Death by denial

People who deny that the HIV virus causes AIDS continue to persist in their beliefs despite overwhelming scientific evidence to the contrary, nurtured by the broad reach of the Internet and cherry-picked scientific claims, AIDS authorities said Monday (Oct. 19).

Researchers from Harvard, elsewhere in the United States, and South Africa convened at the Carpenter Center for the Visual Arts to decry HIV “denialism,” saying that the continued questioning of HIV’s role in AIDS harms those infected with the virus by discouraging both testing and treatment.

According to the speakers, denialism takes two major forms. Some skeptics deny that HIV plays a role in AIDS, or that it even exists, while others believe in AIDS conspiracies, acknowledging that HIV causes AIDS but questioning HIV’s origins, saying it results from a government conspiracy, is intended as a genocide campaign against blacks, that it was created in CIA labs, or is of other sinister origin or purpose.

The event, sponsored by the Harvard University Center for AIDS Research, was presented in conjunction with the Carpenter Center’s exhibit “ACT UP New York: Activism, Art, and the AIDS Crisis, 1987-1993.” The exhibit contains posters, T-shirts, fliers, and pamphlets from ACT UP’s AIDS activism campaigns which, through sometimes graphic and jarring messages, pushed government action against AIDS. The campaign argued that the government dragged its feet because of homophobia and racism aimed at two groups prone to the ailment: gay men and intravenous drug users, who are often minorities.

Laura Bogart, associate professor of pediatrics at Harvard Medical School and Children’s Hospital Boston, introduced the event, saying that denialism also includes odd beliefs, such as that drugs for HIV treatment actually cause AIDS. Denialism, she said, is gaining momentum because of the reach that its proponents have on the Internet, and it may have greater traction in communities that already mistrust the government because of past discrimination, revelations of secret medical experiments, and the like.

The symposium examined how denialism affects prevention and treatment, public policy, and human rights.

“Bad ideas have bad consequences,” Bogart said.

Seth Kalichman, professor of psychology at the University of Connecticut, said denialist beliefs are surprisingly widespread. He said most people’s attitude when hearing of HIV denial is, “Oh, those people are still around?” In the uncertain early years of the AIDS epidemic, Kalichman said, denialists were dissidents from the prevailing but still uncertain scientific views. As the body of evidence about the nature of HIV and AIDS grew, dissent turned into denial, wrapped in conspiracy theories. Now, Kalichman lumps HIV denialists with those who deny the Holocaust and global warming, and who believe 9/11 conspiracy theories. All use similar strategies, he said, including false experts, bad science, and selective use of valid scientific results.

Kalichman cited a 2007 report on 696 gay men in five U.S. cities that showed a surprisingly high acceptance of denialist beliefs. Forty-five percent, he said, agreed with the statement “HIV does not cause AIDS,” and 51 percent agreed with the statement “HIV drugs can harm you more than help you,” remarking that it would be troubling if even half those numbers believed such statements.

Kalichman said research shows that the Internet is a critical source of denialist information, and that people who hold denialist beliefs are more likely to have symptoms, less likely to adhere to drug regimens, and less likely to take treatment medication in the first place.

Denialism may have done its most damage in South Africa during the tenure of President Thabo Mbeki. Mbeki, who endorsed denialist beliefs, delayed the beginning of large-scale AIDS drug treatment, which allowed the pandemic to grow unchecked.

Nicoli Nattrass, director of the AIDS and Society Research Unit and economics professor at the University of Cape Town in South Africa, presented preliminary results from a large-scale study of teenagers and young adults there. The results, which are still being analyzed, show that denialist beliefs are held disproportionately by black African men and are far more likely to be held by those supportive of Mbeki’s health minister, who has been replaced by the current administration.

Recent research showed how damaging denialist beliefs can be, concluding that Mbeki’s failure to roll out HIV drugs between 2000 and 2005 resulted in 330,000 unnecessary deaths and the infection of 3,500 infants with HIV.