yet another study (22), pub-
lished simultaneously with these images
(in fact, printed as an adjoining article),
reported: even purified HIV samples har-
bor protein particles (called microvesi-
cles), considered to be contaminants. These
microvesicles do not disappear during the
purifying process. In other words, even
when technicians purify HIV samples, cer-
tain cellular proteins bound to non-viral
particles (i.e., microvesicles) can copurify
with [the] virus, and appear in the EM
images. The question, then, remains: are
the EM images seen in these purified sam-
ples, pictures of HIV itself, or of other
elements/particles? (36).
In 2010, Ettiene de Harven the scientist
who “produced the first electron micro-
graph of a retrovirus (the Friend leukemia
virus)” [(32), p.13] through EM research in
1960 (Table 1) (37) – added to the debate:
All the images of particles supposedly
representing HIV and published in
scientific as well as in lay publications
derive from EM studies of cell cultures.
They never show HIV particles com-
ing directly from an AIDS patient [(7),
p. 70 – emphasis added].
Why is it important to obtain EM images
of HIV from AIDS patients, as opposed to
images of HIV cultured in a laboratory?
According to de Harven, non-viral micoor-
ganisms frequently contaminate cell cul-
tures and show up very easily in EM. It
is quite difficult to obtain absolutely pure
cell cultures, especially because the cultur-
ing process itself the growth factors added
to the culture, such as “T cell lymphocyte
growth factor (TCGF), interleukin 2, or
corticosteroid hormones [(23), p. 4] – can
introduce potential contaminants. HERVs,
for example, are often generated by cells
that have been stressed or hyperstimulated
to grow in cultures. HIV cultures obtained
from patients with AIDS may not require
as much stimulation or addition of growth
factors, thus resulting in less contaminated,
purer cultures.
Montagnier also acknowledges the
problems with relying on EM to identify a
retrovirus, given the difficulties with puri-
fying viral samples. In an interview given in
1997, he reflects on those first HIV images
from cultured samples, produced in his
laboratory at the Pasteur Institute:
DT (Djamel Tahi): Why do the EM
photographs published by you, come
from the culture and not from the
purification?
LM (Luc Montagnier): There was so
little production of virus it was impos-
sible to see what might be in a concen-
trate of virus from a gradient. There
was not enough virus to do that . . .
(. . .)
DT: How is it possible without EM
pictures from the purification, to
know whether these particles are viral
and appertain to a retrovirus, more-
over a specific retrovirus?
LM: Well, there were the pictures of
the budding. We published images of
budding which are characteristic of
retroviruses. Having said that, on the
morphology alone one could not say
it was truly a retrovirus . . . (38).
It appears, therefore, there is little con-
sensus regarding what the existing EM
images reflect: are the visualized parti-
cles HIV or something else? According
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Goodson HIV/AIDS: 30 years of dissent
to Papadopulos-Eleopulos and colleagues,
“some of the best known retrovirologists
including Peter Duesberg, Robert Gallo,
and Howard Temin have been telling us
that particles may have the morphologi-
cal characteristics of retroviruses but are
not viruses”[(39), p. 2]. It is feasible, there-
fore, that EM images are, in fact, depictions
of (a) microvesicles (or protein particles),
not viral or infectious in nature, but not
eliminated even when using purified sam-
ples (22); or (b) human endogenous retro-
viruses defective, non-infectious retro-
viruses associated with the host’s own
genome (see discussion above on HERVS).
EFFICACY OF ANTI-RETROVIRAL DRUGS
From the epidemic’s onset, researchers
worked relentlessly to find a vaccine to keep
the virus from spreading and to develop
drugs for managing the symptoms from
opportunistic infections (40). The chal-
lenges inherent in developing both vac-
cine and treatment were daunting: post-
infection, HIV appears to mutate and
recombine continually, thus making it dif-
ficult to design an effective vaccine (41, 42).
Furthermore, designing treatments for a
retrovirus is a tricky feat, given it shares
many of the same characteristics of the
host’s immune cells thus, an attack on the
virus can become a simultaneous attack on
the healthy host cells (14, 32, 35).
After the public announcement regard-
ing the probable cause of AIDS, vari-
ous pharmaceutical companies tried to
develop drugs to thwart the action of
the virus’ reverse transcriptase enzyme (an
enzyme essential for the replication of
retroviruses). AZT became the first med-
ication of this kind, approved specifically
for treating AIDS patients in 1987 (43).Azi-
dothymidine (AZT) also known as Retro-
vir, a drug originally designed, but proven
unsuccessful, for treating leukemia – made
history not only because it was the first
available treatment specifically for AIDS,
but also due to how quickly it was
approved: AZT received “investigational
new drug (IND) status (initial approval
for testing) within 5 days of application
[(44), p. 134]. Given the desperate need
for specific treatment, the drug’s placebo-
controlled trials also moved fast, lasting
only 6 months before approval was given
for general sale” [(44), p. 134]. Phase II
trials were interrupted, mid-way, due to
findings that fewer patients taking AZT
were dying of AIDS when compared to the
control group not taking the drug (44, 45).
Approving AZT, however, did not pre-
vent scientists from trying to develop other
drugs, during the following decade; but
most attempts would make little head-
way into the treatment of AIDS. Adding
to these difficulties, AZT was proving to
be extremely toxic and not as effective as
initially anticipated. Researchers did learn,
meanwhile, that prescribing AZT in lower
dosages and in combination with other,
well-known drugs such as heparin, acy-
clovir, and bactrim, was beginning to curb
mortality rates (44).
Thus, in the mid-90s combination
therapy” became available. Also referred to
as the “drug cocktail, combination ther-
apy comprised a joint attack on HIV using
three main classes of drugs, simultane-
ously: (a) those inhibiting reverse tran-
scriptase’s ability to duplicate the virus’
genetic material using host DNA sub-
divided into two classes nucleoside and
non-nucleoside inhibitors; (b) protease
inhibitors (designed to limit certain pro-
teins needed for HIV assembly); and (c)
myristoylation or entry/fusion inhibitors
(blocking the virus from entering the host
cells). These three classes of drugs – known
collectively as HAART (highly active ARV
therapy) or antiretrovirals (ARVs) have
been praised for their ability to restore the
health of patients with AIDS who become
extremely ill [(24, 44, 46), p. 240].
Antiretrovirals also are praised for their
ability to reduce patients’ viral loads and,
therefore, their level of infection and ability
to transmit the virus (or infectivity). This
reduction in viral load has been deemed so
significant that, in 2012, the FDA approved
using one of the combination drugs (Tru-
vada) for pre-exposure prophylaxis or PrEP
(47).
PrEP or “HIV treatment-as-prevention
(48) involves administering to non-
infected persons one pill of the antiretro-
viral, daily, to stave off infection: an ini-
tiative crowned Breakthrough of the Year
by the journal Science, in 2011 (47). Tri-
als conducted world-wide have consistently
demonstrated low rates of HIV infection
among people taking PrEP (41, 48). The
2011 breakthrough, therefore, was the con-
clusion: “The early initiation of ARV ther-
apy reduced rates of sexual transmission of
HIV-1 and clinical events, indicating both
personal and public health benefits from
such therapy” [(41), p. 493].
Yet, as with most treatment drugs, ARVs
also produce important side-effects. Even
mainstream scientists who praise the drugs
by saying, “Combination theory [sic] was a
miracle, comparable with antibiotics, anes-
thesia, and the polio vaccine in the annals
of the history of medicine . . . a ‘quantum
leap”’ candidly admit: “The miracle was
not without complications.” [(44), pp. 246,
247]. Because these drugs also attack non-
infected cells, they can destroy the immune
systems healthy T-cells, and even cause a
collapse identical to AIDS. Authors of a
study reporting on the first decade of ARV
use concluded,
The results of this collaborative study,
which involved 12 prospective cohorts
and over 20,000 patients with HIV-
1 from Europe and North America,
show that the virological response
after starting HAART has improved
steadily since 1996. However, there
was no corresponding decrease in the
rates of AIDS, or death, up to 1 year
of follow-up. Conversely, there was
some evidence for an increase in the
rate of AIDS in the most recent period
[2002–2003] [(49), p. 454 empha-
sis mine].
Critics’ concerns center on the potential
association between use of HAART and
a depressed immune system. This associ-
ation carries significant implications for
the prophylactic use of ARVs. For instance,
studies have documented patients’ com-
promised immune systems as preceding
their seroconversion (50, 51). Therefore,
having non-infected persons take HAART
as prophylaxis may, over time, impact their
immune systems negatively, and predis-
pose them to becoming infected with vari-
ous agents, including HIV itself. Moreover,
there is evidence that ARVs can acceler-
ate aging of cells in ways that promote
progressive multi-organ disease (52). Crit-
ics also point to data on patients taking
ARVs who develop Pneumocystis Carinii,
and Candida albicans (opportunistic infec-
tions typical of patients with AIDS) while
on the drugs, despite the fact the pro-
tease inhibitors have “marked anticandidal
and antipneumocystis effects” [(7), p. 71].
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Goodson HIV/AIDS: 30 years of dissent
Equally vexing, are the deaths among ARV-
treated patients, resulting from acute liver
failure. These deaths point to the ARVs’
detrimental effects, given that HIV, itself,
does not cause liver toxicity (7, 53, 54).
Critics also highlight studies document-
ing the reduction of plasma HIV RNA
among patients treated with ARVs, but
the non-reduction in HIV DNA, suggest-
ing there is “continued expression of viral
agents”even after 1 year of treatment [(55),
p. 320]. Compounding these difficulties are
the often debilitating side effects (45), the
drugs’extremely high costs (AZT alone cost
around $6,000 a year and the cocktails can
easily tally $12,000 13,000 a year per
patient) [(44), pp. 245–246] and the often-
times daunting regimen some prescrip-
tions require, leading to patients’ less-than-
optimal compliance during treatment.
Despite this host of problems, ortho-
dox scientists and practitioners still claim
HAART has changed the face of the AIDS
epidemic: once considered a lethal syn-
drome, testing positive for HIV does not
equate to a death sentence any longer;
merely to a lifetime of managing a chronic
infection (56, 57). Critics, on the other
hand, assert: because the drugs are anti-
viral and anti-bacterial in nature, they give
a false impression of being effective for
treating HIV infection. What appears a
miraculous recovery in many patients is,
in fact, the drugs’ effects upon the oppor-
tunistic infectious agents the person may
harbor at the time, other than HIV. Con-
trary to the reigning enthusiasm for ARVs’
effectiveness for prevention and treatment,
critics will argue the risks associated with
ARVs appear to outweigh the benefits,
especially if these drugs are consumed over
long periods of time. In short, unorthodox
scholars believe the appearance of effec-
tiveness of ARVs does not represent strong
evidence for the role of HIV in AIDS and,
in a paradoxical manner; ARVs may actu-
ally be the cause of AIDS-defining illnesses
and non-AIDS-defining ones.
EPIDEMIOLOGICAL DATA
It is easy to obtain current statistics describ-
ing the HIV-AIDS distribution, world-
wide. One has only to access the website
of the Joint United Nations Program on
HIV to learn: “In 2012, there were 35.3
million [32.2–38.8 million] people living
with HIV” and that, in the same year, “1.6
million [1.4–1.9 million] people died from
AIDS-related causes worldwide compared
to 2.3 million [2.1–2.6 million] in 2005”
(58).
Scholars on both sides of the debate
agree: epidemiologic studies and data can
show only that a risk factor is statistically
associated (correlated) with a higher dis-
ease incidence in the population exposed
to that risk factor” [(59), p. 42]. Epidemi-
ological data do not provide evidence for
causation. All the data can do is reveal
risk factors and illness co-occurring in
a given group. Despite this well-known
caveat, mainstream scientists argue that
because HIV has spread among high-risk
groups as expected, the AIDS epidemic has,
indeed, a viral, infectious agent: its “epi-
demic curves resemble . . . such infectious
agents as hepatitis B and genital herpes
viruses” [(59), p. 53]. These scientists also
will explain the differences observed in the
frequency of certain illness in specific geo-
graphic regions (e.g., higher numbers of
HIV-related Tuberculosis in sub-Saharan
Africa) as caused by the “background flora
of infectious disease agents” present in
these regions [(59), p. 54].
Curiously, however, even among main-
stream scholars who believe epidemiolog-
ical data constitute valuable evidence of a
viral cause for AIDS, there are those who
have turned a critical eye toward the data
the US and the WHO have compiled. James
Chin one such critic (Table 1) writes in
his book,The AIDS Pandemic: The Collision
of Epidemiology with Political Correctness:
Estimation and projection of HIV
infections and AIDS cases and deaths
(HIV/AIDS) can be considered more
of an art than a science because of the
marked limitations of both available
data and methods for estimation and
projection. These limitations make
it possible for UNAIDS and other
AIDS program advocates and activists
to issue misleading and inflated esti-
mates and projections [(59), p. 137].
The questions regarding the validity and
reliability of epidemiological data emerg-
ing from within the mainstream/orthodox
views have been echoed and amplified by
unorthodox scholars. Both camps’ con-
cerns center on four problems plaguing
the estimates of incidence (new cases),
prevalence (remaining cases), and projec-
tion (future cases) of HIV infections, AIDS
diagnoses, and AIDS-related deaths: (a) the
varying clinical definitions of AIDS (the
official definition has changed four times
since 1982) (60); (b) variability in the cri-
teria for seropositivity in HIV tests; (c) the
absence of testing in many regions of the
world (many developing countries do not
have the laboratories needed to test every
single AIDS case); and (d) the mistakes in
estimation, data management and report-
ing (e.g., the revision of projections for year
2006 by UNAIDS) (5962).
This article’s space limitations do not
allow an expanded treatment of each
problem-area, but readers can find further
details within the works cited. For instance,
in Rebecca Culshaw’s book Science Sold
Out: Does HIV Really Cause AIDS (32)
readers will find 13 “failed predictions”
regarding the spread of HIV and AIDS,
including the prediction that HIV infec-
tion would spread randomly among popu-
lations (i.e., outside specific risk groups).
Culshaw also tells her personal story of
having written a master’s thesis, received a
Ph.D. based on her work with “mathemati-
cal models of the immunological aspects of
HIV infection,” and eventually concluding
“there is good evidence that the entire basis
for this theory is wrong [(32), p.7].
UNORTHODOX THEORIES: IF NOT HIV,
THEN WHAT?
If the criticisms outlined above pinpoint
significant problems with each type of data
used to support the HIV-AIDS hypothe-
sis, they only contribute to deconstructing
the hypothesis, not to providing explana-
tions for what might cause AIDS if not a
retrovirus. However, alternative hypothe-
ses abound. Anchoring themselves in well-
established causes of immune system mal-
function, these hypotheses point to phar-
macological (drug) factors, immune dis-
balance factors, latent infection overload,
and malnutrition as culprits.
Although several scientists investigated
the role drugs might play in causing
immune suppression before HIV was iden-
tified [see a list of these studies in Dues-
berg et al. (46)], the main proponent of
the drug-AIDS hypothesis in the epidemic’s
early years was Peter Duesberg, a profes-
sor of Molecular and Cell Biology at UC
Berkeley. According to Seth Kalichman,
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Goodson HIV/AIDS: 30 years of dissent
who wrote Denying AIDS (a harsh critique
of unorthodox views and of Duesberg in
particular), “In every respect, HIV/AIDS
denialism starts and ends with Peter Dues-
berg” [(63), p. 175]. Duesberg’s arguments
gained notoriety among unorthodox the-
ories not only due to his expertise and
prominence (see Table 1), but also to his
challenge of the medical and scientific
establishments early in the history of the
epidemic, employing clear empirical logic.
Duesberg began challenging the viral
hypothesis for AIDS soon after the publi-
cation (in 1984) of the four seminal articles
pointing to HIV as the “probable cause
(6467). In two key publications in 1987
and 1989 in Cancer Research and in
the Proceedings of the National Academy
of Sciences (68, 69) Duesberg cogently
argued: retroviruses are not known for
killing cells. In other words, retroviruses are
not “cytocidal.” If anything, retroviruses
were once thought to be associated with
cancer because they cause precisely the
opposite of cell death; they contribute to
cells’growth or proliferation. In Duesberg’s
words, . . . retroviruses are . . . considered
to be plausible natural carcinogens because
they are not cytocidal and hence compati-
ble with neoplastic growth and other slow
diseases.” [(68), p. 1200]. In his view, HIV’s
inability to kill cells could not explain the
suppression of the T-cells in the immune
system, as proposed by the teams who
discovered HIV
3
. According to Farber,
In other fields, such as gene therapy,
it is axiomatic that retroviruses are
the ideal carriers for genetic materials,
because they ‘don’t kill cells’. Incred-
ibly, this is where the so-called HIV
debate first forked in 1987, and where
the camps remain bitterly divided to
this day [(14), p. 50].
For Duesberg and scientists agreeing with
him, then, other agents would have to
be responsible for the disastrous immune
function collapse seen in AIDS patients.
These scientists saw as prominent among
such causes, the use of drugs, both recre-
ational and routinely prescribed ones.
As author Gary Null points out, even
before AIDS, researchers were document-
ing the immune-suppressing effects of
amyl nitrites or “poppers (the form of
amyl nitrites popular among gay men in
the early and mid-80s) and determining
both their toxicity and carcinogenic prop-
erties in humans and animals (45). How-
ever, two studies CDC published in 1983,
one in which they were unable to detect
any toxicity from amyl nitrites, the other,
unable to document a significant associa-
tion between inhaled nitrates and Kaposi’s
sarcoma or Pneumocystis carinii pneumo-
nia, led the search to a halt (70, 71).
Investigators later tried to determine if
certain batches might have been contam-
inated with toxic agents but, when they
found no contamination,the focus on pop-
pers/amyl nitrites themselves ceased (1).
Nonetheless, in 1998 Duesberg and Ras-
nick (Table 1) (72) reviewed evidence pub-
lished since 1909, “which prove[s] that
regular consumption of illicit recreational
drugs causes all AIDS-defining and addi-
tional drug-specific diseases at time and
dose-dependent rates [(46), p. 393].
Other drugs such as those given to
transplant patients to prevent organ rejec-
tion, as well as routinely prescribed
antibiotics, also have been implicated
as potential causes of immune dysfunc-
tion. Studies have shown that transplant
patients who develop Kaposi’s sarcoma
will go into remission, once taken off
the drugs required to avoid organ rejec-
tion. Immune-suppressing drugs (as well
as amyl nitrites) have, for instance, been
directly correlated with Kaposi’s sarcoma,
the rare skin cancer found frequently
among AIDS patients during the epi-
demics’ early days [see reviews by Null (45)
and Kremer (35)].
Anti-retroviral drugs used to treat HIV
infection/disease, also, are indicted by
Duesberg and those who agree with him as
potentially causing AIDS (43, 62). Because
the drug cocktails include “DNA chain-
terminators and protease inhibitors” that
affect healthy cells as well as the virus,
and because “many studies find that peo-
ple receiving ARV medications experi-
ence AIDS-defining diseases to a greater
extent than controls not receiving those
medications” [(73), p. 122], antiretro-
virals are viewed as potential immune
suppressors.
In a review of the chemical bases for
AIDS, published in 2003, Duesberg and his
colleagues (46) outlined the epidemiolog-
ical and bio-chemical evidence supporting
different causes for the AIDS epidemics
in the US/Europe and in Africa, none of
which are viral or contagious. The authors
concluded:
The chemical-AIDS hypothesis pro-
poses that the AIDS epidemics of
the US and Europe are caused by
recreational drugs, alias lifestyle, and
anti-HIV drugs . . . and by other
non-contagious risk factors such as
immunosuppressive proteins associ-
ated with transfusions of blood clot-
ting factors . . . pediatric AIDS is due
to prenatal consumption of recre-
ational and anti-HIV drugs by unborn
babies together with their pregnant
mothers . . . The chemical basis of
African AIDS is proposed to be
malnutrition and lack of drinkable
water . . . exactly as proposed origi-
nally by the now leading HIV-AIDS
researchers Fauci and Seligman: “The
commonest cause of T-cell immunod-
eficiency worldwide is protein-calorie
malnutrition . . . and others . . . [(46),
p. 392].
Alongside a drug hypothesis, another pro-
posed cause for AIDS is the iNOS hypoth-
esis, or immune dis-balance hypothesis. In
his book, The Silent Revolution in Cancer
and AIDS Medicine, Kremer (35) (Table 1)
explains that much of what scientists now
know about the immune system and its
functions was not well understood at the
time they identified HIV. In particular, the
research on NO, or nitric oxide, was still in
its infancy: NO is “an important intracel-
lular and intercellular signaling molecule”
acting as . . .an important host defense
effector in the immune system [(74), p.
639]. Even though NO (and its deriva-
tive iNOs) is “involved in the regulation of
diverse physiological and pathophysiologi-
cal mechanisms in cardiovascular, nervous,
and immunological systems, researchers
have shown it can also become a harmful,
cytotoxic agent in pathological processes,
particularly in inflammatory disorders”
[(74),pp. 639–640]. Put simply, at adequate
3
In fact, evidence supporting the notion “HIV kills T-cells” has been so conspicuously absent that, currently, scientists don’t believe HIV “kills T-cells in any way. Rather,
they believe HIV primes T-cells to commit suicide at some later time” [(32), p. 73]
www.frontiersin.org September 2014 | Volume 2 | Article 154 | 7
Goodson HIV/AIDS: 30 years of dissent
levels NO helps regulate blood pressure as
well as “wound repair and host defense
[sic] mechanisms” [(75), p. 277]. Excessive
amounts, however, lead to T-cell depletion,
“inflammation, infection, neoplastic dis-
eases [cancer] liver cirrhosis, [and diabetes”
[(75), p. 277]. This change from adequate-
to-excessive amounts of NO in the human
body results from multiple factors, includ-
ing “nitrite inhalation [e.g., using ‘pop-
pers’], microbial antigen, and toxin stim-
ulation [e.g., suffering repeated infections
with different viruses/bacteria], immuno-
toxic medications [e.g., taking ARVs and
antibiotics], [and] many other stress fac-
tors [(35), p. 49].
A closely related perspective, placing the
blame for AIDS on bio-chemical processes
gone awry within human cells is the oxida-
tive stress (or redox) hypothesis. Oxidative
stress is a cellular-level electro-chemical
phenomenon that diminishes a cell’s ability
to absorb oxygen. This diminished capacity
to process oxygen at optimal levels leads to
the cell’s disruption and death. Scientists
have either hypothesized or empirically
connected oxidative stress to many dis-
eases, including type 2 diabetes and cancer
(35, 45, 76). According to this hypothesis’
main proponents,
At first sight it appears that there is
no common factor, apart from HIV
infection, linking the various AIDS
risk groups. However, homosexuals
are exposed to relatively high levels of
nitrites and anally deposited sperm,
drug abusers to opiates and nitrites,
hemophiliacs to factor VIII. All these
are known potent oxidizing agents . . .
[(77), p. 147 – emphasis mine].
For these proponents of the redox hypoth-
esis even Luc Montagnier (the head of the
French team that discovered HIV) agrees
“that anti-oxidants should be used for
treatment of HIV/AIDS patients”[(78, 79),
p. 6].
Viewing a persons immune system as
a complex dynamic balancing act among
various elements, which sometimes behave
as defenders, other times, as offenders, is
also consistent with the “latent infection
overload hypothesis” proposed by Kary
Mullis (Table 1). According to Mullis,
as people become infected with multiple
viruses and experience many latent infec-
tions, the immune system embarks on
a chain-reaction-response to each virus.
Latent infections are those without visible
symptoms, and according to Mullis, “at a
given time most viral infections in an indi-
vidual are latent” [(80), p. 196]. Eventually,
the system overloads itself and becomes
dysfunctional. AIDS, he says, “may be the
result of such a chain reaction.” This
hypothesis assumes:
. . . there is not a single organism
that is the cause of AIDS, and there
should exist AIDS patients who do not
test positive for HIV
4
. It is an over-
whelming number of distinct organ-
isms, which causes the immune dys-
function. These may individually be
harmless [(80), p. 197].
Perhaps the most intriguing alterna-
tive hypothesis, however if not from its
bio-chemical perspective, at least from the
perspective of who supports it is the
one proposing HIV may not be the pri-
mary villain, but merely an accomplice in
causing AIDS (83). Joseph Sonnabend a
prominent physician/researcher responsi-
ble for encouraging his gay patients to lead
a healthy lifestyle to avoid developing AIDS,
and one who did not accept HIV = ADS
theory for many years” – recently changed
his views and “has come to think that HIV,
together with other factors, may play a sub-
sidiary causative role” [(73, 84), p. 120].
Even Montagnier and Gallo (leaders of the
French and American teams, respectively,
that discovered HIV), at various times
since the epidemic began, have suggested
HIV might be a co-factor in AIDS, not its
exclusive causative agent (85).
Other hypotheses have been proposed
over the years, but none have garnered as
much attention as those outlined above.
Some of these other hypotheses claimAIDS
is caused by (a) multiple factors; some
factors explaining some cases, other fac-
tors accounting for other cases; (b) undi-
agnosed or untreated syphilis infection;
(c) autoimmunity; (d) selenium deficiency,
and (e) psychological factors, including
stress and trauma [see Bauer (73), pp. 124,
136–139 for details on these hypotheses].
The positive or reassuring aspect of
these alternative hypotheses is the tangi-
ble hope for prevention, treatment, and
cure they embody. Nevertheless, it is dif-
ficult not to agree with Bauer when he
concludes, . . .it is hardly reassuring that
this array of suggestions has been in cir-
culation for something like (three) decades
without having been adequately explored”
[(73), p. 139].
DISCUSSION
At this point, readers might be wonder-
ing: given the problems with the main-
stream hypothesis, how did we get here?
How did we come so far, tethered to such
a problematic perspective? The complexity
of the answers to these questions aside, it
may help to bear in mind the notion that
HIV-causes-AIDS emerged and developed
within a very specific scientific-cultural-
historic context. Although the scope of this
article precludes dealing with this complex
context, for our purposes it is important
to recall at least one element: Funding for
President Nixons War on Cancer campaign
ended in 1981 with very little achieved in
the quest for an infectious cancer agent (15,
8587). The only exception was the dis-
covery connecting select retroviruses to a
few, rare cancers. Other than this, scientists
had a handful of “orphaned”viruses which,
they suspected, might play a role in causing
illnesses, but no known diseases to which
these viruses could be connected. Propos-
ing a connection between an emerging syn-
drome and one of these viruses (even if only
a circumstantial connection) proved entic-
ing enough to pursue. And pursue they did,
as soon as AIDS began to appear in larger-
than-expected numbers among otherwise
healthy adults.
If viewed from this perspective, then,
why scientists so quickly and assuredly
4
Some would argue this is the strongest evidence against the HIV-AIDS hypothesis: cases of AIDS with no documentable presence of HIV. However, say the critics, the
difficulty with this argument lies in the definition of AIDS: because AIDS is defined as “the final stage of HIV infection (81), AIDS presupposes infection with HIV, making
the definition a circular one (i.e., AIDS = final stage of HIV infection = opportunistic infections + high viral load + low CD
4
counts). Due to the circularity in the logic,
if there is no HIV, there can be no AIDS. Nonetheless, cases of patients with AIDS-defining opportunistic infections and low CD
4
counts without HIV do exist (see, for
example, the review by Green and colleagues (82)).
Frontiers in Public Health | Public Health Education and Promotion September 2014 | Volume 2 | Article 154 | 8
Goodson HIV/AIDS: 30 years of dissent
“jumped on the HIV bandwagon may not
be very difficult to understand. That the
scientific establishment world-wide insis-
tently refuses to re-examine the HIV-
AIDS hypothesis, however, is more difficult
to accept, especially when one examines
the credentials of those proposing such a
revision. Their expertise carries as much
weight as the teams who defend the ortho-
dox hypothesis (Table 1). Seth Kalich-
man, a critic of AIDS denialists, rec-
ommends adamantly: anyone who enter-
tains alternative views should consider the
source: credibility of where the article is
reported as well as the researchers them-
selves must be weighed” [(63), p. 159]. I
could not agree more: taking into account
the credibility of the scholars who ques-
tion the HIV-AIDS hypothesis is, per-
haps, the strongest argument in favor of
seriously considering their critiques, not
against it.
Furthermore, credibility as an argu-
ment works both ways: if to question the
trustworthiness of unorthodox scholars is
vital, it is equally crucial to question the
reliability of those supporting the HIV-
AIDS hypothesis. Readers who care to learn
about HIV-AIDS’ history will encounter
ethically questionable actions carried out
by some of the most notable orthodox
researchers, as well as ethical misconduct
charges made against them [for an exten-
sive treatment of these ethical and legal
issues, backed by extensive official docu-
mentation, see Crewdson (88)].
If it is difficult to dismiss the unortho-
dox views due to the credibility of their
sources, then, why are not orthodox sci-
entists and practitioners more willing to
rethink the hypothesis or, at the very least,
test the unorthodox arguments in a sci-
entific, open debate? Although there have
been, in fact, several attempts to engage
the orthodox community in dialog, nearly
all have been unsuccessful [for examples,
see Ref. (14, 85, 88)]. Most likely, rea-
sons for denying the calls to re-examine
the orthodox stance lie in the complex,
synergistic dynamics within the scientific,
medical, economic, and political systems
or ideologies worldwide. Even brief spec-
ulation about these reasons would exceed
the scope of this article, therefore I refer
the reader, once again, to the sources ref-
erenced [in particular, see Epstein (89) and
Bauer (73)].
Here I would argue, nonetheless, that
the debate between orthodox and unortho-
dox scientists comprises much more than
an intellectual pursuit or a scientific skir-
mish: it is a matter of life-and-death. It is
a matter of justice. Millions of lives, world-
wide, have been and will be significantly
affected by an HIV or AIDS diagnosis. If
we the public health workforce lose
sight of the social justice implications and
the magnitude of the effect, we lose “the
very purpose of our mission [(3, 90), p.
690].
In particular, a pressing concern for
public health is the move or push toward
(a) HIV screening for “patients in all
health-care settings” (with opt-out screen-
ing) (91) and (b) placing persons-at-
risk (even if not yet infected with HIV),
on retroviral medication as a form of
prophylaxis (see discussion about PrEP,
above) (92). If in 1986 the CDC recom-
mended voluntary testing for people in
high-risk groups, in 2013 the U.S. Pre-
ventive Services Task Force gave rou-
tine HIV screening of all adolescents and
adults, ages 15–65, an A rating” [(93),
p. 1]. The recently approved Affordable
Care ACT requires or incentivizes new
private health plans, Medicare, and Med-
icaid to provide preventive services rated
A or ‘B’ at no cost to patients” [(93), p.
1]. Thus, routine screening of every ado-
lescent and adult in all populations is, now,
the goal (91, 94).
If,to this goal we juxtapose the problems
with the HIV tests, with the definition(s)
of AIDS, and with the toxicity of the ARVs
currently prescribed, we begin to under-
stand the potential for harm inherent in
them. Put blatantly: these recommenda-
tions can be harmful or iatrogenic (95).
PUBLIC HEALTH WORKFORCE: OUR ROLE
What can the public health workforce do,
given such potential for harm? As stated
in the introduction, this paper represents a
call to reflect upon our public health prac-
tice vis-à-vis HIV-AIDS. Reflecting upon
and questioning the status quo constitute
important dimensions of public health
professionals competencies and practice.
If the only hope the HIV-AIDS hypothesis
can offer, 30 years later, is to provide highly
toxic drugs to treat HIV infection and to
prevent high-risk but healthy persons from
becoming infected, health promoters have
a professional duty to reflect on the avail-
able data and question the usefulness of
the hypothesis. Only in doing so can public
health professionals maintain their profes-
sional integrity,tend to public health’s roots
in social justice, and contribute to develop-
ing knowledge using ethical methods.
James Jones, in his book Bad Blood:
The Tuskegee Syphilis Experiment (96),
reminds us poignantly that not asking
whether health professionals “should be
doing” something, but continuing to do
it uncritically, because “it can be done”
was, ultimately, the mind-set sustaining
the Tuskegee syphilis study for 40 years
unquestionably one of the worst cases of
scientific misconduct in American history.
The AIDS epidemic if managed with-
out questioning or without the dialogical
process of action-reflection may, with
time, overshadow Tuskegee in the magni-
tude of its negative impact.
Specifically, I propose the public health
workforce can undertake such an action-
reflection process by engaging in the fol-
lowing tasks:
(1) Learning about the history of the
HIV/AIDS epidemic, of the problems
surrounding the discovery of HIV, and
about the development of drug ther-
apies and PrEP. Publications record-
ing this history abound in the profes-
sional and trade literatures, represent-
ing both mainstream and unorthodox
view-points. To understand the forces
shaping the HIV/AIDS epidemic, we
currently experience represents a cru-
cial responsibility of a competent and
ethics-driven workforce.
(2) Conducting its own research to test
alternative theories for the cause(s)
of AIDS and/or to portray the
inconsistencies and contradictions in
the orthodox hypothesis. Qualita-
tive inquiry, for instance, exploring
unorthodox views and the practices
of providers, patients, and scientists,
might be a fruitful option for challeng-
ing prevailing assumptions.
(3) Fostering and mediating a debate
among HIV-infected persons, scien-
tists, and health-care providers, to crit-
ically assess current beliefs and prac-
tices. Public health professionals who
are well-informed about the ortho-
dox and unorthodox perspectives’
www.frontiersin.org September 2014 | Volume 2 | Article 154 | 9
Goodson HIV/AIDS: 30 years of dissent
strengths and weaknesses – could play
an important role as facilitators in this
much-needed dialog.
Although carrying out the tasks out-
lined above may represent a novelty for
many public health professionals, for the
scientists, practitioners, and investigators
who believe a viral hypothesis for AIDS is
unproductive, none of this is new. They
have combed historical documents (or
played a role in the history, themselves);
they have amassed substantial amounts
of data, and they have made numerous
calls for debate. They have held to their
beliefs, steadfastly, for the past 30 years.
Twenty four years after the first article chal-
lenging HIV, Duesberg and colleagues, for
instance, still claimed HIV is only a “pas-
senger virus” (one “not sufficient and not
necessary to cause a disease”) [(62), p. 81].
While not all unorthodox scholars agree
with Duesberg, most still actively defend
their critiques of the HIV-AIDS hypoth-
esis and persist in their questioning. As
we face the next decade with AIDS still
rampant, then, it becomes vital that pub-
lic health professionals attend to the debate
and embark in a questioning of their own.
ACKNOWLEDGMENTS
The open access publishing fees for this
article have been covered by the Texas
A&M University Online Access to Knowl-
edge (OAK) Fund, supported by the Uni-
versity Libraries and the Office of the Vice
President for Research.
REFERENCES
1. Duesberg PH. Inventing the AIDS Virus. Washing-
ton, DC: Regnery Publishing, Inc (1996). 722 p.
2. Delborne JA. Transgene and transgressions: sci-
entific dissent as heterogeneous practice. Soc
Stud Sci (2008) 38(4):509–41. doi:10.1177/
0306312708089716
3. Goodson P. Theory in Health Promotion Research
and Practice: Thinking Outside the Box. Sud-
bury, MA: Jones & Bartlett Publishers (2010).
245 p.
4. Altman L. Federal Official Says He Believes Cause of
AIDS has been Found. The New York Times (1984).
1 p.
5. The HJ Kaiser Family Foundation. HIV/AIDS at
30: A Public Opinion Perspective. A report based
on the Kaiser Family Foundations 2011 Survey of
Americans on HIV/AIDS. Menlo Park, CA: The
Kaiser Family Foundation (2011). Available from:
www.kff.org
6. Altman L. New U.S. Report Names Virus that may
Cause AIDS. The New York Times (1984). 1 p.
7. de Harven E. Human endogenous retroviruses and
AIDS research: confusion, consensus, or science?
J Am Phys Surg (2010) 15(3):69–74.
8. The Durban declaration. Nature (2000) 406:15–6.
doi:10.1038/35017662
9. Martin R, Jankovic D, Goel A, Mulders M, Dabbagh
A, Khetsuriani N, et al. Vital signs: HIV preven-
tion through care and treatment United States.
MMWR (2011) 60(47):1618–23.
10. Altman L. Red Cross Evaluates Test to Detect AIDS
in Donated Blood. The New York Times (1984).
Section C; Page 2, Column 1.
11. OraQuick. What is OraQuick? [Internet]. Avail-
able from: http://www.oraquick.com/What-is-Ora
Quick
12. CDC. Antibodies to a retrovirus etiologically asso-
ciated with acquired immunodeficiency syndrome
(AIDS) in populations with increased incidences
of the syndrome. MMWR (1984) 33(27):377–9.
13. Johnson C. Whose antibodies are they anyway?
Continuum (1996) 4(3):4–5.
14. Farber C. Serious Adverse Events: An Uncensored
History of AIDS. Hoboken,NJ:Melville HousePub-
lishing (2006).
15. Center for Infectious Diseases, CDC. Cur-
rent trends classification system for human T-
lymphotropic virus type III/lymphadenopathy-
associated virus infections. MMWR (1986)
35(20):334–9.
16. CDC. Perspectives in disease prevention and
health promotion public health service guide-
lines for counseling and antibody testing to pre-
vent HIV infection and AIDS. MMWR (1987)
36(31):509–15.
17. CDC. Revision of the CDC surveillance case defi-
nition for acquired immunodeficiency syndrome.
MMWR (1987) 36(1S):3S–15S.
18. Bauer H. HIV tests are not HIV tests. J Am Phys
Surg (2010) 15(1):05–09.
19. Papadopulos-Eleopulos E, Turner V, Papadim-
itriou J. Is a positive western blot proof of HIV
infection? Biotechnology (1993) 11:696–707. doi:
10.1038/nbt0693-696
20. Gluschankof P, Mondor I, Gelderblom H, Satten-
tau Q. Cell membrane vesicles are a major conta-
minant of gradient-enriched human immunode-
ficiency virus type-1 preparations. Virology (1997)
230:125–33. doi:10.1006/viro.1997.8453
21. Helma J, Schmidthals K, Lux V, Nuske S, Scholz
A, Krausslich H, et al. Direct and dynamic detec-
tion of HIV-1 in living cells. PLoS One (2012)
7(11):e50026. doi:10.1371/journal.pone.0050026
22. Bess J, Gorelick R, Bosche W, Henderson L, Arthur
L. Mocrovesicles are a source of contaminating
cellular proteins found in purified HIV-1 prepa-
rations. Virology (1997) 230:134–44. doi:10.1006/
viro.1997.8499
23. de Harven E. Problems with Isolating HIV.
[Internet]. Available from: http://www.altheal.org/
isolation/isolhiv.htm
24. AIDS gov. What is Viral Load? [Internet]. Available
from: http://www.aids.gov/hiv-aids-basics/just-di
agnosed-with-hiv-aids/understand-your-test-resu
lts/viral-load/
25. Dorak T. Real-Time PCR. New York, NY: Taylor &
Francis (2006).
26. Sax P, Cohen C, Kuritzkes D. HIV Essentials. 6th ed.
Burlington, MA: Jones & Bartlett Learning (2013).
27. Owens D, Holodniy M, Garber A, Scott J, Son-
nad S, Moses L, et al. Polymerase chain reac-
tion for the diagnosis of HIV infection in adults:
a meta-analysis with recommendations for clin-
ical practice and study design. Ann Intern Med
(1996) 124(9):803–15. doi:10.7326/0003-4819-
124-9-199605010-00004
28. Rodriguez B, Sethi A, Cheruvu V, Mackay W,
Bosch R, Kitahata M, et al. Predictive value of
plasma HIV RNA level on rate of CD4 T-cell
decline in untreated HIV infection. JAMA (2006)
296(12):1498–506. doi:10.1001/jama.296.12.1498
29. Lauritsen J. Has Provincetown Become Protease
Town? [Internet]. Available from: http://www.
virusmyth.com/aids/hiv/jlprotease.html
30. Nelson P, Carnegie P, Martin J, Ejtehadi H, Hooley
P, Roden D, et al. Demystified… human endoge-
nous retroviruses. Mol Pathol (2003) 56:11–8.
doi:10.1136/mp.56.1.11
31. Singh SK. Endogenous retroviruses: suspects
in the disease world. Future Microbiol (2007)
2(3):269–75. doi:10.2217/17460913.2.3.269
32. Culshaw R. Science Sold Out: Does HIV Really
Cause AIDS? Berkeley, CA: North Atlantic Books
(2007).
33. Dictionary.com. Electron-Microscope. [Internet].
Available from: http://dictionary.reference.com/
browse/electron-microscope
34. Barre-Sinoussi F, Chermann J, Rey F, Nugeyre
M, Chamaret S, Gruest J, et al. Isolation of
a T-lymphotropic retrovirus from a patient
at risk for acquired immune deficiency syn-
drome (AIDS). Science (1983) 220:20. doi:10.1126/
science.6189183
35. Kremer H. The Silent Revolution in Cancer and
AIDS Medicine. Xlibris Corporation (2008).
36. Tahi D. Between the lines: a critical analysis of Luc
Montagnier’s interview answers to Djamel Tahi by
Eleni Eleopulos and colleagues. Continuum (1997)
5(2):36–46.
37. de Harven E, Friend C. Further electron micro-
scope studies of a mouse leukemia induced by
cell-free filtrates. J Cell Biol (1960) 7(4):747–52.
doi:10.1083/jcb.7.4.747
38. Tahi D. Did Luc Montagnier discover HIV? “I
repeat: we did not purify!” Continuum (1997)
5(2):31–5.
39. Papadopulos-Eleopulos E, Turner V, Papadim-
itriou J, Page B, Causer D. Questions regarding
whether the recently reported particles are
authentic HIV virions? (2006). Available from:
http://www.theperthgroup.com/REJECTED/
StructureLetterPG.pdf
40. Esparza J. A brief history of the global effort to
develop a preventive HIV vaccine. Vaccine (2013)
31:3502–18. doi:10.1016/j.vaccine.2013.05.018
41. Cohen M, Chen YQ, McCauley M, Gamble T,
Hosseinipour MC, Kumarasamy N, et al. Preven-
tion of HIV-1 infection with early antiretroviral
therapy. New Engl J Med (2011) 365(6):493–505.
doi:10.1056/NEJMoa1105243
42. National Institute of Allergy and Infectious Dis-
eases. Challenges in Designing HIV Vaccines. [Inter-
net]. Available from: http://www.niaid.nih.gov/top
ics/HIVAIDS/Understanding/Prevention/Pages/va
ccineChalle
43. Lauritsen J. Poison by Prescription: The AZT Story.
New York, NY: Asklepios (1990).
Frontiers in Public Health | Public Health Education and Promotion September 2014 | Volume 2 | Article 154 | 10
Goodson HIV/AIDS: 30 years of dissent
44. Engel J. The Epidemic: A Global History of AIDS.
New York, NY: Smithsonian Books/Harper Collins
(2006).
45. Null GAIDS. A Second Opinion. New York, NY:
Seven Stories Press (2002).
46. Duesberg P, Koehnlein C, Rasnick D. The chem-
ical bases of the various AIDS epidemics: recre-
ational drugs, anti-viral chemotherapy and mal-
nutrition. J Biosci (2003) 28(4):383–412. doi:10.
1007/BF02705115
47. Alberts B. Science breakthroughs. Science (2011)
334:23. doi:10.1126/science.1217831
48. Cohen J. A powerful and perplexing new HIV pre-
vention tool. Science (2010) 330:3. doi:10.1126/
science.330.6009.1298
49. The Antiretroviral Therapy (ART) Cohort
Collaboration. HIV treatment response and
prognosis in Europe and North America in
the first decade of highly active antiretroviral
therapy: a collaborative analysis. Lancet
(2006) 368:451–8. doi:10.1016/S0140-6736(06)
69152-6
50. Moore P, Allen S, Sowell A, Van de Perre P, Huff
D, Srufilira A, et al. Role of nutritional status and
weight loss in HIV seroconversion among Rwan-
dan women. J Acq Immun Def Synd (1993) 6:
611–6.
51. The Perth Group. HIV Infection the Cause
or Effect of Acquired Immune Deficiency? [Inter-
net]. Available from: http://www.theperthgroup.
com/REJECTED/AIDScausesHIV3.pdf
52. Payne BAI, Wilson IJ, Hateley CA, Horvath R,
Santibanez-Koref M, Samuels DC, et al. Mito-
chondrial aging is accelerated by anti-retroviral
therapy through the clonal expansion of mtDNA
mutations. Nat Rev Genet (2011) 43(8):806–10.
doi:10.1038/ng.863
53. Alberta Reappraising AIDS Society. Concerns
about HAART (Highly Active Anti-Retroviral Ther-
apy). [Internet]. Available from: http://aras.ab.ca/
haart-ineffective.html
54. Martinez E, Milinkovic A, Buira E, de Lazzari
E, Leon A, Larrousse M, et al. Incidence and
causes of death in HIV-infected persons receiv-
ing highly active antiretroviral therapy compared
with estimates for the general population of sim-
ilar age and from the same geographical area.
HIV Med (2007) 8:251–8. doi:10.1111/j.1468-
1293.2007.00468.x
55. Zaunders JJ, Cunningham PH, Kelleher AD, Kauf-
man GR, Jaramillo AB, Wright R, et al. Potent anti-
retroviral therapy of primary human immunod-
eficiency virus type 1 (HIV-1) infection: partial
normalization of T Lymphocyte subsets and lim-
ited reduction of HIV-1 DNA despite clearance
of plasma viremia. J Infect Dis (1999) 180:320–9.
doi:10.1086/314880
56. Valdiserri R. Thirty years of AIDS in Amer-
ica: a story of infinite hope. AIDS Educ Prev
(2011) 23(6):479–94. doi:10.1521/aeap.2011.23.6.
479
57. Torian L, Chen M, Rhodes P, Hall I. HIV. Surveil-
lance – United States, 1981–2008. MMWR (2011)
60(21):689–728.
58. UNAIDS. Fact Sheet People Living with HIV.
[Internet]. Available from: http://www.unaids.
org/en/resources/campaigns/globalreport2013/
factsheet/
59. Chin J. The AIDS Pandemic: The Collision of Epi-
demiology with Political Correctness. Oxford: Rad-
cliffe Publishing (2007).
60. Root-Bernstein R. The Evolving Definition of AIDS.
[Internet]. Available from: http://www.virusmyth.
com/aids/hiv/rrbdef.html
61. Craven B, Stewart G. Economic implications of
socio-cultural correlates of HIV/AIDS: an analy-
sis of global data. Appl Econ (2013) 45:1789–800.
doi:10.1080/00036846.2011.639737
62. Duesberg PH, Mandrioli D, McCormack A,
Nicholson J, Rasnick D, Fiala C, et al. AIDS since
1984: no evidence for a new, viral epidemic
not even in Africa. Ital J Anat Embryo (2011)
116(2):73–92.
63. Kalichman S. Denying AIDS: Conspiracy Theories,
Pseudoscience, and Human Tragedy. New York, NY:
Copernicus Books; Springer (2009).
64. Sarngadharan M, Popovic M, Bruch L, Schup-
bach J, Gallo R. Antibodies reactive with human
T-lymphotropic retroviruses (HTLV-III) in the
serum of patients with AIDS. Science (1984) 224:4.
doi:10.1126/science.6324345
65. Gallo R, Salahuddin S, Popovic M, Shearer G,
Kaplan M, Haynes B, et al. Frequent detection
and isolation of cytopathic retroviruses (HTLV-
III) from patients with AIDS and at risk for AIDS.
Science (1984) 224:4. doi:10.1126/science.6200936
66. Popovic M, Sarngadharan M, Read E, Gallo R.
Detection, isolation and continuous production of
cytopathic retroviruses (HTLV-III) from patients
with AIDS and pre-AIDS. Science (1984) 224:4.
doi:10.1126/science.6200935
67. Schupbach J, Sarngadharan M, Gallo R. Antigens
on HTLV-infected cells recognized by leukemia
and AIDS sera are related to HTLV viral glyco-
protein. Science (1984) 224:4. doi:10.1126/science.
6324349
68. Duesberg PH. Retroviruses as carcinogens and
pathogens: expectations and reality. J Can Res
(1987) 47:1199–220.
69. Duesberg PH. Human immunodeficiency virus
and acquired immunodeficiency syndrome: corre-
lation but not causation. Proc Natl Acad Sci U S A
(1989) 86:755–64. doi:10.1073/pnas.86.3.755
70. CDC. An evaluation of the immunotoxic poten-
tial of isobutyl nitrite. MMWR (1983) 64:
457–8.
71. Jaffe H, Choi K, Thomas P, Haverkos H, Auer-
bach D, Guinan M, et al. National case-control
study of Kaposi’s sarcoma and Pneumocystis carinii
pneumonia in homosexual men: part 1, epidemio-
logic results. Ann Intern Med (1983) 99(2):145–51.
doi:10.7326/0003-4819-99-2-145
72. Duesberg P, Rasnick D. The AIDS dilemma: drug
diseases blamed on a passenger virus. Genetica
(1998) 104:85–132. doi:10.1023/A:1003405220186
73. Bauer H. The Origin, Persistence and Failings of
HIV/AIDS Theory. Jefferson, NC: McFarland &
Company, Inc., Publishers (2007).
74. Aktan F. iNOS-mediated nitric oxide production
and its regulation. Life Sci (2004) 75:639–53. doi:
10.1016/j.lfs.2003.10.042
75. Lechner M, Lirk P, Rieder J. Inducible nitric
oxide synthase (iNOS) in tumor biology: the
two sides of the same coin. Semin Cancer Biol
(2005) 15:277–89. doi:10.1016/j.semcancer.2005.
04.004
76. Watson JD. Type 2 diabetes as a redox disease.
Lancet (2014) 383:841–43. doi:10.1016/S0140-
6736(13)62365-X
77. Papadopulos-Eleopulos E, Turner V, Papadim-
itriou J. Oxidative stress, HIV and AIDS. Res
Immunol (1992) 143:145–8. doi:10.1016/S0923-
2494(92)80156-F
78. Gougeon M, Montagnier L. Apoptosis in
AIDS. Science (1993) 260:28. doi:10.1126/science.
8098552
79. Papadopulos-Eleopulos E, Turner V, Papadim-
itriou J, Causer D, Hedland-Thomas B, Page B. A
critical analysis of the HIV-T4-cell-AIDS hypoth-
esis. In: Duesberg P, editor. AIDS: Virus- or Drug
Induced? Kluwer Academic Publishers (1996). p.
3–22. Available from: 10.1007/978-94-009-1651-
7_1
80. Mullis K. A hypothetical disease of the immune
system that may bear some relation to the acquired
immune deficiency syndrome. Genetica (1995)
95:195–7. doi:10.1007/BF01435010
81. AIDS gov. Overview of HIV Treatments. [Internet].
Available from: http://aids.gov/hiv-aids-basics/
just-diagnosed-with-hiv-aids/treatment-options/
overview-of-hiv-treatments/index.html
82. Green H, Paul M, Vidal L, Leibovic L. Prophy-
laxis of Pneumocystis pneumonia in Immuno-
compromised non-HIV-infected patients: system-
atic review and meta-analysis of randomized con-
trolled trials. May Clin Proc (2007) 82(9):1052–9.
doi:10.4065/82.9.1052
83. Giraldo R. “Co-factors” Cause AIDS. [Internet].
Available from: http://www.robertogiraldo.com/
eng/papers/CoFactorsCauseAIDS.html
84. Sonnabend J. Letter to the editor. Lancet (2000)
355:2163.
85. Duesberg PH, editor. AIDS: Virus- Or Drug
Induced? (Vol. Vol 5). Dordrecht, The Netherlands:
Kluwer Academic Publishers (1996).
86. Proctor R. Cancer Wars: How Politics Shapes What
We Know and Don’t Know About Cancer. New York,
NY: Basic Books (1995).
87. Root-Bernstein R. Rethinking AIDS: The Tragic
Cost of Premature Consensus. New York, NY: Free
Press (1993).
88. Crewdson J. Science Fictions: A Scientific Mystery,
a Massive Cover-Up, and the Dark Legacy of Robert
Gallo. Boston, MA: Little, Brown and Company
(2002).
89. Epstein S. Impure Science: AIDS, Activism and the
Politics of Knowledge. Berkeley, CA: University of
California Press (1996).
90. Fee E, Brown TM. The past and future of pub-
lic health practice. Am J Public Health (2000)
90(5):690–1. doi:10.2105/AJPH.90.5.690
91. Branson B, Handsfield H, Lampe M, Janssen R,
Taylor A, Lyss S, et al. Revised recommendations
for HIV testing of adults, adolescents,and pregnant
women in health-care settings. MMWR (2006)
55(RR14):1–17.
92. Hirnschall G, Harries A, Easterbrook P, Doherty
M, Ball A. The next generation of the World
Health Organizations global antiretroviral guid-
ance. J Int AIDS Soc (2013) 16:1–7. doi:10.7448/
IAS.16.1.18757
93. The HJ Kaiser Family Foundation. Fact Sheet:
State Medicaid Coverage of Routine HIV Screening.
[Internet]. Available from: http://kff.org/hivaids/
www.frontiersin.org September 2014 | Volume 2 | Article 154 | 11
Goodson HIV/AIDS: 30 years of dissent
fact-sheet/state-medicaid-coverage-of-routine-
hiv-screening/
94. The White House Office of National AIDS Policy.
National HIV/AIDS Strategy for the United States.
[Internet]. Available from: www.whitehouse.gov/
onap
95. Buchanan DR. An Ethic for Health Promotion:
Rethinking the Sources of Human Well-Being. New
York, NY: Oxford University Press (2000).
96. Jones JH. Bad Blood: The Tuskegee Syphilis Exper-
iment. New and Expanded Edition. New York: The
Free Press (1993).
Conflict of Interest Statement: The author declares
that the research was conducted in the absence
of any commercial or financial relationships
that could be construed as a potential conflict of
interest.
Received: 03 July 2014; accepted: 07 September 2014;
published online: 23 September 2014.
Citation: Goodson P (2014) Questioning the HIV-AIDS
hypothesis: 30 years of dissent. Front. Public Health
2:154. doi: 10.3389/fpubh.2014.00154
This article was submitted to Public Health Education
and Promotion, a section of the journal Frontiers in
Public Health.
Copyright © 2014 Goodson. This is an open-access arti-
cle distributed under the terms of the Creative Commons
Attribution License (CC BY). The use, distribution or
reproduction in other forums is permitted, provided the
original author(s) or licensor are credited and that the
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One of the ways in which sexual transmission of AIDS is addressed is through moral interventions by organisations affiliated with Christian churches. However, this approach has been heavily criticised in recent literature, implying that moral interventions by church-affiliated organisations generally lead to stigmatisation which is one of the major obstacles to their involvement in HIV prevention. This article explores the origin of this accusation and discusses the Christian-ethical aspects related to HIV or AIDS. The conclusion is that the fact that churches take the Word of God and Christian morality as point of departure in HIV or AIDS intervention programmes does not imply that people who transgressed religious moral teachings may be condemned. On the contrary, the church preaches Christian forgiveness, mercy and empathy. Churches and organisations affiliated with churches should therefore be regarded as valuable partners in the fight against AIDS, for while propagating a normative lifestyle, they also preach love, compassion and support for people living with HIV.
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Background: An estimated 1.2 million persons in the United States were living with human immunodeficiency virus (HIV) infection in 2008. Improving survival of persons with HIV and reducing transmission involve a continuum of services that includes diagnosis (HIV testing), linkage to and retention in HIV medical care, and ongoing HIV prevention interventions, including appropriately timed antiretroviral therapy (ART). Methods: CDC used three surveillance datasets to estimate recent HIV testing and HIV prevalence among U.S. adults by state, and the percentages of HIV-infected adults receiving HIV care for whom ART was prescribed, who achieved viral suppression, and who received prevention counseling from health-care providers. Published data were used to estimate the numbers of persons in the United States living with and diagnosed with HIV and, based on viral load and CD4 laboratory reports, linked to and retained in HIV care. Results: In 2010, 9.6% of adults had been tested for HIV during the preceding 12 months (range by state: 4.9%-29.8%). Of the estimated 942,000 persons with HIV who were aware of their infection, approximately 77% were linked to care, and 51% remained in care. Among HIV-infected adults in care, 45% received prevention counseling, and 89% were prescribed ART, of whom 77% had viral suppression. Thus, an estimated 28% of all HIV-infected persons in the United States have a suppressed viral load. Conclusions: Prevalence of HIV testing and linkage to care are high but warrant continued effort. Increasing the percentages of HIV-infected persons who remain in HIV care, achieve viral suppression, and receive prevention counseling requires additional effort. Implications for Public Health Practice: Public health officials and HIV care providers should improve engagement at each step in the continuum of HIV care and monitor progress in every community using laboratory reports of viral load and CD4 test results.