Ignorance about HIV and AIDS
Posted by Henry Bauer on 2011/03/21
“[C]ontinuing, unaddressed public ignorance
about the routes and actual risks of HIV transmission
informs policy making at every level and
burdens the lives of people living with HIV”.
That, you might think, was said by a Rethinker, but it wasn’t. It comes from Rene Bennett-Carlson, managing attorney at the Center for HIV Law and Policy (CHLP) in New York City: “This young man may lose 15 years of his life to a prison cell for being HIV positive. If he hadn’t gotten an HIV test he wouldn’t be facing these penalties.”
Bennett-Carlson’s appropriate comments were stimulated by the case of a Missouri man charged with “recklessly and knowingly exposing some one to HIV” — because he is alleged to have bitten a police officer (“Advocates alarmed by spike in Missouri HIV prosecutions — Contrary to medical evidence, Missouri law makes biting a felony”).
The Michigan advocates properly cast aspersions at Missouri laws that are based on ignorance about HIV. But they are blind to the mote in their own eyes: “Michigan’s law . . . criminalizes only sexual behavior without disclosure of an HIV-positive status” — which is also based on ignorance of the fact that “HIV-positive” has never been shown to be transmissible by sexual behavior any more than by biting.
Possibly the most serious ignorance among adherents to HIV/AIDS theory is about the high prevalence of false-positive HIV test-results — many physiological conditions can deliver “HIV-positive” results: pregnancy and other conditions that are not unhealthy, and also tuberculosis and many other conditions that bespeak ill health. In other words, “HIV-positive” may indicate ill health for some reason or it may not, and the “not” probably corresponds to something like half of all reported “positives” (Medical students in Africa need not fear HIV; REPRINT of Galletti & Bauer).
[I am using “false-positive” here in this sense, that the “positive” does not reflect any sort of health threat. As I’m often reminded, all “HIV-positive” results are false in the sense that they do not demonstrate the presence of an AIDS-causing agent or the presence of an active retroviral infection.]
The virtually universal ignorance about the high frequency of false-positives on “HIV” tests undermines the credibility of a great deal of the technical literature. Since about half of all “HIV-positive” results are likely to be false-positive in every sense of that term, the statistical evaluation of possible correlations will be invalid in many instances; variables described as “HIV-associated” may actually be false-positive- associated; and correlations not statistically significant may turn out to be statistically significant.
Take the higher incidence of bone-density-loss and bone fracture among “HIV-positive” people. An awareness of the false-positive frequency would require a closer investigation of all the factors that could lead to bone loss and bone fracture and that might at the same time conduce to a false-positive “HIV”-test. Consider the most recent publication on “HIV-associated” bone fracture — Young et al., “Increased rates of bone fracture among HIV-infected persons in the HIV Outpatient Study (HOPS) compared with the US general population, 2000-2006”, Clinical Infectious Diseases, 10 March 2011 [Epub ahead of print] PMID: 21398272 (annoyingly cited incorrectly as “2010;52:1061-1068” on Endocrine Today).
The main point about the need to consider false positives is this:
If all the bone fractures occurred among the “HIV-positive” individuals whose positive test reflected some sort of health threat, then the rate of fracture among those health-threatened ones would be twice that reported here, and associations doubtfully significant might well be statistically significant.
Thus, according to the text of the article, there was no observed association between risk of fracture and “ART exposure”, which presumably corresponds to “ARV exposure” in the table above (extracted from the article’s Table 4) — no significant association with exposure among the 3856-4087 exposed or not known to be exposed. Yet there is an almost statistically significant association among the 3749 exposed to HAART.
Almost all the ARV-exposed were also HAART-exposed — 3749 out of between 3856 and 4087 — so it cannot be true that the association with ARV is so drastically different from the association with HAART.
This illustrates that the data, statistics, and inferences in this article are much less than confidence-inspiring for reasons beyond the neglect of false-positives. However, the data do clearly suggest that bone fracture is HAART-associated: there is a statistically significant association with diabetes, which is a known risk of HAART, and an almost statistically significant association with peripheral neuropathy, also a known risk of HAART. In any case, risk of osteoporosis and bone fracture were also found to be HAART-associated in earlier studies (HIV: It can do anything, everything . . . or nothing?); and HAART components are known to cause osteonecrosis (bone death), see NIH Treatment Guidelines, 29 January 2008, pp. 23, 30, 67, 69, 80, 84, 101, 102.
The median age of the people studied by Young et al. was 40, far too young for any appreciable incidence of diabetes or peripheral neuropathy in absence of HAART. Note too that anti-depressants and proton-pump inhibitors and drugs used to treat diabetes II also show hints of contributing to the risk of bone fracture. Being diagnosed as “HIV-positive” is, of course, a strong reason why a person might be being subjected to treatment with anti-depressants.
Note further that there is a positive association of fractures with lower CD4 counts, but no association with viral load: yet HIV/AIDS theory demands that CD4 counts and viral load be strongly correlated. (That they are not was already shown by Rodriguez et al. — JAMA, 296  1498-1506 —, something conveniently forgotten or ignored or invalidly explained away by true believers.)
The ignorant belief that a positive HIV-test demonstrates infection, “having HIV”, continues to bring criminal charges against people who have sex, e.g. “Help available for victims of HIV-positive Vermilion [Ohio] man”.
The same ignorant belief underlies scare stories like “HIV infection passed via donated kidney: U.S. Report — Donor screening didn’t use most sensitive test, leading to infection of recipient, researchers say”: once again, “researchers” are cited about supposedly sensitive tests, which cannot be known in absence of a gold-standard test; and higher sensitivity is in any case produces a higher rate of false-positives on any test, in this case entirely non-health-threatening “positives”.
It’s often said that ignorance of the law is no excuse; but
Is there an excuse for laws that are ignorant of science?
Is there an excuse for researchers
who are ignorant of central facts pertinent to their research?
Is there an excuse for medical practitioners
who are ignorant of central facts
pertinent to their practices?
Is there an excuse for clinical laboratories
that issue reports of “HIV-positive” without pointing out
that this does not constitute a diagnosis of infection?
This entry was posted on 2011/03/21 at 12:52 pm and is filed under antiretroviral drugs, experts, HIV tests, HIV transmission, Legal aspects, sexual transmission, uncritical media. Tagged: false-positive tests, HIV and bone fracture, HIV and the law. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.