Saving the HIV/AIDS hypothesis
Posted by Henry Bauer on 2011/05/02
Philosophy in general and philosophy of science in particular spent much effort on issues like, “Can a theory ever be proved beyond doubt?”; “Can empirical data ever prove a theory?”. On the whole, it was eventually agreed that no amount of empirical data could ever prove any theory beyond a shadow of doubt — a common illustration being that no matter how many swans have been seen to be white, in accord with the theory that “All swans are white”, tomorrow one might nevertheless somewhere encounter a non-white swan. That’s a very nice illustration because it’s what actually happened when Europeans discovered in the 17th century that the swans in Western Australia are black.
Conversely, the common belief that theories can be shown to be false by a single inconvenient fact may be true in principle or for abstract intellects, but science in practice is not like that at all. Imre Lakatos is usually credited with the observation that when a theory seems in danger of being disproved, the mainstream invents ad hoc hypotheses subsidiary to the theory to alter the theory’s “predictions” in relatively minor ways that accommodate the inconvenient fact, thereby “saving the hypothesis” (“History of Science and its Rational Reconstruction”, pp. 1-40 in Method and Appraisal in the Physical Sciences, ed. Colin Howson, Cambridge University Press, 1976.). For example in the case of the West-Australian swans, a recalcitrant hypothesis-saving-at-all-costs mainstream could argue that they aren’t really swans, and lengthy arguments could ensue over intricate technicalities, say about how much DNA must creatures share to be considered the same species? Perhaps this is just another example of convergent evolution?
HIV/AIDS theory and practice afford innumerable examples of such Lakatosian evasions, for instance:
→ In the early 1980s, the hypothesis was that HIV causes AIDS, whose iconic manifestation then was Kaposi’s sarcoma.
Uh-oh! Lots of Kaposi’s sarcoma patients turned out to be HIV-negative.
Save the hypothesis: human herpes virus 8 (HHV-8) (or KSHV), the actual cause of Kaposi’s sarcoma, must have entered the USA simultaneously and in company with HIV; and of course the presence of HIV facilitates infection by KSHV; but soon HIV and KSHV went their own separate ways and KS became rarer and rarer as KSHV died out whereas HIV prospered and spread.
→ In the early 1980s, HIV was hypothesized to be the cause of the apparently acquired immunedeficiency found in the gay men who were “suddenly” coming down with Pneumocystis carinii pneumonia and candidiasis as well as Kaposi’s sarcoma.
Uh-oh! Many gay men with “PCP-candidiasis-AIDS” were also HIV-negative.
Save the hypothesis: Those fellows didn’t have AIDS, they had a previously unknown disease, idiopathic CD4-T-cell lymphopenia (ICL), defined as immunedeficiency of unknown origin affecting the CD4 cells.
That, of course, had been the original definition of AIDS. But the hypothesis is saved by re-defining AIDS as acquired immunedeficiency in the presence of HIV. Ever since then, HIV has caused AIDS by definition.
→ HAART defeats HIV infection and thereby extends life-spans and indeed saves lives.
Uh-oh! Many people on HAART become even more ill soon after starting treatment, even when CD4 counts go up or even when viral load declines.
Save the hypothesis: When the immune system is reconstituted, the body rebels, a previously unknown phenomenon. That patients get worse is owing not to the drugs but to “immune restoration syndrome” (appropriately acronym-ed IRS).
Another of the hypothesis-breaking facts is that all attempts to observe sexual transmission of HIV have failed, and inferential calculations based on assumptions about who infected who and when yield rates of transmission no greater than a few per 1000 acts of unprotected intercourse. That’s far too low to account for the claimed African epidemics. James Chin (The AIDS pandemic: The collision of epidemiology with political correctness, Radcliffe Publishing 2007) tried to rescue the hypothesis by postulating that 20-40% of sub-Saharan African adults have on average about 10 sex partners at any given time and change those partners about annually. That didn’t stand up to actual investigation which found that this sort of “multiple concurrency” of sex isn’t happening (Sawers & Stillwaggon, “Concurrent sexual partnerships do not explain HIV epidemics in sub-Saharan Africa — An exhaustive review of the evidence”, XVIII International AIDS Conference, Vienna 2010; THPDC104.).
Well, then: It must be that HIV-infected needles are ubiquitous all over sub-Saharan Africa and are spreading HIV like the proverbial wildfire (Gisselquist et al., “HIV infections in sub-Saharan Africa not explained by sexual or vertical transmission”, International Journal of STD & AIDS, 13  657-66). And in Eastern Europe, where only drug addicts seem to get HIV or AIDS, of course again it’s sharing infected needles by those addicts that has produced the epidemics there — which aren’t really epidemics, just occasional isolated outbreaks whenever an HIV-infected needle suddenly appears out of nowhere.
All this utter nonsense is faithfully parroted by the media, for instance:
“Injection drug use helps drive HIV/AIDS in Africa” (29 April 2011, Joe DeCapua).
“Injection drug use has long been a driving factor in the HIV/AIDS epidemic in Eastern Europe and Central Asia. But now, there are signs it’s a growing problem in sub-Saharan Africa, as well. . . . ‘Globally, we know that it is quite a serious problem. . . . one in every three new infections is attributable to injecting drug use. . . . in Eastern Europe, Central Asia, the former Soviet Union, it continues to be the major driver of the epidemic there.
. . . the whole question of injecting drug use and HIV prevention has been one that’s really been under resourced and not really paid adequate attention to, either from a policy or a programmatic point of view’ . . . .
‘the sharing of syringes by drug addicts is a very easy way to transmit HIV. Far easier than sexual transmission’. . . .
as is the case in many sectors of the HIV/AIDS epidemic, women have it worse than men. . . . ‘Women who are drug users have a much higher HIV risk than men who are drug users. So that one reason for that is that many women, who inject drugs, turn to sex as a way of raising money to buy drugs. So there’s an overlap between sex work and drug use’”.
It is of course quite true that drug addicts are prone to get “AIDS”. Gordon Stewart observed that already in the 1960s drug addicts were coming down with the ailments later called “AIDS” (Neville Hodgkinson, AIDS: The Failure of Contemporary Science, Fourth Estate, 1996, p. 103ff.). It is also true that AIDS in Africa is — or was long ago — associated with drug abuse; as Chirimuuta and Chirimuuta (AIDS, Africa and racism, Free Association Books, 1989) pointed out, in the 1980s “AIDS” in Africa was a disease of the wealthier classes who could afford “recreational” drugs. But it’s not needle-transferred “HIV” that causes “AIDS” in drug addicts, it’s the contents of those needles. One of the extraordinary “side” effects of the HIV/AIDS business has been to suppress the fact that drug abuse causes ill health, wasting away, malnutrition, ultimately death.