Skip to main content

Advertisement

Springer Nature Link
Log in

AIDS Denialism and Public Health Practice

  • Review Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

In this paper, we respond to AIDS denialist arguments that HIV does not cause AIDS, that antiretroviral drugs are not useful, and that there is no evidence of large-scale deaths from AIDS, and discuss the key implications of the relationship between AIDS denialism and public health practice. We provide a brief history of how the cause of AIDS was investigated, of how HIV fulfills Koch’s postulates and Sir Bradford Hill’s criteria for causation, and of the inconsistencies in alternatives offered by denialists. We highlight clinical trials as the standard for assessing efficacy of drugs, rather than anecdotal cases or discussions of mechanism of action, and show the unanimous data demonstrating antiretroviral drug efficacy. We then show how statistics on mortality and indices such as crude death rate, life expectancy, child mortality, and population growth are consistent with the high mortality from AIDS, and expose the weakness of statistics from death notification, quoted by denialists. Last we emphasize that when denialism influences public health practice as in South Africa, the consequences are disastrous. We argue for accountability for the loss of hundreds of thousands of lives, the need to reform public health practice to include standards and accountability, and the particular need for honesty and peer review in situations that impact public health policy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
€32.70 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Singapore)

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Notes

  1. Science Guardian. Awards in Washington for Duesberg and Farber. Available at: <http://www.scienceguardian.com/blog/whistleblower-awards-in-washington-for-duesberg-and-farber.htm>. Accessed 2009 Sept 5.

  2. For a summary citing original studies, see [10].

  3. See http://duesberg.com/faq.html. Accessed 2009 Nov 25.

  4. See FDA’s Center for Drug Evaluation and Research. Available at:<http://www.fda.gov/Drugs/default.htm>. Accessed 08/06/2009.

  5. Example from ref. 3: Duesberg quotes a Lancet study (May MT et al. 2006;368:451–458) that ARVs have “not translated into a decrease in mortality” when the full statement reads “Virological response after starting HAART improved over calendar years, but such improvement has not translated into a decrease in mortality.” The authors are comparing 1998 mortality on HAART with 1995–1996 and 2002–2003 on HAART, not ARVs versus nothing.

  6. US Census Bureau International Database. Available at: <http://www.census.gov/ipc/www/idb/country.php>. Accessed 2009 Aug 9.

  7. http://www.avert.org/safricastats.htm. Accessed 2009 Aug 9.

  8. Joint United Nations Programme on HIV/AIDS (UNAIDS) Reference Group on Estimates, Modelling and Projections. Available at: <http://www.epidem.org/>. Accessed 2009 Aug 9.

  9. UNAIDS. Report on the Global HIV/AIDS Epidemic. Geneva: UNAIDS; 2000, 2002, 2004, 2006. In the 2006 report, UNAIDS suggests that its earlier modeling could have overestimated the prevalence of AIDS and death statistics. We used the estimates from the 2006 report for both 2005 and 2003 estimates, and the 2002 report for 2001 estimates.

  10. Health Systems Trust, South Africa. Available at: <http://www.hst.org.za/healthstats/178/data>. Accessed 2009 Aug 9.

  11. Health Systems Trust, South Africa. Available at: http://www.healthlink.org.za/healthstats/86/data>. Accessed 2009 Aug 9.

  12. Quoted by BBC News, 2008 Nov 7. Available at: <http://news.bbc.co.uk/2/hi/africa/7716128.stm>. Accessed 2009 Aug 7.

  13. Quoted in The Guardian, 2001 Jun 12. Available at: <http://www.guardian.co.uk/world/2001/jun/12/aids.chrismcgreal>. Accessed 2009 Aug 7.

  14. International Criminal Court. Available at:  <http://www.icc-cpi.int/about/Official_Journal.html>. Accessed 2007 Nov 20.

References

  1. Chigwedere P, Seage GR 3rd, Gruskin S, Lee TH, Essex M. Estimating the lost benefits of antiretroviral drug use in South Africa. J Acquir Immune Defic Syndr. 2008;49:410–5.

    PubMed  Google Scholar 

  2. Nattrass N. AIDS and the scientific governance of medicine in post-apartheid South Africa. African Affairs. 2008;107:157–76.

    Google Scholar 

  3. Duesberg PH, Nicholson JM, Rasnick D, Fiala C, Bauer HH. HIV-AIDS hypothesis out of touch with South African AIDS—a new perspective. Med Hypotheses. 2009; Epub ahead of print (withdrawn).

  4. Lenzer J. AIDS “dissident” seeks redemption… and a cure for cancer. Discover. 2008;29(6):44–50.

    Google Scholar 

  5. Duesberg P. HIV is not the cause of AIDS. Science. 1988;241(4865):514, 517. Other of Duesberg’s writings available at: <http://www.duesberg.com/>. Accessed 2009 Nov 17.

  6. Baleta A. South Africa’s AIDS care thrown into confusion. Lancet. 1999;354:1711.

    CAS  PubMed  Google Scholar 

  7. Cohen J. South Africa. AIDS researchers decry Mbeki’s views on HIV. Science. 2000;288:590–1.

    CAS  PubMed  Google Scholar 

  8. Horton R. Mbeki defiant about South African HIV/AIDS strategy. Lancet. 2000;356(9225):225.

    CAS  PubMed  Google Scholar 

  9. Masland T, King P. Flirting with strange ideas. Mbeki reaches out to a controversial AIDS researcher. Newsweek. 2000;135(16):36.

    CAS  PubMed  Google Scholar 

  10. Essex M, Mboup S. The etiology of AIDS. In: Essex M, Mboup S, Kanki P, Marlink R, Tlou S, editors. AIDS in Africa. New York: Kluwer Academic/Plenum; 2002. p. 1–10.

    Google Scholar 

  11. Gottlieb MS, Schroff R, Schanker HM, et al. Pneumocystis carinii pneumonia and mucosal candidiasis in previously healthy homosexual men: evidence of a new acquired cellular immunodeficiency. N Engl J Med. 1981;305(24):1425–31.

    CAS  PubMed  Google Scholar 

  12. Masur H, Michelis MA, Greene JB, et al. An outbreak of community-acquired Pneumocystis carinii pneumonia: initial manifestation of cellular immune dysfunction. N Engl J Med. 1981;305(24):1431–8.

    Article  CAS  PubMed  Google Scholar 

  13. Siegal FP, Lopez C, Hammer GS, et al. Severe acquired immunodeficiency in male homosexuals, manifested by chronic perianal ulcerative herpes simplex lesions. N Engl J Med. 1981;305(24):1439–44.

    CAS  PubMed  Google Scholar 

  14. Epidemiological aspects of the current outbreak of Kaposi’s sarcoma and opportunistic infections. N Engl J Med. 1982; 306: 248–52.

  15. Masur H, Michelis MA, Wormser GP, et al. Opportunistic infection in previously healthy women. Initial manifestations of a community-acquired cellular immunodeficiency. Ann Intern Med. 1982;97(4):533–9.

    CAS  PubMed  Google Scholar 

  16. Davis KC, Horsburgh CR Jr, Hasiba U, Schocket AL, Kirkpatrick CH. Acquired immunodeficiency syndrome in a patient with hemophilia. Ann Intern Med. 1983;98(3):284–6.

    CAS  PubMed  Google Scholar 

  17. Poon MC, Landay A, Prasthofer EF, Stagno S. Acquired immunodeficiency syndrome with Pneumocystis carinii pneumonia and Mycobacterium avium-intracellulare infection in a previously healthy patient with classic hemophilia. Clinical, immunologic, and virologic findings. Ann Intern Med. 1983;98(3):287–90.

    CAS  PubMed  Google Scholar 

  18. Jett JR, Kuritsky JN, Katzmann JA, Homburger HA. Acquired immunodeficiency syndrome associated with blood-product transfusions. Ann Intern Med. 1983;99(5):621–4.

    CAS  PubMed  Google Scholar 

  19. Curran JW, Lawrence DN, Jaffe H, et al. Acquired immunodeficiency syndrome (AIDS) associated with transfusions. N Engl J Med. 1984;310(2):69–75.

    Article  CAS  PubMed  Google Scholar 

  20. Rubinstein A, Sicklick M, Gupta A, et al. Acquired immunodeficiency with reversed T4/T8 ratios in infants born to promiscuous and drug-addicted mothers. JAMA. 1983;249(17):2350–6.

    CAS  PubMed  Google Scholar 

  21. Francis DP, Curran JW, Essex M. Epidemic acquired immune deficiency syndrome: epidemiologic evidence for a transmissible agent. J Natl Cancer Inst. 1983;71(1):1–4.

    CAS  PubMed  Google Scholar 

  22. Durack DT. Opportunistic infections and Kaposi’s sarcoma in homosexual men. N Engl J Med. 1981;305(24):1465–7.

    Article  CAS  PubMed  Google Scholar 

  23. Brennan RO, Durack DT. Gay compromise syndrome. Lancet. 1981;2(8259):1338–9.

    CAS  PubMed  Google Scholar 

  24. Kitchen LW, Barin F, Sullivan JL, et al. Aetiology of AIDS—antibodies to human T-cell leukaemia virus (type III) in haemophiliacs. Nature. 1984;312(5992):367–9.

    CAS  PubMed  Google Scholar 

  25. Sarngadharan MG, Popovic M, Bruch L, Schüpbach J, Gallo RC. Antibodies reactive with human T-lymphotropic retroviruses (HTLV-III) in the serum of patients with AIDS. Science. 1984;224(4648):506–8.

    CAS  PubMed  Google Scholar 

  26. Barre-Sinoussi F, Chermann JC, Rey F, et al. Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS). Science. 1983;220(4599):868–71.

    CAS  PubMed  Google Scholar 

  27. Gallo RC, Sarin PS, Gelmann EP, et al. Isolation of human T-cell leukemia virus in acquired immune deficiency syndrome (AIDS). Science. 1983;220(4599):865–7.

    CAS  PubMed  Google Scholar 

  28. Aschengrau A, Seage GR. Essentials of epidemiology in public health. 2nd ed. Sudbury, MA: Jones & Bartlett; 2008. p. 383–410.

    Google Scholar 

  29. Knight DC, Schrotter G. Robert Koch: father of bacteriology. New York: Franklin Watts; 1961.

    Google Scholar 

  30. Ambrose Z, KewalRamani VN, Bieniasz PD, Hatziioannou T. HIV/AIDS: in search of an animal model. Trends Biotechnol. 2007;25(8):333–7.

    CAS  PubMed  Google Scholar 

  31. Cohen J. Fulfilling Koch’s postulates. Science. 1994;266:1647.

    Google Scholar 

  32. O’Brien SJ, Goedert JJ. HIV causes AIDS: Koch’s postulates fulfilled. Curr Opin Immunol. 1996;8(5):613–8.

    PubMed  Google Scholar 

  33. Hill AB. The environment and disease: association or causation? Proc R Soc Med. 1965;58:295–300.

    CAS  PubMed  Google Scholar 

  34. Schechter MT, Craib KJ, Gelmon KA, Montaner JS, Le TN, O’Shaughnessy MV. HIV-1 and the aetiology of AIDS. Lancet. 1993;341(8846):658–9.

    CAS  PubMed  Google Scholar 

  35. Darby SC, Ewart DW, Giangrande PL, Dolin PJ, Spooner RJ, Rizza CR. Mortality before and after HIV infection in the complete UK population of haemophiliacs. UK Haemophilia Centre Directors’ Organisation. Nature. 1995;377(6544):79–82.

    CAS  PubMed  Google Scholar 

  36. Biggar RJ. AIDS incubation in 1891 HIV seroconverters from different exposure groups. International Registry of Seroconverters. AIDS. 1990;4(11):1059–66.

    CAS  PubMed  Google Scholar 

  37. Prins M, Veugelers PJ. Comparison of progression and non-progression in injecting drug users and homosexual men with documented dates of HIV-1 seroconversion. European Seroconverter Study and the Tricontinental Seroconverter Study. AIDS. 1997;11(5):621–31.

    CAS  PubMed  Google Scholar 

  38. Engels EA, Rosenberg PS, O’Brien TR, Goedert JJ. Plasma HIV viral load in patients with hemophilia and late-stage HIV disease: a measure of current immune suppression. Multicenter Hemophilia Cohort Study. Ann Intern Med. 1999;131(4):256–64.

    CAS  PubMed  Google Scholar 

  39. Mellors JW, Rinaldo CR Jr, Gupta P, White RM, Todd JA, Kingsley LA. Prognosis in HIV-1 infection predicted by the quantity of virus in plasma. Science. 1996;272(5265):1167–70.

    CAS  PubMed  Google Scholar 

  40. Hammer SM, Squires KE, Hughes MD, et al. A controlled trial of two nucleoside analogues plus indinavir in persons with human immunodeficiency virus infection and CD4 cell counts of 200 per cubic millimeter or less. N Engl J Med. 1997;337:725–33.

    CAS  PubMed  Google Scholar 

  41. Katzenstein DA, Hammer SM, Hughes MD, et al. The relation of virologic and immunologic markers to clinical outcomes after nucleoside therapy in HIV-infected adults with 200 to 500 CD4 cells per cubic millimeter. AIDS Clinical Trials Group Study 175 Virology Study Team. N Engl J Med. 1996;335(15):1091–8.

    CAS  PubMed  Google Scholar 

  42. O’Brien WA, Hartigan PM, Martin D, et al. Changes in plasma HIV-1 RNA and CD4+ lymphocyte counts and the risk of progression to AIDS. Veterans Affairs Cooperative Study Group on AIDS. N Engl J Med. 1996;334(7):426–31.

    PubMed  Google Scholar 

  43. Levy JA. HIV and the pathogenesis of AIDS. 3rd ed. Washington: ASM Press; 2007.

    Google Scholar 

  44. Knipe DM, Howley PM, editors. Fields’ virology. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2007.

    Google Scholar 

  45. Cohen J. Duesberg and critics agree: hemophilia is the best test. Science. 1994;266:1645–6.

    CAS  PubMed  Google Scholar 

  46. Horton R. Will Duesberg now concede defeat? Lancet. 1995;346(8976):656.

    CAS  PubMed  Google Scholar 

  47. Duesberg PH. Is HIV the cause of AIDS? Lancet. 1995;346(8986):1371–2.

    CAS  PubMed  Google Scholar 

  48. Blattner W, Gallo RC, Temin HM. HIV causes AIDS. Science. 1988;241(4865):515–6.

    CAS  PubMed  Google Scholar 

  49. Pachl C, Todd JA, Kern DG, et al. Rapid and precise quantification of HIV-1 RNA in plasma using a branched DNA signal amplification assay. J Acquir Immune Defic Syndr Hum Retrovirol. 1995;8(5):446–54.

    CAS  PubMed  Google Scholar 

  50. Henrard DR, Phillips JF, Muenz LR, et al. Natural history of HIV-1 cell-free viremia. JAMA. 1995;274(7):554–8.

    CAS  PubMed  Google Scholar 

  51. Coffin JM. HIV population dynamics in vivo: implications for genetic variation, pathogenesis, and therapy. Science. 1995;267(5197):483–9.

    CAS  PubMed  Google Scholar 

  52. Ho DD, Neumann AU, Perelson AS, Chen W, Leonard JM, Markowitz M. Rapid turnover of plasma virions and CD4 lymphocytes in HIV-1 infection. Nature. 1995;373(6510):123–6.

    CAS  PubMed  Google Scholar 

  53. Collier AC, Coombs RW, Schoenfeld DA, et al. Treatment of human immunodeficiency virus infection with saquinavir, zidovudine, and zalcitabine. AIDS Clinical Trials Group. N Engl J Med. 1996;334(16):1011–7.

    CAS  PubMed  Google Scholar 

  54. Essex M, Mboup S, Kanki P, Marlink R, Tlou S, editors. AIDS in Africa. New York: Kluwer Academic/Plenum; 2002.

    Google Scholar 

  55. Lu Y, Essex M, editors. AIDS in Asia. New York: Kluwer Academic/Plenum; 2004.

    Google Scholar 

  56. Duesberg PH. Inventing the AIDS virus. Washington: Regnery; 1997. p. 10.

    Google Scholar 

  57. Duesberg PH. Inventing the AIDS virus. Washington: Regnery; 1997. p. 169.

    Google Scholar 

  58. Duesberg PH, Rasnick D. The AIDS dilemma: drug diseases blamed on a passenger virus. Genetica. 1998;104:85–132.

    CAS  PubMed  Google Scholar 

  59. Duesberg PH. Inventing the AIDS virus. Washington: Regnery; 1997. p. 255–97.

    Google Scholar 

  60. Duesberg PH. Human immunodeficiency virus and acquired immunodeficiency syndrome: correlation but not causation. Proc Natl Acad Sci USA. 1989;86:755–64.

    CAS  PubMed  Google Scholar 

  61. Duesberg PH. AIDS epidemiology: inconsistencies with human immunodeficiency virus and with infectious disease. Proc Natl Acad Sci USA. 1991;88:1575–9.

    CAS  PubMed  Google Scholar 

  62. Duesberg PH. Inventing the AIDS virus. Washington: Regnery; 1997. p. 175.

    Google Scholar 

  63. Duesberg PH. Duesberg defends challenges to the existence of HIV. Continuum. 1996;4(2):8–9.

    Google Scholar 

  64. Duesberg PH. The role of drugs in the origin of AIDS. Biomed Pharmacother. 1992;46:3–15.

    CAS  PubMed  Google Scholar 

  65. Duesberg PH. Foreign-protein-mediated immunodeficiency in hemophiliacs with and without HIV. Genetica. 1995;95:51–70.

    CAS  PubMed  Google Scholar 

  66. Allain JP. Transfusion risks of yesterday and of today. Transfus Clin Biol. 2003;10(1):1–5.

    PubMed  Google Scholar 

  67. Duesberg P, Koehnlein C, Rasnick D. The chemical bases of the various AIDS epidemics: recreational drugs, anti-viral chemotherapy and malnutrition. J Biosci. 2003;28(4):383–412.

    PubMed  Google Scholar 

  68. Kalichman SC. Denying AIDS: conspiracy theories, pseudoscience, and human tragedy. New York and London: Copernicus/Springer; 2009. p. 44.

    Google Scholar 

  69. Duesberg PH. Inventing the AIDS virus. Washington: Regnery; 1997. p. 184–5.

    Google Scholar 

  70. Duesberg PH. Inventing the AIDS virus. Washington: Regnery; 1997. p. 187.

    Google Scholar 

  71. Duesberg PH. Inventing the AIDS virus. Washington: Regnery; 1997. p. 419.

    Google Scholar 

  72. UNAIDS. Report on the global HIV/AIDS epidemic. Geneva: UNAIDS; 2008.

    Google Scholar 

  73. Barnhart HX, Caldwell MB, Thomas P, et al. Natural history of human immunodeficiency virus disease in perinatally infected children: an analysis from the Pediatric Spectrum of Disease Project. Pediatrics. 1996;97(5):710–6.

    CAS  PubMed  Google Scholar 

  74. European Collaborative Study. Children born to women with HIV-1 infection: natural history and risk of transmission. Lancet. 1991;337(8736):253–60.

    Google Scholar 

  75. Newell ML, Borja MC, Peckham C. European Collaborative Study. Height, weight, and growth in children born to mothers with HIV-1 infection in Europe. Pediatrics. 2003;111(1):e52–60.

    PubMed  Google Scholar 

  76. UNAIDS. Report on the global HIV/AIDS epidemic. Geneva: UNAIDS; 2000.

    Google Scholar 

  77. Duesberg PH. AIDS acquired by drug consumption and other noncontagious risk factors. Pharmac Ther. 1992;55:201–77.

    CAS  Google Scholar 

  78. Msisha WM, Kapiga SH, Earls F, Subramanian SV. Socioeconomic status and HIV seroprevalence in Tanzania: a counterintuitive relationship. Int J Epidemiol. 2008;37(6):1297–303.

    PubMed  Google Scholar 

  79. Piot P, Greener R, Russell S. Squaring the circle: AIDS, poverty, and human development. PLoS Med. 2007;4(10):1571–5.

    PubMed  Google Scholar 

  80. Begtrup K, Melbye M, Biggar RJ, Goedert JJ, Knudsen K, Andersen PK. Progression to acquired immunodeficiency syndrome is influenced by CD4 T-lymphocyte count and time since seroconversion. Am J Epidemiol. 1997;145(7):629–35.

    CAS  PubMed  Google Scholar 

  81. Vermund SH, Hoover DR, Chen K. CD4+ counts in seronegative homosexual men. The Multicenter AIDS Cohort Study. N Engl J Med. 1993;328(6):442.

    CAS  PubMed  Google Scholar 

  82. Des Jarlais DC, Friedman SR, Marmor M, et al. CD4 lymphocytopenia among injecting drug users in New York City. J Acquir Immune Defic Syndr. 1993;6(7):820–2.

    CAS  PubMed  Google Scholar 

  83. Donegan E, Stuart M, Niland JC, et al. Infection with human immunodeficiency virus type 1 (HIV-1) among recipients of antibody-positive blood donations. Ann Intern Med. 1990;113(10):733–9.

    CAS  PubMed  Google Scholar 

  84. Hughes SM, Amadi B, Mwiya M, et al. CD4 counts decline despite nutritional recovery in HIV-infected Zambian children with severe malnutrition. Pediatrics. 2009;123(2):e347–51.

    PubMed  Google Scholar 

  85. Aina O, Dadik J, Charurat M, et al. Reference values of CD4 T lymphocytes in human immunodeficiency virus-negative adult Nigerians. Clin Diagn Lab Immunol. 2005;12(4):525–30.

    CAS  PubMed  Google Scholar 

  86. Maclure M. Inventing the AIDS virus hypothesis: an illustration of scientific vs unscientific induction. Epidemiology. 1998;9(4):467–73.

    CAS  PubMed  Google Scholar 

  87. Cohen J. The Duesberg phenomenon. Science. 1994;266:1642–4.

    CAS  PubMed  Google Scholar 

  88. Kalichman SC. Denying AIDS: conspiracy theories, pseudoscience, and human tragedy. New York and London: Copernicus/Springer; 2009. p. 9.

    Google Scholar 

  89. Schünemann HJ, Fretheim A, Oxman AD. Improving the use of research evidence in guideline development: 9. Grading evidence and recommendations. Health Res Policy Syst. 2006;4:21.

    PubMed  Google Scholar 

  90. Chin R, Lee BY. Principles and practice of clinical trial medicine. London: Academic Press; 2008.

    Google Scholar 

  91. Light RJ, Pillemer DB. Summing up: the science of reviewing research. Cambridge: Harvard University Press; 1984.

    Google Scholar 

  92. Egger M, Davey Smith G, Altman DG, editors. Systematic reviews in health care: meta-analysis in context. 2nd ed. London: BMJ; 2001.

    Google Scholar 

  93. Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF. Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Quality of Reporting of Meta-analyses. Lancet. 1999;354(9193):1896–900.

    CAS  PubMed  Google Scholar 

  94. Chigwedere P, Seage GR, Lee TH, Essex M. Efficacy of antiretroviral drugs in reducing mother-to-child transmission of HIV in Africa: a meta-analysis of published clinical trials. AIDS Res Hum Retroviruses. 2008;24(6):827–37.

    CAS  PubMed  Google Scholar 

  95. Atkins D, Best D, Briss PA, et al. GRADE Working Group. Grading quality of evidence and strength of recommendations. BMJ. 2004;328(7454):1490.

    PubMed  Google Scholar 

  96. Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996;17(1):1–12.

    CAS  PubMed  Google Scholar 

  97. Institute of Medicine. Adverse events associated with childhood vaccines: evidence bearing on causality. Washington: National Academy Press; 1993.

    Google Scholar 

  98. Stoto MA. Research synthesis for public health policy: experience of the Institute of Medicine. In: Stangl D, Berry D, editors. Meta-analysis in medicine and health policy. New York: Marcel Dekker; 2000.

    Google Scholar 

  99. Volmink J, Siegfried NL, van der Merwe L, Brocklehurst P. Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection. Cochrane Database Syst Rev. 2007;1:CD003510.

    PubMed  Google Scholar 

  100. Suksomboon N, Poolsup N, Ket-Aim S. Systematic review of the efficacy of antiretroviral therapies for reducing the risk of mother-to-child transmission of HIV infection. J Clin Pharm Ther. 2007;32:293–311.

    CAS  PubMed  Google Scholar 

  101. Bartlett JA, Benoit SL, Johnson VA, et al. Lamivudine plus zidovudine compared with zalcitabine plus zidovudine in patients with HIV infection. A randomized, double-blind, placebo-controlled trial. North American HIV Working Party. Ann Intern Med. 1996;125(3):161–72.

    CAS  PubMed  Google Scholar 

  102. Nachman SA, Stanley K, Yogev R, et al. Nucleoside analogs plus ritonavir in stable antiretroviral therapy-experienced HIV-infected children: a randomized controlled trial. Pediatric AIDS Clinical Trials Group 338 Study Team. JAMA. 2000;283(4):492–8.

    CAS  PubMed  Google Scholar 

  103. Darbyshire J, Foulkes M, Peto R, et al. Zidovudine (AZT) versus AZT plus didanosine (ddI) versus AZT plus zalcitabine (ddC) in HIV infected adults. Cochrane Database Syst Rev. 2000;3:CD002038.

    PubMed  Google Scholar 

  104. Jordan R, Gold L, Cummins C, Hyde C. Systematic review and meta-analysis of evidence for increasing numbers of drugs in antiretroviral combination therapy. BMJ. 2002;324(7340):757.

    CAS  PubMed  Google Scholar 

  105. Rutherford G, Sangani P, Kennedy GE. Three- or four- versus two-drug antiretroviral maintenance regimens for HIV infection. Cochrane Database Syst Rev. 2003;3:CD002037.

    Google Scholar 

  106. Siegfried N, van Deventer PJU, Mahomed FA, Rutherford G. Stavudine, lamivudine and nevirapine combination therapy for treatment of HIV infection and AIDS in adults. Cochrane Database Syst Rev. 2006;2:CD004535.

    PubMed  Google Scholar 

  107. Humphreys E, Hernandez LB, Rutherford G. Antiretroviral regimens for patients with HIV who fail first-line antiretroviral therapy. Cochrane Database Syst Rev. 2007;4:CD006517.

    PubMed  Google Scholar 

  108. Shey M, Kongnyuy EJ, Shang J, Wiysonge CS. A combination drug of abacavir-lamivudine-zidovudine (Trizivir®) for treating HIV infection and AIDS. Cochrane Database Syst Rev. 2009;3:CD005481.

    PubMed  Google Scholar 

  109. Djomand G, Roels T, Ellerbrock T, et al. Virologic and immunologic outcomes and programmatic challenges of an antiretroviral treatment pilot project in Abidjan, Cote d’Ivoire. AIDS. 2003;17(Suppl 3):S5–15.

    Article  PubMed  Google Scholar 

  110. Coetzee D, Hildebrand K, Boulle A, et al. Outcomes after two years of providing antiretroviral treatment in Khayelitsha, South Africa. AIDS. 2004;18(6):887–95.

    PubMed  Google Scholar 

  111. Wester CW, Kim S, Bussmann H, et al. Initial response to highly active antiretroviral therapy in HIV-1C-infected adults in a public sector treatment program in Botswana. J Acquir Immune Defic Syndr. 2005;40(3):336–43.

    PubMed  Google Scholar 

  112. Etard JF, Ndiaye I, Thierry-Mieg M, et al. Mortality and causes of death in adults receiving highly active antiretroviral therapy in Senegal: a 7-year cohort study. AIDS. 2006;20(8):1181–9.

    PubMed  Google Scholar 

  113. Stringer JS, Zulu I, Levy J, et al. Rapid scale-up of antiretroviral therapy at primary care sites in Zambia: feasibility and early outcomes. JAMA. 2006;296(7):782–93.

    CAS  PubMed  Google Scholar 

  114. Ivers LC, Kendrick D, Doucette K. Efficacy of antiretroviral therapy programs in resource-poor settings: a meta-analysis of the published literature. Clin Infect Dis. 2005;41(2):217–24.

    CAS  PubMed  Google Scholar 

  115. Hammond R, Harry TC. Efficacy of antiretroviral therapy in Africa: effect on immunological and virological outcome measures: a meta-analysis. Int J STD AIDS. 2008;19(5):291–6.

    PubMed  Google Scholar 

  116. Braitstein P, Brinkhof MW, Dabis F, et al. Antiretroviral therapy in lower income countries (ART-LINC) collaboration; ART cohort collaboration (ART-CC) groups. Mortality of HIV-1-infected patients in the first year of antiretroviral therapy: comparison between low-income and high-income countries. Lancet. 2006;367(9513):817–24.

    PubMed  Google Scholar 

  117. Preston S, Heuveline P, Guillot M. Demography: measuring and modeling population processes. Oxford: Wiley-Blackwell; 2000. p. 1–20.

    Google Scholar 

  118. Statistics South Africa. Mortality and causes of death in South Africa, 2006: findings from death notification. South Africa: Statistics South Africa; 2008.

    Google Scholar 

  119. Stanecki KA, Walker N. Current estimates and projections for the epidemic. In: Essex M, Mboup S, Kanki P, Marlink R, Tlou S, editors. AIDS in Africa. New York: Kluwer Academic/Plenum; 2002. p. 281–96.

    Google Scholar 

  120. Dorrington R, Bourne D, Bradshaw D, Laubscher R, Timæus I. The impact of HIV/AIDS on adult mortality in South Africa. Burden of Disease Research Unit, Medical Research Council (SA); 2001:10. Available at: <http://www.mrc.ac.za/bod/complete.pdf> . Accessed 2009 Aug 9.

  121. UNAIDS Reference Group on Estimates, Modelling and Projections. Improved methods and assumptions for estimation of the HIV/AIDS epidemic and its impact: recommendations of the UNAIDS Reference Group on Estimates, Modelling and Projections. AIDS. 2002;16(9):W1–14.

    Google Scholar 

  122. Walker N, Stanecki KA, Brown T, et al. Methods and procedures for estimating HIV/AIDS and its impact: the UNAIDS/WHO estimates for the end of 2001. AIDS. 2003;17(15):2215–25.

    PubMed  Google Scholar 

  123. Stover J, Johnson P, Zaba B, Zwahlen M, Dabis F, Ekpini RE. The spectrum projection package: improvements in estimating mortality, ART needs, PMTCT impact and uncertainty bounds. Sex Transm Infect. 2008;84(Suppl 1):i24–30.

    PubMed  Google Scholar 

  124. Stover J, Ghys PD, Walker N. Testing the accuracy of demographic estimates in countries with generalized epidemics. AIDS. 2004;18(Suppl 2):S67–73.

    PubMed  Google Scholar 

  125. Grassly NC, Morgan M, Walker N, et al. Uncertainty in estimates of HIV/AIDS: the estimation and application of plausibility bounds. Sex Transm Infect. 2004;80(Suppl 1):i31–8.

    PubMed  Google Scholar 

  126. Walker N, Grassly NC, Garnett GP, Stanecki KA, Ghys PD. Estimating the global burden of HIV/AIDS: what do we really know about the HIV pandemic? Lancet. 2004;363(9427):2180–5.

    PubMed  Google Scholar 

  127. Gouws E, Mishra V, Fowler TB. Comparison of adult HIV prevalence from national population-based surveys and antenatal clinic surveillance in countries with generalised epidemics: implications for calibrating surveillance data. Sex Transm Infect. 2008;84(Suppl 1):i17–23.

    PubMed  Google Scholar 

  128. Actuarial Society of South Africa. ASSA 2003 AIDS and demographic model. Cape Town: Actuarial Society of South Africa; 2005.

    Google Scholar 

  129. Boerma JT, Nunn AJ, Whitworth JA. Mortality impact of the AIDS epidemic: evidence from community studies in less developed countries. AIDS. 1998;12(Suppl 1):S3–14.

    PubMed  Google Scholar 

  130. Blacker J. The impact of AIDS on adult mortality: evidence from national and regional statistics. AIDS. 2004;18(Suppl 2):S19–26.

    PubMed  Google Scholar 

  131. Stover J, Way P. Projecting the impact of AIDS on mortality. AIDS. 1998;12(Suppl 1):S29–39.

    PubMed  Google Scholar 

  132. The Durban Declaration. Nature 2000;406:15–6.

    Google Scholar 

  133. Horton R. African AIDS beyond Mbeki: tripping into anarchy. Lancet. 2000;356(9241):1541–2.

    CAS  PubMed  Google Scholar 

  134. Kalichman SC. Denying AIDS: conspiracy theories, pseudoscience, and human tragedy. New York and London: Copernicus/Springer; 2009. p. 8–13.

    Google Scholar 

  135. Cameron E. Witness to AIDS. London: I. B. Tauris; 2005.

    Google Scholar 

  136. Moore JP. The dangers of denying HIV. Nature. 2009;459:168.

    CAS  Google Scholar 

  137. Geffen N. Justice after AIDS denialism: should there be prosecutions and compensation? J Acquir Immune Defic Syndr. 2009;51(4):454–5.

    PubMed  Google Scholar 

  138. Wainberg M. In: Scovill R. The other side of AIDS (film); 2004. Available at: http://www.theothersideofaids.com/free_to_question.html. Accessed 2009 Nov 27.

  139. Muga W. When public negligence can become criminal. African Business 2009 May.

  140. Moore JP, Bergman J, Wainberg MA. The AIDS denialists are still around. IAS Newsl. 2007:4–5.

  141. Chigwedere PM. Antiretroviral drug use in South Africa: from science to practice and malpractice (Dissertation). Boston: Harvard School of Public Health; 2008.

    Google Scholar 

Download references

Acknowledgments

We wish to acknowledge Professor George Seage who critiqued and helped refine the arguments on causation of AIDS in an earlier version of the argument.

Conflict of Interest

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

  1. Harvard School of Public Health AIDS Initiative and Department of Immunology and Infectious Diseases, Harvard School of Public Health, FXB 402, 651 Huntington Ave, Boston, MA, 02115, USA

    Pride Chigwedere & M. Essex

Authors
  1. Pride Chigwedere
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Essex
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Essex.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chigwedere, P., Essex, M. AIDS Denialism and Public Health Practice. AIDS Behav 14, 237–247 (2010). https://doi.org/10.1007/s10461-009-9654-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-009-9654-7

Keywords

Search

Navigation