HIV/AIDS Skepticism

Pointing to evidence that HIV is not the necessary and sufficient cause of AIDS

Posts Tagged ‘HIV/AIDS experts’

GURUS IN WHITE COATS

Posted by Henry Bauer on 2007/12/03

I referred less than respectfully to “experts” both unnamed and named, in my “LIES” post of 2 December. Contributing in an important way to the HIV/AIDS mess is the uncritical adulation extended by media and (therefore) public to “experts” bearing the brand of medicine or science, who are wont to advertise their status by wearing white coats for photo-ops. I believe that a significant reason why HIV=AIDS continues to be accepted, despite all the evidence against it, is that media and public cannot conceive that authoritatively and officially promulgated views could be so wrong. So it’s good to be aware of rampant misconceptions that foster this state of affairs.

You should of course ask, what makes Bauer think he’s qualified to discuss misconceptions about science ?

In high school, I became captivated by science in general and chemistry in particular, and later taught chemistry and did research in electrochemistry for a couple of decades. I started to wonder about gaps in what science concerns itself with, and the role that heterodox claims play, and how to distinguish between real science and pseudo-science. So I switched from chemistry to the then-fledgling field of “science studies”, which incorporates approaches from history of science, philosophy of science, sociology of science, and other fields as well. What I learned is described at some length in several books (1, 2), which have detailed discussion and supporting citations for the assertions I’m going to make here and that are particularly pertinent to what goes on with HIV/AIDS. The most authoritative and comprehensive descriptions of all facets of scientific activity are by John Ziman (3).

I haven’t lost my fascination with science or my respect for science; it’s as noble and worthwhile an activity as human beings can aspire to (though not necessarily more so than some others). But I’ve learned that science can be only somewhat better than its practitioners and institutions, and that if those practitioners and institutions become sufficiently incompetent or corrupt, then the whole enterprise can let us down as much as can a corrupt commercial enterprise (an Enron, say) or a corrupt government (a Stalin, say). Science and medicine are not exempt, either, from being taken over by fads, fashions, and bandwagons that the experts approve right up until the moment that the bubble bursts, as with the financial bubbles that burst periodically. (On the latter, essential reading is J. K. Galbraith’s [1990/93] A Short History of Financial Euphoria.)

* * * * * *

Science is not infallible. It progresses by trial and error. Theories are never true in any absolute sense, they are just convenient temporary summaries of what has so far been learned. They are helpful as guides to further research, and that further work then brings modifications or total abandonment of the pre-existing theory that stimulated the work.

Scientists range widely in competence. Individual scientists are much more fallible than science as a whole, because facts don’t become part of “science” until there is reasonably wide agreement about them. Agreements are reached better and more reliably, the more honest and competent are the scientists who are involved. Conflicts of interest can be very damaging. Deliberate cheating is far from unknown, especially in recent times where the competition for grants and positions has become intensely cutthroat: presently the National Institutes of Health, the largest source of grants for research in biology and medicine, funds only about 1 in 5 grant applications (4)–and for young researchers, getting grants is usually necessary for job security and advancement.

There is no impersonal “scientific method” that automatically makes reliable whatever a researcher does. The “scientific method” consists of the interaction among scientists.

Medicine is not science. It’s related to science rather like engineering is related to science. It’s concerned with what works, not why it does.
Corollary: Medical doctors are trained to apply existing agreed-on knowledge, they are not taught to question it. Scientists are trained to question existing knowledge in order to contribute to correcting it and expanding it.
Caveat: Some MDs do become first-rate researchers.
Nevertheless, it is worth noting that a high proportion of HIV/AIDS researchers are MDs–for example, the statistically illiterate ones mentioned in the “LIES” post. Among those who question whether HIV = AIDS there is a high proportion of research-trained PhDs.

Institutions of medicine and science are not doctors or scientists. They are bureaucracies, whose primary aim is aggrandizement: increasing their own importance, their size, their status, their prestige. The media should be as searching of reports and press releases from institutions of science and medicine as they are of reports and press releases from commercial enterprises, government agencies, and political entities.

Administrators are not doctors and they are not scientists, even if they once were. Their primary role is to administer, to safeguard their territories, and that takes priority over caring for patients or furthering science. The media should be as searching of statements from administrators of science and medicine as they are of administrators or spokespeople for commercial enterprises or government agencies.

Scientists vary widely in competence. The greatest successes in science tend to come from single-minded obsessive work, so the most accomplished scientists are not necessarily the most intelligent, practical, judicious, or sensible. The winner of a Nobel Prize might make a good administrator–but probably not; or a good advisor on public policy–but often not.

Serendipity, luck, being in the right place at the right time with the right tools is a significant factor in success in science (5), just as in many other fields of human activity. The most brilliant success in science does not bespeak some overall inherent brilliance or even competence: Nobel Prize winners rarely win a second such Prize. An analogy might be the mutual-fund managers who top the rankings in a given year; they rarely repeat, because the insight that brought success was right just for a particular time and set of circumstances.

My distinguished friend Jack (I. J.) Good is fond of pointing out that geniuses are cranks who happen to be right, and cranks are geniuses who happen to be wrong: they are stubborn, obsessive, impervious to criticism. If their obsession is with something that turns out right, they are likely to be ranked as genius; if their obsession is with a phantom, they are likely to be remembered as cranks; see chapters 9 and 10 in (2) for illustrative examples.

There is no reliable guide to deciding beforehand or at the time, whether one’s interest is in a genuine phenomenon or an illusory one (6-8). So herds of researchers can be chasing what later turns out to have been a phantom: cancer-causing viruses, say, or vaccines against HIV. Some maverick claims are later vindicated, others not (6); some accepted “scientific truths” remain useful for a long time with relatively little modification, others suffer sudden, often unforeseen eclipse in a “scientific revolution” (9).

That science and medicine are replete with jargon and technicalities does not mean that they cannot be assessed by outsiders. Just as with politics, finance, or any other specialized activity, outsiders can judge whether statements are self-consistent, whether they offend common sense, whether questions are evaded rather than answered, whether promises or predictions come to pass. Media and public should treat doctors and scientists as human beings who happen to have some particular knowledge and abilities but who remain fallible even in their area of expertise. Media and public should be as skeptical of administrators and institutions of medicine and science as they are of company executives and commercial enterprises. If that had been the case with HIV/AIDS, then the bandwagon would not have been able to evade such issues as:
— What are the specific scientific publications proving that a positive HIV-test means that infectious virus is present?
— What are the specific scientific publications proving that HIV causes AIDS?
— What are the specific scientific publications proving that the proteins and genes taken to be the characteristic constituents of HIV are actually present in whole infectious particles of retrovirus?
— What was the basis for expanding the set of “AIDS-defining” diseases beyond the opportunistic infections and Kaposi’s sarcoma that caused AIDS to be identified and defined in the first place?
— How could something (HIV) spread in epidemic fashion when it is apparently transmitted sexually at an average rate of only 1 per 1000 acts?
And that, of course, hardly exhausts the possible list.

(1) Bauer (1992) Scientific Literacy and the Myth of the Scientific Method
(2) Bauer (2001) Fatal Attractions: The Troubles with Science
(3) John Ziman, especially Real Science (2000) and Prometheus Bound (1994)
(4) Daniel Greenberg, “So many labs, so little money”, Chronicle of Higher Education, 8 September 2006, B20.
(5) Paula E. Stephan & Sharon G. Levin (1992) Striking the Mother Lode in Science: The Importance of Age, Place, and Time
(6) Bauer (2001) Science or Pseudoscience: Magnetic Healing, Psychic Phenomena, and Other Heterodoxies
(7) Bauer (1984) Beyond Velikovsky
(8) Bauer (1986) The Enigma of Loch Ness: Making Sense of a Mystery
(9) Thomas S. Kuhn (1962/70) The Structure of Scientific Revolutions,

Posted in experts, HIV skepticism, uncritical media | Tagged: , , , , | 2 Comments »

MATHEMATICAL AND STATISTICAL LIES ABOUT HIV/AIDS

Posted by Henry Bauer on 2007/12/02

I had some trouble settling on a title for this story. I tried “Incompetent…”, “Statistically illiterate…”, “Innumerate…”. But really, when numbers are put out that are misleading, that make or imply unwarranted claims, numbers that are plainly misleading, “lies” seems apt enough. The choice might also be justified by reference to the well known saying about “Lies, damned lies, and statistics”.

* * * * * *

As Oigen commented (11/29, to “HIV/AIDS: NUMBERS THAT DON’T ADD UP”), HIV/AIDS estimates for China are dropping even faster than elsewhere, from “nearly 1 million” to 840,000 in 2004 to 650,000 in 2005 and now 223,501, according to a Nov. 29 AP report from Beijing, “China reports sharp drop in HIV/AIDS”. “Experts have said the figures are probably accurate because they are in line with a change in the way data are collected.”

No sooner said, though, than experts at the same official sources said something different: same date of 29 November from Beijing, “China increases estimate of people with HIV”:
“The number of people estimated to be living with HIV in China has risen to 700,000, says a report released Thursday by the United Nations and the Chinese government. The government had previously estimated that 650,000 people were living with HIV. . . . There were 50,000 new cases in 2007, mainly among intravenous drug users and sex workers [emphasis added] . . . . ‘China’s HIV epidemic remains one of low prevalence overall, but with pockets of high infection among specific sub-populations,’ says the 38-page report, which was to be released officially on Saturday, World AIDS Day. ‘A number of core challenges remain.’ Those include the need for better advocacy and education, improved treatment and care, and more focused education and discrimination reduction . . . . The report also notes that the number of HIV cases officially reported still remained at 223,501–far lower than the estimated total in part because of people’s reluctance to seek testing in China. The officially reported figure includes those who developed AIDS and those who died from the disease. HIV gained a foothold in China largely due to unsanitary blood plasma-buying schemes and tainted transfusions in hospitals.”

Among the points deserving of comment:
1. The glaring incompetence as well as gall of that “1” in 223,501–as though they know it’s not 223,502 or 223,500.
2. That “Experts have said the figures are probably accurate” even as (presumably other) “experts” give a much larger number.
3. Asserting as known what cannot be known.

ONE:
Official reports, press releases, and media commentary are rife with these examples of incompetence in the most rudimentary practices of mathematics and statistics. An elementary point in writing numbers is that the meaningful digits–those not zero–represent a claim as to accuracy. “223,500” claims that it is known that the actual value lies between 223,450 and 223,549; in other words, that it is known to within ±50, which is a few parts per 1000, a fraction of a percent. Given that over the space of 5 years, the supposed number of HIV/AIDS cases has been changed by a factor of more than 4, such a claim of now being accurate to less than a percent would be laughable–were the claim not so much more absurd, that the actual value is 223,501 and therefore lies between 223,500.5 and 223,501.49.
Unfortunately, this cannot be written off as the result of poor reporting or of non-peer-reviewed press releases, because the same blatant error is committed in one the flagship medical journals, JAMA: “The estimated number of US cases of HIV/AIDS among MSM by year of diagnosis in the 33 states and US dependent areas with confidential named-based HIV reporting increased from 16 167 in 2001 to 18 296 in 2005” (Jaffe, Valdiserri, & De Cock, 298 [2007] 2412-4). So even though these are estimates and not actual counts, the authors offer this ridiculous array of “significant” digits. “16,200” and “18,300” might be acceptable, though “16,000” and “18,000” would reflect better the uncertainty of these estimates. This is more than a small blot, not only on the authors but on JAMA’s peer-reviewing as well; if the peer reviewers don’t pick up on this sort of point, what confidence can one have in their assessment of more complicated matters?
Remarkably, astonishingly, sadly, this sort of frank incompetence is far from uncommon in the HIV/AIDS literature. My book cites several instances of similar blunders by the Centers for Disease Control and Prevention–incorrect use of “significant figures” notation (pp. 110-1, 192), claims of correlation not borne out by the data (p. 110 ff.), and assertions that correlation proves causation (pp. 194-5), which students of statistics are warned against in their first course, if not their very first lecture.

TWO:
That unnamed experts assert as probably accurate, numbers that are clearly unreliable, underscores how uncritically the media handle matters of medicine and science. Unnamed “experts”, incessantly cited in all sorts of connection by the media, never deserve to be taken or offered as authoritative. When it comes to HIV/AIDS, examples abound of incompetent and unjustified statements even by named “experts”, even in the peer-reviewed literature, disseminated uncritically by the media; for instance, reporting (on and about 28 November) on the piece in JAMA referred to above:

“ ‘Lack of HIV prevention efforts among MSM fueling increase in new diagnoses, JAMA Commentary says’ (http://allafrica.com/stories/200711281011.html, citing Kaisernetwork.org).
A lack of HIV prevention efforts and an increase in risky sexual behaviors among men who have sex with men are fueling an increase in new HIV diagnoses among the group . . . the number of HIV/AIDS cases among U.S. MSM increased by 13% — from 16,167 to 18,296 — between 2001 and 2005”.

Those ridiculously precise numbers are reported without comment. Moreover, that a lack of prevention efforts and increases in risky behavior are among the reasons is sheer speculation and should be identified as such, not reported as fact.
This is no mere quibble. Failing to make clear that these are guesses strengthens the implication that these cited experts know what’s going on and are to be believed. This is misleading in an important sense.

THREE:
Several of the cited assertions might appropriately be greeted by asking, “How do you know that?”
— While reported cases are about 225,000, the “real” number is 700,000.
— Better advocacy, education, and “discrimination reduction” would change matters.
— HIV gained a foothold in China via contaminated blood.

Just posing the question, “How could you know?”, can reveal how shaky the assertions are:
— The validity of the method used to estimate the “real” numbers could only be checked against actual counts–and if actual counting were feasible, estimates wouldn’t be needed in the first place.
— The belief that HIV is sexually transmitted is the sole reason for believing that behavioral interventions can make a difference. The JAMA article cites studies suggesting that they can, yet has to admit that “How well behavioral interventions work over time or when translated from research into practice is not known”.
— Those recipients of contaminated blood in China must have engaged in very vigorous sharing of infected needles to amplify their foothold into some 700,000 infectees. Or, if instead one blames them for exceptionally vigorous sexual promiscuity, it raises the conundrum that it is sex workers and drug users who are the main groups of HIV-positives in China: Do the sex workers “work” primarily with drug abusers? And do they thereupon transmit HIV among themselves without benefit of clients? Sex workers earn more, the more clients they have; where are all the infected clients?
This is all quite typical of HIV/AIDS discourse. Unqualified assertions are put out even though they are based on presumptions and not on observations or facts, and even when they are frankly implausible.

* * * * * *

STOP PRESS
One really cannot keep up with the changes in official statements. “China increases estimate of people with HIV”, above, revealed that the “50,000 new cases in 2007 [were] mainly among intravenous drug users and sex workers [my emphasis]”. But “Sex now the main cause of HIV in China” (from Henry Sanderson, AP, Beijing, November 30): “Sex has overtaken drug use as the main cause of HIV infections in China . . . according to experts and a report released this week”.

* * * * * *

As to “experts”, the authors of the cited JAMA article are anything but neophytes. Jaffe is described as department of public health director at Oxford University, De Cock as head of HIV-AIDS at the World Health Organization, and Dr. Ronald Valdiserri as chief consultant to the public health strategic health care group of the U.S. Department of Veterans Affairs. Jaffe and De Cock have been in the HIV/AIDS field from its beginning, and both contributed significantly to the wrong track that the field took. Jaffe was lead author on a 1983 study* that revealed a high rate of previous illnesses and drug abuse among AIDS patients, clear support for a lifestyle explanation for AIDS; yet later he went along with the HIV story. De Cock’s early studies in Africa are described in much less than complimentary detail in “AIDS, Africa and Racism” (Chirimuuta & Chirimuuta, 1989).
* Jaffe et al., “National case-control study…”, Annals of Internal Medicine, 99 [1983] 145-51]

Posted in HIV absurdities, HIV transmission, HIV/AIDS numbers, sexual transmission, uncritical media | Tagged: , , , , , , | 4 Comments »