The debilitating distraction of “HIV”

Every now and again, Martin chides me for writing about “HIV” (which doesn’t exist), “infection” (which doesn’t occur), and the like. My standard response has been that I don’t know how to write about HIV/AIDS doings without using the terminology that everyone’s familiar with. In my book, I tried to address the issue by saying that by HIV I would always mean, “Whatever it is that HIV tests detect”, but that repeating this every time, or always putting scare quotes around “HIV”, would get tiresome, for readers as well as the writer. I also used “F(HIV)”, for “frequency of positive HIV-tests”, instead of “the prevalence of HIV” so as not to entrench belief in the existence of an infectious agent.

In principle, I’ve recognized that Martin is right in pointing out that it’s not just terminology, because with every use of the terms (HIV, infection, AIDS, etc.), we absorb as well as disseminate something of the mistaken view. In practice, I haven’t known how to avoid doing this.

I’ve come to appreciate even more the force of Martin’s essential point through grappling, the last few months, with the interpretation of data on deaths from “HIV disease”. The difficulties I was having owed, to an appreciable degree, from having my mind infected with a subterranean notion that “HIV” means something, indeed something  specific — even as I was, on the conscious level, describing “HIV-positive” as being analogous to a fever and not meaning anything specific.

That analogy with fever, for which I’m grateful to Christian Fiala, is indeed an excellent one, concise and easy for people to grasp immediately without further explanation. Like all analogies, though, it isn’t more than an analogy, and can’t encompass all the characteristics of “HIV” — most particularly, that while fevers signal something out of the ordinary, even if not necessarily a serious health challenge, “HIV-positive” may signify nothing at all out of the ordinary, in the sense that “HIV-positive” may not be worth thinking or worrying about any more than, say, having a cold, waking up with an aching joint, just having been vaccinated against flu, or being pregnant.

My research into HIV-associated matters had been stimulated by the unbelievable assertion cited by Harvey Bialy, that in the mid-1980s teen-aged females applying for military service tested HIV-positive as frequently as their male peers. My book recounts what I found about the demography of positive “HIV”-tests: the regular variation with sex, age, race, and geography demonstrates that “HIV-positive” isn’t contagious or infectious. The variations between social groups demonstrates that “HIV-positive” has something to do, at least sometimes, with health challenge, or immune-system reaction, albeit not necessarily any serious threat to health — in groups where one expects to find relatively poor health or manifest illness, the average frequency of positive “HIV”-tests tends to be greater . I even suggested that “HIV-positive” might mean something different with different people: since only a few of the “HIV” proteins, and not always the same ones, are required for the test to be pronounced “positive”, perhaps there are some hidden specificities — maybe “HIV-positive” for gay men is detecting different substances than “HIV-positive” among pregnant women, say (and in neither case are those detected substances necessarily a cause for concern, anything “out of the ordinary”).

I hadn’t looked seriously into death statistics until about a year ago, when Sharon Stone told Larry King that  AIDS is “the fourth leading killer of women in America”. Of course that isn’t the case, it isn’t even in the top ten — World Aids Day: Sharon Stone on Larry King, sharing urban legends (or celebrity facts) , 22 December 2007. However, the data revealed some interesting variations by race and age, so I looked at that in more detail [“HIV Disease” , 28 December 2007;
How to test theories (HIV/AIDS theory flunks), 7 January 2008]. I noticed the peculiarity that black Americans are both more prone to test “HIV-positive” but also to survive that condition to a greater age than white Americans . Though I recognized that as another count against HIV/AIDS theory, I was mind-infected by “HIV signifies something” and didn’t take this to the conclusion that now seems so obvious.

Periodically I would come back to the remarkable fact that people aged around 35-45 always test HIV-positive more frequently than older  as well as younger adults or teenagers, and cite it as confirmation of the demographics that show “HIV” isn’t an infection [for example, “HIV demographics further confirmed: HIV is not sexually transmitted”, 26 February 2008]. I re-emphasized that “’HIV’ and ‘AIDS’ are two separate things” [Unraveling HIV/AIDS, 8 March 2008] — thereby illustrating the mind-infection that Martin kept warning me about; I ought to have remained aware that “HIV” isn’t “a thing” at all. By a few weeks later [“HIV Disease” is not an illness, 19 March 2008], I had come to realize that the death statistics in themselves show that “HIV disease” isn’t an illness, because the greatest risk of death is among 35-45-year-olds whereas all other illnesses, diseases, and “natural causes” too bring the greatest risk of death at older ages, the risk increasing about exponentially with age from the teens or twenties upward. I even recognized an implication of the fact that the age distributions of “HIV-positive” and of “HIV disease” deaths virtually superpose — the implication I recognized being that there’s no “latent period” and no evidence that HAART has been of benefit, or rather evidence that HAART has NOT been life-extending. But I didn’t grasp this further reminder that “HIV” isn’t “a thing”.

I’ve even commented on cognitive dissonance [for example, “HIV/AIDS illustrates cognitive dissonance“, 29 April 2008] — in others, that is, while not seeing what was staring me in the face, because I was mind-infected with the term “HIV”, as though “HIV” were a “thing”. I’d even been warned against that sort of mistake in many encounters with philosophers, for whom “reification” is a well-recognized fallacy: imagining there is “a thing” just because a name, a term, has been invented.

It was the egregious claim that HAART had saved millions of life-years that brought me back to looking at death statistics [HIV/AIDS scam: Have antiretroviral drugs saved 3 million life-years?, 6 July 2008]. I noted the peculiarity that all this life-saving and life-extending had left the average age of death from “HIV disease” at around 40 — but apparently I wasn’t yet able to tie this in with the fact that “HIV” isn’t “a thing”. I wasn’t yet able to see that the disjunction between low mortality and average age of death [More HIV/AIDS GIGO (garbage in and out): “HIV” and risk of death, 12 July 2008] is obviously to be expected, because “HIV” isn’t “a thing”.

I returned to the strange fact that the age of maximum likelihood of testing “HIV-positive” is always about the same as the age of maximum likelihood of dying from ”HIV disease” [How “AIDS Deaths” and “HIV Infections” vary with age — and WHY, 15 September 2008] and was finally set on a productive line of thought through noticing the stark disjunction between mortality from “HIV disease” and average age of death “from ‘HIV disease’” [HAART saves lives — but doesn’t prolong them!?, 17 September 2008]. But I was still in the mind-frame of arguing against latent periods and HAART benefits [No HIV “latent period”: dotting i’s and crossing t’s, 21 September 2008].

A re-statement of these matters in “Poison in South Africa” [26 October 2008] aroused comments from defenders of the HIV/AIDS faith that spurred me to carry out some laborious calculations that I’d been procrastinating about. The age distribution of people living with AIDS was like that of people tested for HIV and like that of deaths among PWAs. Finally I recognized that the disjunction between mortality and age of death is because both are based on “HIV” but “HIV” isn’t “a thing”, and you can’t classify PWAs or deaths on such a basis.

Take ANY group of people, apply “HIV” tests, and the frequency of positive tests will be at a maximum in the age range 35-45 or so. There are indications that the range may be a bit different for females as for males, and for people with different racial ancestries, but those differences — if indeed there are any — seem to be small.
Take ANY group of people, HEALTHY OR ILL, do “HIV” tests, and the frequency of positive tests will be at a maximum in the age range 35-45 or so. I had pointed this out in my book, with data from blood donors, gay men, heterosexuals at STD clinics, soldiers, sailors, marines, in the Job Corps, in all racial groups, in both sexes . . . . In other words, “HIV-positive” has nothing specifically to do with illness or with death.
That can be difficult to bear in mind, in part because of the habit of thinking of “HIV” as “a thing”; in part because the likelihood of positive “HIV”-tests does vary with physiological condition, and some illnesses are associated with a high probability of “positive” “HIV” tests. But never forget that many non-illnesses, like pregnancy, are also associated with a high probability of “positive” “HIV” tests: “HIV-positive” has nothing specifically to do with illness or with death.

The confusion came about because Gallo et al. were looking for things that might be common to victims of AIDS, who were very ill people (high likelihood of “positives”) and happened to be of average age in the mid-to-upper thirties (in any group, maximum probability of “positive” tests). What they came up with was an artefact; a sort of thermometer that is particularly prone to detect fever in certain physiological conditions, and that is also particularly likely to read “fever” by mistake, in certain other physiological conditions and especially with people aged about 35-45.
It’s hard to ingrain that firmly in one’s thinking, and keep it at the forefront of one’s mind, after being used to imagining that “HIV” is “a thing”.

So it took me “longer than otherwise necessary” to grasp what the disjunction of death ages and mortality rates illustrates: mortality rates are reported for the population of “people with AIDS”, but that has nothing specifically to do with illness or death, because inclusion in the group has as sine qua non a positive “HIV” test, which signifies nothing specifically about illness or risk of death. I kept thinking about “the median age of death” as pointing to a particular life expectancy, a lack of benefit from HAART, generally a conundrum for HIV/AIDS theory — while the straightforward meaning is simply this:
Take ANY group of people, apply “HIV” tests, and the frequency of positive tests will be at a maximum in the age range 35-45 or so.
Take those people who have been mistakenly diagnosed as infected by “the ‘HIV’ thing”, and the frequency of positive tests among them will be at a maximum in the age range 35-45 or so.
Take ANY group of people who have just died FOR ANY REASON, carry out “HIV” tests on the cadavers, and the frequency of positive tests will be at a maximum in the age range 35-45 or so.

It’s just meaningless to compare median age of death, in any group categorized by “HIV tests”, with mortality among that group, because “HIV” has nothing to do with risk of death. That’s why the attempt to compare those things revealed a stark disjunction, with different “relationships” between death age and mortality at different times — up to 1986/87, from then to 1992, discontinuity at 1992/93, different again to 1996, another discontinuity at 1996/97, different “relationship” again after that.

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So, Martin: thanks for your periodic reminders, thanks for not giving up on me. I think I may finally have grasped the point. Not that it will necessarily make it easier to write about this stuff without using misleading terms, but maybe I’ll be able to make the meanings of what I write less misleading.

Best holiday wishes!