AIDS Denialism: Ancient History or Ongoing Threat?

Despite the almost daily advances in the HIV sciences, the shadow of AIDS denialism still looms large, casting doubt and distraction among those who are often in the most need of care.

While the major voices of dissent (Peter Duesberg, Celia Farber) may no longer be able to grab the media spotlight they had back in the 1980s and 90s—when far less was known about HIV and fear provided a ready platform for those on the fringes of legitimate science—their messages and methods still have impact today.

To dismiss their ideas as medical "quackery" or remnants of a less enlightened past greatly underplays the effect that denialism has on the public's perception of HIV, as well as the unspoken fears and emotions they feed into.

In 2010, a survey of 343 adults diagnosed with HIV found that one in five participants believed there is no proof that HIV causes AIDS. One in three believed that scientists are debating whether HIV causes AIDS.

Those beliefs affected their adherence to treatment. Participants who believed that scientists are debating whether HIV causes AIDS were significantly less likely to be on antiretroviral therapy. Those who were on medications were less likely to be taking them regularly if they reported denialism beliefs.

Where Does AIDS Denialism Begin?

According to the Oxford Dictionary, a denialist is "a person who refuses to admit the truth of a concept or proposition that is supported by the majority of scientific or historical evidence."

Chris Hoofnagle, senior staff attorney of Samuelson Law, Technology & Public Policy Clinic at the University of California, Berkeley, extends the definition by stating:

"Since legitimate dialogue is not a valid option for those who are interested in protecting bigoted or unreasonable ideas from scientific facts, their only recourse is to use...rhetorical tactics."

Some of the rhetorical tactics identified by Tara C. Smith, associate professor of epidemiology at the University of Iowa College of Public Health, and Dr. Steven Novella of Yale University School of Medicine include:

• Portraying mainstream science as either intellectually compromised or interest-driven (e.g., biased by "drug money").
• Selectively choosing which authorities to believe and which to dismiss in order to frame a conspiracy argument, or to suggest that a proven science is being debated.
• Lowering the status of the denied science to that of deeply rooted (often persecuted) faith, while characterizing scientific consensus as dogmatic and suppressive.
• "Pushing back the goalpost" by demanding more scientific evidence than is currently available, and then insisting upon new evidence when those demands are met.

Vulnerable to Denialism?

Meanwhile, members of the public who embrace denialist beliefs are often seen to be vulnerable to misinformation or fraud, or simply lacking the education needed to make an informed judgment. Research from the University of Connecticut seems to suggest otherwise.

Of internet users in the study who endorsed a specific AIDS denialist belief, ratings for trust and believability were higher for a mainstream medical website (Tufts Medical School) than for two denialist websites they were shown (Matthias Rath, Jonathan Campbell). This seems to indicate that denialist messages don't as much instigate personal belief, but rather validate the suspicions and doubts of those unwilling (or unable) to accept medical fact against their own better judgment.

According to a study conducted by the CDC, only 44% of Americans diagnosed with HIV are linked to medical care. Misinformation about HIV—tied in with the fear of disclosure and lack of HIV appropriate care—is considered a key reason as to why many choose to delay treatment until the onset of symptomatic disease.

So, while AIDS denialism may seem like ancient history to some, its ability to confound and disrupt remains just as potent as ever.