Talk:AIDS reappraisal
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This is a controversial topic, which may be disputed. |
For older discussion, see Talk:AIDS reappraisal/archive 1
I read this purely for interest. I note that the structure seems to be misleading: All the dissidents' claims are rebutted within the documentation of the claim, and then, afterward, the mainstream position gets its own section. There are a few topics in the latter not seen in the former, but this seems unbalanced. joeclark
I'm about ready to give up on this article. I have better ways of wasting my time. Revolver
Let me rephrase that. It appears that this topic is simply too religious to be developed as an article on wikipedia. When the different sides completely disagree not just upon facts, but upon basic ontological and epistemological viewpoints, it's impossible to say anything that anyone can agree upon. This is reflected in the constant debates over language and terminology. It's also reflected in the fact that dissidents and orthodox don't just disagree over "facts", they disagree over methods of thinking and methods of reaching conclusions. It often boils down to a "this is why; no, that's not a valid way of reasoning" argument. This is very difficult to reconcile to anyone's satisfaction. Also, the constant langauge of the orthodox ("denialism", "revisionism", etc.) reveals a clear POV that reflects the almost religious tone of the debate. Revolver
I've been spending a lot of time on non-Wikipedia activities lately, but I've kept an eye on what's happening here. I agree with Revolver that things are getting somewhat out of control, and am also tempted to forget I ever saw this article, but I strongly feel that we need this article, particularly because it is a matter of such near-religious proportions. Like the other controversial articles, the very nature of this subject makes it almost impossible to find a neutral treatment of it. Wikipedia is one of the only places that such a neutral treatment is conceivable (if not entirely feasible).
From what I can gather from a cursory inspection of the editing conflicts to date, the disagreements generally seem to be about (1) what terminology to use, (2) what constitutes fact, and (3) what constitutes a valid line of reasoning (essentially what Revolver has indicated above).
It seems to me that the matter of terminology can be most easily resolved by an introductory statement similar to what is already there under "Terminology", but more explicitly designed to explain the choice of terminology used in the article. There is probably no such thing as a totally neutral set of terminology, so we must make it neutral by stating at the outset that "We call it the HIV theory, but this should not be taken to imply the correctness of any particular viewpoint" or some such.
As for what constitutes fact, at least regarding the "facts" about how the disease is caused and develops, we could just stick with facts about viewpoints. Duesberg observed X, which he believes indicates Y, but Kary Mullis thinks Z. Making purportedly factual claims about the disease itself is where the trouble begins.
The third point, what constitutes a valid line of reasoning, is probably just as easily resolved. Again, the article should present information about those who hold these particular viewpoints; the article itself should not hold these viewpoints. Wikipedia articles can't hope to resolve the deeply philosophical matter of what approach to understanding "reality" is the most appropriate or valid. In general, science prevails around here, but since there is disagreement on what even qualifies as scientific, it's probably best to let the players speak for themselves, and let readers do their own reasoning.
All of the above is simply a re-statement of Wikipedia's NPOV policy, of course. We all gotta cooperate or we'll get nowhere. We know it can be done, since it has been done with so many other controversial topics.
My opinion is this: The first step towards getting this article into a worthwhile form is to begin mercilessly summarizing. There are a lot of tangential discussions, arguments and counterarguments, but nothing to really lead the reader along in understanding the significance of the debate itself. As a reader of this article, I feel as though I'm stuck in between two guys bickering with each other for an hour. I would much prefer brief, concise, and neutral-as-possible statements. Tell me the story of AIDS reappraisal. Don't make it a play-by-play. Take a cue from some of the fantastic journalists that have written on the subject, and let us in to walk around; don't ram it down our throats. Just my opinion :-) -- Wapcaplet 22:31, 3 Nov 2003 (UTC)
It's not a debate, it's a scientific hypothesis capable of proof or disproof. I sympathize with your impatience: "reappraisers" need to do the science necessary to support their position, rather than debate it. Yours, the nuisance, Cheesemonkey 06:40, 4 Nov 2003 (UTC)
- And many people would say it has been more than disproven. How are you to say they're wrong? By interpreting available data and evidence. This is called "argumentation" and "debate". I don't know what you mean by "do the science necessary". Typical orthodox nonsense reasoning. Revolver 08:34, 23 May 2005 (UTC)
Well, clearly there is disagreement over how best to prove that hypothesis, and how to interpret the scientific (and non-scientific) data that we have. There certainly is some debate :-) But I don't think anyone is claiming that debate alone is enough to prove anything. -- Wapcaplet 11:12, 4 Nov 2003 (UTC)
| Contents |
What's the point?
I don't understand the motivation of denying that HIV causes AIDS. Is it to make people feel safe while engaging in homosexual acts?
Like:
- Moralists oppose homosexuality.
- Moralists promote the thesis that HIV causes AIDS, not because it's true but because they hope to scare people out of the homosexual lifestyle.
- Gay rights activists counter the thesis that HIV causes AIDS, not because they believe the thesis is false but because they hope to assure people that the homosexual lifestyle is safe (see: slogan:Living with AIDS).
The whole thing puzzles me: doesn't anyone care about avoiding death? --Uncle Ed 18:52, 2 Dec 2003 (UTC)
- I don't think is a matter of denying anything; those who doubt that HIV causes AIDS do so because they do not believe there is sufficient evidence to show that it does. There are some who feel that falsely (in their eyes) attributing the syndrome to HIV may direct attention away from the real causes.
- Excuse me for interrupting, but that sounds like O. J. Simpson searching for the "real killers" of his ex-wife. --Uncle Ed 14:35, 3 Dec 2003 (UTC)
- In other words, if we have spent two decades under the assumption that HIV is the sole cause of AIDS, and it hasn't gotten us anywhere in terms of finding a cure or even treating it, it may be wise to consider other possible causes.
- This doesn't make sense. We also know that malaria is spread by mosquito bites, and that knowledge has not led to the disease's eradication. Does that mean we should look for an alternate cause in this case, too? --Uncle Ed 14:45, 3 Dec 2003 (UTC)
- I think that everyone involved is trying to avoid death, but there are many differing perspectives on how to do that. If HIV is indeed the sole cause, then we should follow the standard procedure of avoiding infection with it; but if HIV is not the sole cause, or even a contributing cause, then avoiding HIV isn't going to save any lives.
- Studies testing this point have already been conducted: hardly anyone without HIV has AIDS, and most people with HIV get AIDS and then die from it. What more proof do you need? --Uncle Ed 14:45, 3 Dec 2003 (UTC)
- Peter Duesberg, for a while anyway, believed that AIDS was caused predominantly (even exclusively) by long-term IV drug abuse. If he were right, then making sure you have clean needles isn't going to help you, and having safer sex is irrelevant.
- Ditto for this point: long-term IV drug abuse has been around for over a century, and no one ever get AIDS before HIV showed up. It's easy to check whether it's the drug abuse itself or transmission of HIV via contaminated needles is the cause of AIDS. --Uncle Ed 14:45, 3 Dec 2003 (UTC)
- Duesberg and many others do not think that there is enough evidence to establish, without question, that HIV is the sole cause, and that if we are not certain about HIV being the sole cause, then it may be dangerous and even lethal to proceed as though it were. The known toxic effects of AZT (see above) are just one example of this.
- If there is any motivation in denying, or questioning, that HIV causes AIDS, I think it is simply scientific investigation at work. When a theory fails to adequately explain our observations, we tend to look for a better theory. Those who are doing this questioning do not think that the HIV theory is doing a very good job of explaining their observations, and a better theory may lead us towards better treatment, or a cure.
- That's how I see it, anyway. -- Wapcaplet 21:38, 2 Dec 2003 (UTC)
Wapcaplet, I would be interested in seeing a condensed article here. It seems like some points are reiterated and it seems more like a Usenet thread than an article. I would be interested in what the HIV thesis critics think about the reduction in AIDS rates in certain African countries after safe sex campaigns. If that is in the article I missed it. Rmhermen 15:05, Dec 3, 2003 (UTC)
- Me, too. My own church claims credit for helping to reduce AIDS in Uganda via a campaign involving chastity or sexual abstinence. I hesitate to add anything about these claims until someone else corroborates them. --Uncle Ed 17:00, 3 Dec 2003 (UTC)
Regarding comments above by Ed Poor: I personally do not have good answers to your questions. This very debate has been going on for somewhere around ten years, and very few compromises or agreements have been reached among the varying parties involved. But the fact remains: Many people have questioned how much we really know about how AIDS is caused. I don't know what causes AIDS, and I am certainly not interested in getting in a debate over it :-) But I would like to see this article happen. The problem with it thus far is that it tends to degenerate into a series of diatribes and internal debates. I don't think there's room in a single Wikipedia article to detail all the claims, counter-claims, and counter-counter-claims of each camp.
I agree with Rmhermen that the article could use some merciless summarizing, and possibly even a complete rewrite (no offense to Revolver who wrote the original framework, but I don't think this format is going to work out after all). Other than the comments I've already made above, I am not sure how best to approach this problem, or even that I'm the person to initiate it, but I will give it a shot when I have the time. -- Wapcaplet 19:21, 3 Dec 2003 (UTC)
- Thank you for your mild and reasoned response. Sorry if I seemed strident; I don't want to pick a fight. I really am interested in serious alternatives to the conventional 'HIV causes AIDS' theory. An article about that, without diatribes, sounds good to me. --Uncle Ed 21:00, 3 Dec 2003 (UTC)
I just read the article without having been involved in any editing before. It was an interesting read but as this is a minority opinion, I don't quite understand why the article is longer than the AIDS and HIV articles taken together. A short summary of maybe 2 or 3 paragraphs should be enough; I don't think the arguments of the debate should be stated here in any breadth. I am not going to do this though as I don't want to hurt the feelings of some of the people that are very involved here. SmilingBoy 01:00, 12 Jan 2004 (UTC)
- There's no problem with length in and of itself (since Wikipedia is not paper). It's a minority opinion, but very inflammatory and controversial, and I don't think a short summary can really provide the necessary explanation. There is no doubt that this article needs a lot of work, though. As I stated above, the point-by-point description of the various sides of the argument is probably not the best way to do it, so I agree with you that the arguments should be summarized if possible. Please feel free to do some rewriting - you won't hurt my feelings! If you plan to do a complete rewrite, perhaps it'd be good to work on it in a temporary location like Talk:AIDS reappraisal/temp. -- Wapcaplet 16:47, 12 Jan 2004 (UTC)
Here's the most interesting part:
> (This was the public position in 1991 of Luc Montagnier and Robert Gallo the co-discoverers of HIV, who were both active in the search for cofactors.)
Obviously we need to know what their opinion is TODAY, 14 YEARS
AFTER THE ABOVE REMARK!
Why not ask them what their opinion of HIV/AIDS was in 1980?
Inconsistent numbers
Mainstream scientists reply that this suggests only that the number of new infections are approximately equal to the number of deaths; thus, the level of infection remains consistent.
This doesn't make sense according to expert figures. The CDC [1] (http://www.cdc.gov/hiv/stats/hasr1402/table7.htm) estimates that between 15-20,000 people die in the U.S. each year of AIDS (between 1998-2002), while experts believe [2] (http://www.usatoday.com/news/health/2003-02-11-hiv-rates-rising_x.htm) that about 40,000 or more new infections are occuring each year. Revolver 01:13, 11 Jun 2004 (UTC)
Sex in U.S.
They also note that sexual practices in the U.S. may be different from those in Africa.
Indeed, they are. The U.S. is the most sexually active and promiscuous country in the world. So, this does little to bolster the ridiculous "heterosexual AIDS in Africa because Africans are promiscuous and truck drivers screw with prostitutes a lot" argument. Revolver 01:33, 11 Jun 2004 (UTC)
- Revolver, even if you had evidence for the assertion that "the U.S. is the most sexually active and promiscuous country in the world", I think you'd still be attacking a straw man, since "promiscuous... screw with prostitutes" etc. does not appear in the article. I think this is just an unnecessarily vague summary sentence; what it is most likely referring to is the idea that heterosexual anal sex is relatively common in Africa, as well as the use of astringent substances for "dry sex", and that both of these practices increase the risk of HIV transmission. I can't be sure that that's what the author of the above sentence was talking about, but it is an accurate characterization of arguments that have been made against AIDS skeptics, and more well founded than your caricature suggests. --Hob 04:55, 15 Jun 2004 (UTC)
- Yes, I can give you a reference for the "most sexually active nation" claim, if you want. It's a survey done once every few years by some research institute. The way I related the mainstream argument is the way it has been described to me again and again by mainstream "scientists" or doctors. (i.e. YES, they really say, "Well, Africans have more sex, esp. the truck drivers and the prostitution problem.", of course not quite that way in publications, but in communications) This is apparently supposed to be taken on faith, as rarely is any evidence given to support this. I find it really hard to believe that some difference in heterosexual anal sex behaviour can account for the massive qualitative difference between the two epidemics. Heterosexual anal sex is relatively common in the U.S. I have never seen any kind of accurate numbers on sexual behaviour that would account for the difference in the epidemics. Revolver 04:10, 9 Jul 2004 (UTC)
Here ya go: U.S. has lots of sex (http://abcnews.go.com/sections/world/DailyNews/sexsurvey011127.html) Look under "number of sexual partners": [3] (http://www.elsewhere.org/tmp/durex/Durex-2001-Global-Report.pdf) Revolver 04:17, 9 Jul 2004 (UTC)
Some "truck drivers screwing prostitutes drives AIDS" arguments: [4] (http://www.walnet.org/csis/news/world_2003/aagm-030924.html) [5] (http://www.tedconover.com/trucking.html) [6] (http://www.time.com/time/2001/aidsinafrica/cover4.html) That's what I'm talking about. Revolver 04:26, 9 Jul 2004 (UTC)
Drugs cause AIDS claim removed?
I noticed that in the history the dissident claim of drugs causing AIDS was removed due to POV problems. Below is a section that I was going to add but then realized that I could not find a comprehensive "mainstream" view as well. If someone would be kind enough to write that up I'll (or you can) add this to the article. Thanks. --codepoet Jun 21, 2004
Claim: Drugs cause AIDS
Some dissidents claim that nitrites ("poppers"; a drug commonly used to enhance the sexual experience, principally among homosexual men) were the initial cause of AIDS in the early 1980s. They further claim that since nitrites weaken the immune system enough that opportunistic diseases take over and kill the patient and since HIV spreads through sex more easily through anal intercourse that analisys of the cause of AIDS was misled into following the trail of HIV rather than the drug use that caused its transmission. This theory of AIDS thus claims that drug users using nitrites were the first wave of AIDS patients as the nitirites caused AIDS symptoms.
Dissidents further claim that azidothymidine (AZT) was the primary cause of AIDS symptoms for modern patients diagnosed with HIV. After diagnosis the patient would be prescribed AZT as a preventative drug. AZT works by inhibiting DNA synthesis, thus preventing the creation of new cells. It was hoped that in small amounts this would work on HIV alone. Dissidents claim that in small amounts the drug never reached HIV and affected normal cells, including T-cells, which then caused AIDS symptoms. Since it was prescribed to patients already diagnosed with HIV and has itself caused AIDS, it is considered by dissidents to be a self-fullfilling prophecy. Dissidents commonly site that when AZT fell out of favor as the principal treatment around 1995 that deaths associated with AIDS dropped dramatically CDC (http://www.cdc.gov/hiv/stats/hasrsupp81/fig9.htm).
"Although many questions remain about the role of HIV in AIDS causation..." If backing is wanted, try Stevenson "HIV-1 Pathogenesis" Nature Medicine July 2003:
- Despite considerable advances in HIV science in the past 20 years, the reason why HIV-1 infection is pathogenic is still debated...considerable efforts [>G$100 worth] have gone into identifying the mechanisms by which HIV-1 causes disease, and two major hypotheses have been forwarded...There is a general misconception that more is known about HIV-1 than about any other virus and that all of the important issues regarding HIV-1 biology and pathogenesis have been resolved. On the contrary, what we know represents only a thin veneer on the surface of what needs to be known.
142.177.124.178 22:37, 15 Jul 2004 (UTC)
This is an important topic It is a paradigm that HIV causes AIDS. Most people are unaware that there are well credentialed scientists who have their doubts and the points they bring up are valid. To suggest that HIV is not equal to AIDS usually results in the speaker being treated like a flat earther.
However if the skeptics are right then our approach to AIDS is wrong! The money being spent on AIDS research and programs in AFRICA could be diverted to providing Clean water and sanitation which may well result in huge advances in the health of Africans.
Furthermore large sums may be spent on drugs which are worse than useless and potentially cause more harm than good.
The skeptics need to be heard, they may be wrong, but they could well be right.
There are many people who are HIV-positive and remain healthy 15 or 20 years after testing positive for HIV. Conversely, some HIV-seronegative people develop what would have been considered AIDS-defining diseases had they tested positive.
Can anyone cite statistics for this? How frequent is this?
HIV has remained prevalent at a relatively constant rate in the United States population the past 20 years, suggesting that it has existed long before the outbreak of AIDS.
Maybe I don't get English well, but remaining prevalent at a constant rate sounds meaningless to me. Can't anyone elaborate on the subject?
- It just means that the percentage of people has been more or less constant. Revolver 08:08, 23 May 2005 (UTC)
The Group is a separate thing
I strongly object to the Group given such prominence. The AIDS reappraisal movement is not the same thing as the Group. The Group is PART of the movement, but the article makes it sound like they're identical. HEAL should have just as much right. I'm changing the introduction back. Revolver 08:08, 23 May 2005 (UTC)
recent changes
Some of the recent changes to the article are good. Some are not so good. For example, there are whole sections of the article which are obviously written from the orthodox POV which are stated as is they are simple statements of fact. The section on the changing "definition" of AIDS is an awful example of this. Revolver 08:21, 23 May 2005 (UTC)
weasel terms
I understand avoiding weasel terms, but the guidelines did NOT say, "avoid 'some people say that' by erasing 'some people say that'", they said such statements should be thrown out altogether! What has happened is that those statements which are really the position of the orthodoxy are now stripped to sound like unbiased fact. And the same for dissident positions. I don't think it's a use of weasel terms to say, "Dissidents assert that" or "The mainstream scientific community asserts that". These are fairly specific. As it stands now, there is little mention of who is saying what of anything!, and consequently, the article is more of a mess now. Revolver 08:28, 23 May 2005 (UTC)
Although HIV cannot be found in the blood of people with AIDS, a range of antibody, antigen, RNA tests and cell culture techniques provide indirect evidence of HIV activity that cannot be ignored.
- This is an example of a statement that is clearly POV but presented as neutral fact. There are many other examples. Revolver 08:34, 23 May 2005 (UTC)
false positives
It is a well-known fact that when conducting binary tests for which prevalence is extremely low (such as the prevalence of testing positive for HIV), that the raw rate of false positives, or even the specificity and sensitivity of the test are not always enough to determine how useful the test is. This is why we use the positive/negative predictive values. If prevalence is very low, the specificity and sensitivity may be very good, while the positive predictive value not so good. It is the latter that is important to patients -- you want to know the conditional probability, the probability that you actually have the disease, given that you test positive. Imagine a disease in a population of 1,000,000, where 1,000 have the disease, and all test positive, but another 1,000 who don't have the disease also test positive. The specificity (Sp = P [ Test is negative | Patient is healthy ]) is very good, namely 998,000/999,000 or roughly 99.9%. The sensitivity (Sn = P [ Test is positive | Patient has the disease ]) is also very good, namely 1,000/1,000 or 100%. Yet the test is worse than useless from a patient's perspective, since the positive predictive value (PPV = P [ Patient has the disease | Test is positive ]) is only 1,000/2,000 or 50%. In other words, although the specificity and sensitivity are very high, and the rate of false positives (1,000/1,000,000 = .1%) quite low, if you are a patient, and you are told that you have tested positive, you only have a 50% of actually having the disease. The study given in the article had a population of about 130,000, with only 15 reporting positive, and a single false positive. It's ridiculous to draw such conclusions from such a small number of actual positive results, esp. in a population in which prevalence is very rare. The fact that the WB test is itself questioned as a gold standard only adds to the confusion. The conclusion of the paper is basically, "it's okay to thumb your nose at Bayes' Theorem", which coming from HIV researchers, doesn't surprise me. Revolver 23:19, 7 Jun 2005 (UTC)
Yes, yes, we all know there are many measures of the usefulness of a test. This 1988 paper was accepted and published by the New England Journal of Medicine, whose reviewers clearly did not share your opinion of the paper. Other studies in blood donors (confirming positivity with HIV RNA specific tests) found rates of false positivity of 4.8% of Western blot positive donors and 0.0004% for all donors. Surely you don't prefer the blatantly deceptive version of this article that falsely claimed the study cited demonstrated an 84% false positive rate? - Nunh-huh 23:27, 7 Jun 2005 (UTC)
- No, did I put that back in? (No.) I'm not sure where that came from. Regardless of what the reviewers thought, the statement in the abstract shows a misunderstanding of the use of these terms. The whole point of positive predictive value is that it is supposed to give a more accurate value of usefulness when the prevalence is extremely low. If the purpose of the study was to "determine the usefulness of the test in low-prevalence populations", then the raw false positive rate per patient tested is not the right measure to use, esp. in a population where prevalence is on the order of 1 in 10,000! Whether or not the reviewers chose to ignore this fact out of stupidity or political reasons is not my place to say -- the fact remains, and simply quoting the 1 out of 130,000 number and saying "that proves it's good" without giving the actual number of positives is misleading. Revolver 23:36, 7 Jun 2005 (UTC)
- As I've said before, the fact that something got by peer review in the HIV literature doesn't say much...this example only adds credence to my claim that HIV research itself has almost no scientific standards and is corrupt and incompetent. Revolver 23:38, 7 Jun 2005 (UTC)
- No you didn't put it back in. Neither did you take it out. Which says little for the standards of the reappraisalists. You may want to read the paper if you are unsure as to its purpose. - Nunh-huh 23:42, 7 Jun 2005 (UTC)
A few POV statements?
"Moreover, many of the AIDS-defining diseases, such as cervical cancer, have nothing to do with immune deficiency, and should not be considered part of the definition of AIDS." - "should not be considered" is POV, surely?
"It is for these reasons that the changing AIDS definition is merely a reflection of a broadened understanding of the disease, rather than a "circular" definition requiring a specific etiology." - this is the corresponding counter-POV.
But shouldn't these POVs be atrributed?
- Yes, I think so. Whig 21:48, 13 Jun 2005 (UTC)