Scientists as idiots savants (Science Studies 200)

What do scientists actually do? What do they produce?

Consider, for example, the titles of the articles in volume 53, issue #2, February 2010, of JAIDS (Journal of Acquired Immune Deficiency Syndromes). How relevant are they to the question of interest to AIDS Rethinkers and the public at large, which is whether HIV causes AIDS?

— Urgent need for coordination in adopting standardized antiretroviral adherence performance indicators
— Pairwise comparison of isogenic HIV-1 viruses: R5 phenotype replicates more efficiently than X4 phenotype in primary CD4+ T cells expressing physiological levels of CXCR4
— Prediction of HIV Type 1 Subtype C tropism by genotypic algorithms built from Subtype B viruses
— Maternal antiretroviral use during pregnancy and infant congenital anomalies: The NISDI Perinatal Study
— Insulin sensitivity in multiple pathways is differently affected during Zidovudine/Lamivudine-containing compared with NRTI-sparing combination antiretroviral therapy
— Pooled nucleic acid testing to identify antiretroviral treatment failure during HIV infection
— Short-term bone loss in HIV-infected premenopausal women
— Pharmacokinetic interaction of Ritonavir-boosted Elvitegravir and Maraviroc
— Durability of initial antiretroviral therapy in a resource-constrained setting and the potential need for Zidovudine weight-based dosing
— Hepatitis C and the risk of kidney disease and mortality in veterans with HIV
— Bisexuality, sexual risk taking, and HIV prevalence among men who have sex with men accessing voluntary counseling and testing services in Mumbai, India
— Trends in HIV prevalence, estimated HIV incidence, and risk behavior among men who have sex with men in Bangkok, Thailand, 2003-2007
— Indian men’s use of commercial sex workers: Prevalence, condom use, and related gender attitudes
— The association between alcohol consumption and prevalent cardiovascular diseases among HIV-infected and HIV-uninfected men
— Sustainability of first-line antiretroviral regimens: Findings from a large HIV treatment program in Western Kenya
— Comparison of early CD4 T-Cell count in HIV-1 seroconverters in Cote d’Ivoire and France: The ANRS PRIMO-CI and SEROCO cohorts
— Incident depression symptoms are associated with poorer HAART adherence: A longitudinal analysis from the nutrition for healthy living study
— Prevalence and correlates of HIV infection among male injection drug users in detention in Tehran, Iran
— HIV infection: An independent risk factor of peripheral arterial disease
— Nonalcoholic fatty liver disease in HIV-infected persons: Epidemiology and the role of nucleoside reverse transcriptase inhibitors
— Reply to “Nonalcoholic fatty liver disease among HIV-Infected persons”

This little exercise is intended to illustrate what should be perhaps the first axiom of scientific literacy: Nowadays scientists qua scientists are idiots savants. They are focused professionally on just one very specific and highly technical matter that is almost immeasurably distant from the wider context that matters to everyone else. Popular coverage of science, TV documentaries, magazine and newspaper pieces make it appear as though scientists were grappling continually and always with LARGE questions: the overall story of human evolution, perhaps, or how species become extinct, or how vaccines were invented, and so on and so forth. But the overwhelming proportion of scientists spend their time on esoteric little aspects of obscure little details, and they step into quite other shoes and perform in quite other roles if they are ever brought to speak to the public at large.

Specialization nowadays has reached the degree that the old saw* becomes almost literally true — scientists get to know more and more about less and less, until they know almost everything about almost nothing while knowing essentially nothing about everything else. A minor but instructive example: Medical professionals engaged for several decades in attempts at gene therapy did not keep up with the progressive understanding of genetics and development which has revealed that the initial basis for attempting gene therapy is not valid, because the Central Dogma of “one gene, one protein” was wrong — see for example the review by Ast, “The alternative genome”, Scientific American, April 2005, pp. 58-65. “Genes” are not permanent units of heredity, they are functional assemblages of sub-units that get activated and deactivated by signals from elsewhere, and those signals must be timed and coordinated with exquisite precision.

The very success of science has entailed that achieving ever deeper understanding means that research has to focus on increasingly infinitesimal detail. Scientific research means looking intensely at properties of the markings on individual leaves; which may eventually lead to a better understanding of the leaves; which might eventually contribute to a better understanding of tree growth; which is still a very long distance from knowing much about the forest, let alone the landscape.

In doing research, scientists simply accept as unquestioned the theoretical framework of the prevailing mainstream consensus. HIV/AIDS researchers have no time, no incentive, no reason to wonder whether HIV really causes AIDS — that’s simply a given for them. If it weren’t, then they wouldn’t be HIV/AIDS researchers: they might be scholars of “science and technology studies” (historians, sociologists, philosophers of science, political scientists, and so on), or they might be “HIV-positive” people whose health and lives depend on how the big question is answered.

Suggest to an HIV/AIDS researcher that HIV might not be the cause of AIDS, and you are questioning the very basis of his professional life and implying that he might not be able to trust his colleagues, his guild, his “science”. That’s why those Rethinkers and Skeptics who have approached even friends of theirs who happen to be HIV/AIDS researchers have received very cold, unfriendly, dismissive responses. It is quite literally UNTHINKABLE for an HIV/AIDS researcher that HIV might not be the cause of AIDS.
It’s also unthinkable for the great majority of biologists who are not HIV/AIDS researchers themselves, for they automatically trust their colleagues in other specialties of biology or medicine to be right about their particular specialty, just as they themselves expect to be trusted about their own specialty.
And it’s unthinkable for most scientists that any area of science or medicine could be so visibly and drastically wrong on so major an issue as HIV/AIDS.

Science is a vast mosaic of overlapping specialties glued together by mutual trust. Centuries of modern science appear to the conventional wisdom as a triumphant progress to better understanding of more and more about the natural world. That the progress has actually come by many trials and much error is known only to specialist historians and others. Even for them, this awareness of continual correction of errors, and of the occasional startling “scientific revolutions”, is no preparation for the possibility that HIV is not the cause of AIDS, for history offers no instance of a mistake comparable in its huge, widespread human and financial cost. Lives lost to “AIDS” in one way or another, and resources expended on “HIV/AIDS”, are of a magnitude usually associated with wars, not with a medical-scientific blunder (of which there have been many of lesser magnitude).

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This underscores what Clark Baker, among others, has been saying to Rethinkers for some time: Overturning HIV/AIDS theory will not result from scientific discussions, it can come only through political and social activism. The wider society must decide to force HIV/AIDS theorists to defend their faith under public cross-examination. HIV/AIDS researchers will reconsider the fundamental basis of their work only if forced to do so by irresistible outside pressure.

I’m not saying that the scientific issues are unimportant. They are nowadays of little concern only because all the necessary evidence is already at hand, in the mainstream literature, to demonstrate that “HIV” tests do not detect infection by an HIV retrovirus, that testing “HIV-positive” is not an inevitable prelude to illness, that “HIV-positive” is not in general a sexually transmitted condition; and so on. I am saying that the necessary task is to find some way of presenting that scientific evidence to the media and to the public and to socially and politically influential people in sufficiently concise yet convincing manner that they are forced to think the unthinkable, namely, to question the official mainstream consensus even when there is no precedent for such questioning.

One barrier to such a scenario is scientific illiteracy. Scientists as well as non-scientists are functionally illiterate when it comes to understanding the proper role of science in public affairs and how science should be organized to serve the wider society. That’s how scientific literacy and illiteracy should be defined, in terms of the place of science in human affairs. It’s quite unnecessary for everyone to know what molecules are, or enzymes, but it’s essential in a democratic society that everyone have an understanding of the degree to which experts, including scientists, can be taken at their professional word.

Here are some basics of scientific literacy:
→ There is no scientific method that guarantees objectivity (H. H. Bauer, Scientific Literacy and the Myth of the Scientific Method, University of Illinois Press, 1992).
→ Science is the search for consensual knowledge — consensual among fallible, non-objective human beings (John Ziman, Public Knowledge: An Essay Concerning the Social Dimension of Science, Cambridge University Press, 1968; and others culminating in Real Science—What It Is, and What It Means, 2000).
→ Like other human beings, scientists don’t readily change their views in the face of contradictory evidence. Resistance to new discovery by scientists is endemic. Major advances that modify or overturn an established scientific consensus have always been strenuously resisted, even as afterwards the resistance is forgotten and the formerly resisted ones are pronounced heroes — sometimes posthumously (Bernard Barber, “Resistance by scientists to scientific discovery”, Science, 134 [1961] 596-602; Gunther Stent, “Prematurity and uniqueness in scientific discovery”, Scientific American, December 1972, 84-93; Ernest B. Hook (ed)., Prematurity in Scientific Discovery: On Resistance and Neglect, University of California Press, 2002).
→ The overwhelming majority of scientists nowadays are craftsmen, tinkerers, journeymen. Many are mediocre even in terms of their professional talents. To think of Einstein, Darwin, Freud, and the like as exemplifying scientists is like thinking of Eisenhower, Macarthur, Marshall, and the like as exemplifying soldiers (H. H. Bauer, Beyond Velikovsky: The History of a Public Controversy, University of Illinois Press 1984, 1999, pp. 303-6).
→ The great achievers are typically idiots savants. Nobel-winning scientists usually make very poor administrators or advisers on anything outside their narrow specialty. Nobelist Varmus as head of the National Institutes of Health dropped conflict of interest regulations that led to scandalous behavior by senior scientists (David Willman, series in Los Angeles Times, December 2003). Nobelist Chu as Energy Secretary has already displayed qualities of dogmatic belief and single-mindedness that high-achieving scientists need but that are dysfunctional for administrators who need to be flexible, open-minded, pragmatic, willing to compromise. The enormously successful atom-bomb project had as its director Robert Oppenheimer, a highly knowledgeable physicist but not the highest achiever within physics. (I should enter the caveat that some Nobelists are quite sensible, even wise, for example economists Herbert Simon and James Buchanan.)
→ In research, one accepts the prevailing theoretical framework as the working hypothesis and tries to build on it. That becomes functionally equivalent to believing that theoretical framework to be true. Anomalous phenomena are shoved aside for later attention, or reasons are found for ignoring them as flawed, or ad hoc modifications are added to the basic theory to accommodate them, no matter how illogically or awkwardly — like Ptolemy’s “wheels within wheels within wheels” to preserve the Earth-centered view of the heavens. The accepted theory is abandoned only as a last resort under a tsunami of contradictions. (T. S. Kuhn, The Structure of Scientific Revolutions, University of Chicago Press, 1962/1970; Imre Lakatos, “History of Science and its Rational Reconstruction”, in Method and Appraisal in the Physical Sciences, ed. Colin Howson, 1-40, Cambridge University Press, 1976).

A couple of things about science are relatively new and have so far not become generally recognized even within the interdisciplinary field of science studies:
→ The normal resistance to counter-mainstream views has become actual suppression in an increasing array of fields (H. H. Bauer, “HIV/AIDS in historical context”; “Suppression of science within science”; “The new world order in science”; “21st century science: Knowledge monopolies and research cartels”).
→ Before HIV/AIDS, no scientific theory was so wrong as well as so influential in medical practice as to bring direct physical harm to hundreds of thousands, perhaps even millions of people, also causing unknowable amounts of psychological, social, and fiscal damage. That this is unprecedented makes it all the more difficult for the media and the public and the policy makers, let alone HIV/AIDS researchers themselves, to see it. (Human-caused global-warming theory is just as ill-based scientifically, but it hasn’t caused the same human suffering.)

So, again, what’s needed is to find facts sufficiently obvious to non-specialists, sufficiently incontrovertible, and of sufficient human impact, “human interest”, that the media cannot avoid taking notice and the politicians cannot continue to remain in blissful ignorance. Somehow HIV/AIDS dogma must be forced publicly to reveal and defend its supposed evidentiary basis.

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* I thought I’d read somewhere, perhaps in Gulliver’s Travels, the insight that specialization leads to knowing more and more about less and less; but a search through readily available reference-sources (Bartlett, Hoyt, Bergen Evans, GOOGLE) turned up only “An expert is someone who knows more and more about less and less, until eventually he knows everything about nothing” in a Murphy’s Laws collection, though the first clause is attributed in several places to Nicholas Murray Butler; also “An old complaint about the narrowing of interest of the medical specialist defines him as a person who gradually comes to learn more and more about less and less” (editorial comment, Psychiatric Quarterly, 23 [1949] 567). But I’m still inclined to think that Jonathan Swift, or perhaps George Bernard Shaw, said something along those lines.

Truth in Russia(n)

In the former Soviet Union, the chief official newspaper was called Правда (Pravda), a word that means “truth”. In those years, this had a certain ironic connotation for non-Soviet observers as well as for dissidents and perhaps the general public within the Soviet Union, because the newspaper’s contents were much more to be disbelieved than believed. In today’s Russia, however, the website PRAVDA seems to be ahead of most of the rest of the world’s news media in revealing actual truth:

“AIDS: The Greatest Deadly Lie in the History of Medicine
. . . Where is deserted Africa allegedly doomed for total extinction from AIDS? Gor Shirdel, M.D. of Irish descent who is currently practicing in Kiev, has cured two patients from AIDS.
‘I don’t believe that AIDS is incurable. Weak immune system is an issue that has been around for at least 200 years. It can be solved. Viruses found in the blood of those with AIDS is not the cause of the disease, it’s a consequence of immunodeficiency.   The world thinks AIDS is incurable because two doctors, an American Robert Gallo and a Frenchman Luke Montanye [sic], managed to convince the world in the early 1980s that AIDS is caused by “human immune deficiency virus” (HIV). Montanye even received a Nobel Prize for his “discovery.” Yet, they cannot find this virus in the human body. AIDS patients are diagnosed through the tests that register antibodies in blood, not HIV. These antibodies are developed in blood serum when any virus or bacteria enters the body. The same happens in case of flu, or any other illness or a shot, etc. When antibodies are found in the blood serum, it does not mean that there is a virus in the blood. Positive HIV tests shock patients because proponents of infectious AIDS convinced everyone that an HIV-positive patient will sooner or later die, and that this disease is incurable. . . . [T]here are over six thousand outstanding doctors and scientists in the world who voice their arguments against the opinion that AIDS is incurable. . . . Statistics is stronger than lies. If the published numbers were true, Africa should have become barren by now. Yet, its population exceeds one billion people. The population of South African Republic that has the most cases of AIDS in the world should have declined, but it grew 1.7 times within the period from 1986 to 1999. . . . Not a single person died from AIDS itself. Drug addicts die from drugs that ruin their immune systems.’”

That HIV/AIDS is a scam is underscored by this nicely subtle illustration:

Again unlike most of the rest of the world’s news media, PRAVDA allows its readers to know that there are two sides to the issue:

“Different opinion
Vladimir Nikolaenko, M.D., thinks that doctors all over the world cannot be fooled into treating a made-up disease. ‘Blood tests are used for AIDS diagnostics. If there is no disease, then what affects the results? Also, patients who take anti-viral medications get stabilized. It would not happen if there were no disease. . . . As long as the existence of AIDS has not been denied 100%, doctors must treat their patients and provide them with modern medications to sustain their lives.’”

Nikolaenko exemplifies the situation of practicing physicians, who really have no choice but to act according to official mainstream dogma. Doctors have neither reason nor time to delve into the primary and secondary technical literature to find out whether what they are being told is reliable. There is no reason why Nikolaenko should ever have read the review of testing that states unequivocally that there is no such thing as a gold standard, and therefore no reliable “AIDS” test — Weiss & Cowan, “Laboratory detection of human retroviral infection”, Chapter 8 in Wormser, AIDS and Other Manifestations of HIV Infection, which had gone through 4 editions by 2004.

Doctors, nurses, dentists: Why no risk from HIV?

The assertion that AIDS is caused by an infectious agent brought widespread panic, as anyone with memories of the 1980s can testify. As soon as HIV tests became available, everyone entering a hospital was asked to give “informed consent” to be tested. Teenagers were advised to get their prospective partners tested before having sex. Dentists started to wear masks and to put on new gloves in demonstrative fashion with each new patient. Police had themselves tested if any body fluids from another person came into contact with them, and some people were arrested and charged with attempting to infect others through spitting on them.

Eventually it was recognized that toilet seats were not a transmission route for HIV, and that the risk of contracting HIV via saliva — kissing, oral sex — was negligible. Those facts were not broadcast as continuously and intensively as the initial panicky warnings, though, so even now there are people who believe that “HIV” is readily acquired by almost any contact with almost anything from an “HIV-positive” individual.

Naturally, then, doctors and nurses were regarded as being at high risk from accidental contact with contaminated blood or other fluids, and there were occasional reports of apparent infection of healthcare workers, for example through accidental needle-stick. However, over the years and decades it became clear that doctors, nurses, medical orderlies, etc., are NOT at any perceivable risk of acquiring “HIV” — see sources cited at pp. 47-8 in The Origin, Persistence and Failings of HIV/AIDS Theory. What remains are “urban legends” that will not die, like “the Florida dentist” who supposedly infected 5 of his patients, notably Kimberley Bergalis who subsequently died. In point of fact, that particular story has been thoroughly debunked by, for example, Root-Bernstein (pp. 46-7, 314-5 in Rethinking AIDS, 1993) and Stephen Barr (“Perspective: The 1990 Florida dental investigation: is the case really closed?”, Annals of Internal Medicine 124 [1996] 250-4). Bergalis died in a few short years of treatment with high-dosage AZT.

I was just alerted to an article I had not known about before, recalling in 2004 that dentists, too, have been found to be at no occupational risk of catching “HIV” or “AIDS” — E. J. Neiburger (Director, Center for Dental AIDS Research), “Dentists do not get occupational AIDS: An open letter to the profession — an evidence-based study on the AIDS epidemic in dentistry”, Journal of the American Association of Forensic Dentists, 26, #1-3, 2004:
“There are [not] (and never have been) any documented cases of dental workers getting occupational HIV/AIDS. (1, 2).”
(1) CDC. Health care workers with documented and possible occupationally acquired AIDS/HIV infection, by occupation, reported through June 2000, United States. HIV/AIDS Surveillance Report 2001;12(1):24.
(2) Department of Labor-OSHA. Occupational exposure to bloodborne pathogens: final rule. Federal Register 1991;57 (235):64005-64157.

Incidentally Neiburger cites examples of how the Centers for Disease Control and Prevention (CDC) exaggerates HIV/AIDS numbers, and he discusses CDC’s badly flawed actions concerning “the Florida dentist”. He points out that CDC likes to focus on the 25-44 age group because that’s where HIV/AIDS numbers and percentages are highest — remember that EVERYTHING about “HIV” and “AIDS” is at a maximum in that age range: age of first “HIV infection”, of first “HIV” test, of first “AIDS” diagnosis, and of deaths from “AIDS” or “HIV disease”. There’s no sign of the alleged latent period of a decade between “infection” and illness; and unlike any other disease, let alone an infectious one, let alone a sexually transmitted one, HIV/AIDS affects maximally adults in the prime years of life — “Incongruous age distributions of HIV infections and deaths from HIV disease: Where is the latent period between HIV infection and AIDS?”, Journal of American Physicians and Surgeons, 13 [2008] 77-81; “No HIV ‘latent period’: dotting i’s and crossing t’s”, 21 September 2008; “HAART saves lives — but doesn’t prolong them!?”, 17 September 2008; “How ‘AIDS deaths’ and ‘HIV infections’ vary with age — and WHY”, 15 September 2008.  Older people are less able to withstand any sort of stress, so death rates increase with age — except with “HIV/AIDS” (Table 1, “Age shall not wither them — because HIV really doesn’t kill”, 4 February 2009). Sexually transmitted infections are most common in teenagers and young adults.
The Neiburger article also cites interesting studies of how commonly people lie when asked about high-risk behavior. It mentions false-positive “HIV” tests but cites only a tiny portion of the supporting material. There are a few careless errors, like 1944 for a 1994 reference or Secretary Shalala instead of Secretary Heckler. But the meat of the piece, fully source-documented, is a deconstruction of the 7 cases mentioned by CDC as “’possible’ occupational HIV/AIDS transmission”. Overall, it’s evident that the designation “possible” should really have been “could not be ruled out”, because there were no positive data supporting transmission, just the observation that the dentists were “HIV-positive” in absence of definitively known personal risk factors.
In sum: There is not a single demonstrated case of a dental worker infected occupationally with “HIV”.

That does not prevent “researchers” from asserting, though, that “HIV transmission in the dental care setting continues to be of concern”. In an article published 2 years after Neiburger’s, Scully & Greenspan (Journal of Dental Research, 85 [2006] 794) make that assertion and cite Neiburger only for his mention of two “possible” cases, without telling readers of his deconstruction of those two cases. Further, Scully & Greenspan discuss “the Florida dentist” without even mentioning Barr or Root-Bernstein and their deconstructions, and Scully & Greenspan refer to “genetic similarity” as supporting evidence of transmission even though Barr had discovered, based on publications in Nature, “potentially serious flaws in the phylogenetic analyses used by the CDC to conclude that the dentist and his patients had the same strain of HIV”.
Here we have yet another example of a “peer-reviewed” publication that fails to mention centrally important prior publications. It is not overly cynical, I suggest, not in any way unfaithful to the facts, to recognize that any manuscript about HIV/AIDS whose conclusions fit the mainstream view of an ever-present danger will receive merely cursory “peer review” and approval, while manuscripts questioning the mainstream view are rejected irrespective of their substantive claims. Thus Duesberg has tried to point out that the Statistician General of South Africa has discussed in detail why the official count of about ~15,000 AIDS deaths per year is likely to be accurate within some tens of percent and why the estimates made by the Medical Research Council and UNAIDS of >300,000 is unacceptable; yet JAIDS, which published a political diatribe accusing President Mbeki , and by implication Duesberg, of guilt for some of those “300,000” deaths, refused to publish Duesberg’s correction, and in rejecting it did not even mention the official count of ~15,000 or the Statistician General’s published support for it, let alone argue why they should be ignored.

Bad as all that is, it’s still a subsidiary point compared to the mountain of evidence that “HIV” is not a transmissible infectious agent, illustrated for example by the fact that healthcare workers are at no occupational risk of acquiring “HIV”.
(Of course, the condition of “HIV-positive” may occasionally be contagious, in those circumstances where “HIV-positive” stems from a false-positive “HIV” test occasioned by such infectious agents as Epstein-Barr virus, flu, hepatitis, herpes, syphilis, or others that have been reported to cross-react on “HIV” tests.)

Must read

There is a great deal worth reading about HIV and AIDS and dissent from the mainstream view, and impossible to keep up with it all. So I’m very grateful when I’m alerted to particularly important items. Here’s one:

“Exclusive: A Gut Instinct about AIDS” by Russell Schoch, at reducetheburden.org

When Tony Lance first told me of his idea that intestinal dysbiosis could explain much about HIV/AIDS, I was immediately interested because it was the first explanation I had come across as to why gay men are so prone to test “HIV+”, even when they are not exemplars of the fast-lane drug-abusing lifestyle and even when they turn out to remain quite healthy while “HIV+”, i.e. are “long-term non-progressors” or “elite controllers”.

Since then Tony has turned up a staggering volume of mainstream publications that make his idea, in my view, progress from “plausible” to “compelling”. Russell Schoch’s article provides convincing context to Lance’s work. It is absolutely a MUST read.

Double-talk about multiple concurrent sexual relationships

It has become a shibboleth that the HIV/AIDS epidemic resulted from large networks, or overlapping sets of networks, of people engaged in multiple concurrent sexual partnerships. The basic reasons are that (1) the rate of observed apparent transmission of “HIV” is only a fraction of a percent per act of unprotected intercourse, hundreds of times lower than for common sexually transmitted infections like gonorrhea or syphilis or chlamydia or herpes (p. 46 in The Origin, Persistence and Failings of HIV/AIDS Theory), and (2) an epidemic means spreading to ever-increasing numbers of individuals, the inescapable criterion being that every person who gets infected must infect on average more than one other person within a rather short time.

James Chin, former epidemiologist for the World Health Organization and earlier for the State of California, has published calculations showing that the extent and rapid spread of the sub-Saharan epidemic can be explained only by postulating that 20-40% of the adult population there have been and are engaged in multiple concurrent sexual relationships with changes of partners weekly or monthly to the tune of as many as 100 in a given year (Table 5-1, pp. 64-5, The AIDS Pandemic).

The latest issue of AIDS and Behavior has 9 articles about this central issue of concurrent sexual relationships as a factor in spreading “HIV”, and a healthy diversity of views is represented. From the most outspoken skeptics:

“We would like to thank the authors for their comments on our article that questioned the amount and quality of the evidence to support the hypothesis that concurrent partnerships are a key driver of the HIV epidemics in Africa [8]. All three letters agree with us that we “raise some valid concerns” that the “evidence for this link is still somewhat limited” [10] and that further research is needed [3, 11]. We note further that the three letters were from the most vocal concurrency advocates, and do not necessarily represent mainstream opinion about the current state of knowledge on this important topic [7]. . . . In the end, the burden is on the advocates of concurrency to use empirical data to prove that concurrency is a driving force of the African HIV epidemics; thus far they have been unable to do so. Association and causation are very different levels of evidence, and our colleagues provide no convincing empirical evidence of causation” — Mark N. Lurie and Samantha Rosenthal “The concurrency hypothesis in Sub-Saharan Africa: Convincing empirical evidence is still lacking. Response to Mah and Halperin, Epstein, and Morris”, AIDS and Behavior, 14 #1 (2010) 34-7.

Another article reports that in Zambia “Thirteen percent of rural and 8% of urban men reported more than one ongoing relationship in 1998, and these proportions declined to 8% and 6%, respectively in 2003. The proportion of women reporting concurrent relationships was 0-2%” — Ingvild F. Sandøy, Kumbutso Dzekedzeke1, and Knut Fylkesnes “Prevalence and correlates of concurrent sexual partnerships in Zambia”, ibid.,  pp 59-71.

“HIV” prevalence in Zambia, at 16.5% a few years ago, is about midway between the lowest in sub-Saharan Africa (SSA) and the highest, the range being ~5% to >35% — “Deconstructing HIV/AIDS in ‘Sub-Saharan Africa’ and ‘The Caribbean’”, 21 April 2008.  That 16.5%  rate requires the sort of “fast-lane” multiple concurrency postulated by Chin, 20-40% of the adult population with up to 100 partners in any given year; yet the actual rate of multiple concurrency is far below that; <13% of men and <2% of women reported any concurrent relationship, let alone dozens or scores.

Altogether, the articles that postulate high rates of “concurrency” offer evidence only that people have had more than one sexual partner during a given period (which could mean serially, not necessarily concurrently) or at a given time; but even if half of a population had two partners simultaneously all the time, that would not begin to satisfy the criteria established by Chin’s calculations, which call for weekly or monthly exchange of partners to the tune of dozens or scores per year.

Again, the assertion that Africans do it differently than others is supported only by such weak claims as that, for example, “55% of men and 39% of women in Lesotho . . . reported having more than one regular partner in the previous year, as compared to 3 and 2% of men and 0.2 and 1% of women in Thailand and Sri Lanka, respectively” (Timothy L. Mah and Daniel T. Halperin, “The evidence for the role of concurrent partnerships in Africa’s HIV epidemics: A response to Lurie and Rosenthal”, pp. 25-8) — more than one in year, not excluding serially, is negligible in terms of Chin’s criteria; scores per year would be needed, not “more than one”.

On the other hand, a thoroughgoing survey of 59 countries had found “that the number of lifetime partners is lower in Africa than in industrialized countries, and that the prevalence of multiple partnerships is generally higher in industrialized countries. In addition, more men and women in Africa are sexually abstinent, with two-thirds of the population reporting recent sexual activity compared to three-quarters of the population in industrialized countries. . . . on average, African adults are less sexually active and have fewer lifetime partners than their counterparts in industrialized countries” —  Mark N. Lurie and Samantha Rosenthal, “Concurrent partnerships as a driver of the HIV epidemic in Sub-Saharan Africa? The evidence is limited”, pp. 17-24, citing Wellings et al., “Sexual behavior in context: A global perspective”, Lancet 368 [2006] 1706-28; 369 [2007] 557. Several more references to that same effect are
Brewer et al., “Mounting anomalies in the epidemiology of HIV in Africa: cry the beloved paradigm”, International Journal of STD & AIDS 14 [2003] 144-7;
Gisselquist et al., “HIV infections in sub–Saharan Africa not explained by sexual or vertical transmission”, International Journal of STD & AIDS 13 [2002] 657-66;
McCulloch, “The management of venereal disease in a settler society: colonial Zimbabwe, 1900-30”, Chapter 9, 195-216 in Histories of Sexually Transmitted Diseases and HIV/AIDS in Sub–Saharan Africa, ed. Setel et al., Greenwood 1999.

The mere fact that there is such a healthy to-and-fro between these articles demonstrates that, after more than two decades of intensive study, it remains controversial whether multiple concurrent sexual relationships can account for the purported level of HIV/AIDS in Africa — or elsewhere, because the shibboleth has been used also to rationalize the higher rate of “HIV-positive” among African Americans.

It is interesting to note that none of the 9 articles arguing over concurrency and published in 2010 so much as mention Chin’s book, which had been published 3 years earlier and which quantifies the level of concurrency and multiplicity required to account for an epidemic of African proportions. That omission makes it possible to overlook that all the asserted evidence for concurrency falls very far short of what would be necessary to explain the prevalence of “HIV” in Africa and among African Americans.

Not having to deal with numbers makes it easier also to offer hand-waving “explanations” whose plausibility rests on subterranean racist stereotypes about African sexual behavior — “Racist stereotypes are inherent in HIV/AIDS theory”, 2010/02/08.

AIDS and Behavior, like other mainstream journals, is of course peer-reviewed. How well peer review can work is illustrated by this total ignoring of perhaps the most central publication on this topic, written by an experienced epidemiologist who has held high office in HIV/AIDS-related organizations.