When right wing loons try to “do” science involving vaccines or HIV/AIDS…

If there’s one thing that has irritated me (one might even say, irritated me enough to start this blog), it’s ideology or religion trumping science. Perhaps the most annoying form of this disease is the tendency of the right wing whackosphere to do everything and anything it can to distort and twist science to agree with its ideology, in particular its religion. One area that I used to write about a lot but don’t so much anymore (we bloggers have to subspecialize, I guess, and these days my subspecialty is science-based medicine with only the occasional forays against forms of unreason other than quackery), is “intelligent design” creationism. ID, of course, is nothing more than a “God of the gaps” argument that postulates whenever science can’t explain something fully that “God did it.” Slightly less wacky on the scale of unreason is the unrelenting hostility towards even the hint of an idea that global warming is happening and, if it’s happening, that human activity is contributing to it.

The area of right wing craziness that intersects most directly with my favored targets for not-so-Respectful Insolence tends to be the whole “health freedom” movement. In fact, quackery is the one area where both granola crunching nature mothers and Lyndon LaRouche acolytes can come together, albeit for different reasons. In general, right wingers tend to come to quackery through a distrust of government and government regulation of medicine, resulting in the “health freedom” movement, which is in reality nothing more than the ideology that supplement manufacturers and quacks use to justify “freeing” themselves from pesky government interference into their “right” to sell quackery to the unsuspecting. Left wingers, on the other hand, tend to come to their distrust of conventional medicine and love of woo through a distrust of industry, in particular the pharmaceutical industry.

Be that as it may, this week has been a particularly rich week for hilarious right wing abuses of science. The first is a preview. The second is just pathetic. So let’s start with the first “study,”, just as a little wafer to cleanse the palate.

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Nonsense about contraception and AIDS

Our first entry in the “Whose science is most brain dead?” is this gem of a press release from the Population Research Institute, which describes itself thusly:

The Population Research Institute is a non-profit research group whose goals are to expose the myth of overpopulation, to expose human rights abuses committed in population control programs, and to make the case that people are the world’s greatest resource.

Its mission statement proclaims its mission to be (among other things):

  • To debunk the myth of overpopulation, which cheapens human life and paves the way for abusive population control programs
  • To expose the relentless promotion of abortion, abortifacient contraception, and chemical and surgical sterilization in misleadingly labeled “population stabilization,” “family planning,” and “reproductive health” programs.
  • To defund these programs by exposing the coercion, deception, and racism inherent in them.

This time around, PRI’s trying to “prove” that the use of oral contraceptives–the dreaded “pill”–result in an increased risk of acquiring HIV or of progressing to AIDS if HIV-positive. To argue it, the PRI published a post entitled The Pill’s Deadly Affair with HIV/AIDS. It’s a masterpiece of the same sorts of arguments that creationists and anti-vaccinationists make, beginning with suitably apocalyptic language:

The world’s deadliest killer, HIV/AIDS, and the Birth Control Pill have been carrying on a secret and deadly “love affair” for decades. While women swallowed their “freedom” with the morning orange juice, studies that should have made global headlines yellowed in medical journals, unknown to the general public. Only doctors learned about the pills deadly affair with HIV/AIDS, and they were too busy writing prescriptions for hormonal contraceptives to talk.

More than 50 medical studies, to date, have investigated the association of hormonal contraceptive use and HIV/AIDS infection. The studies show that hormonal contraceptives–the oral pill and Depo-Provera–increase almost all known risk factors for HIV, from upping a woman’s risk of infection, to increasing the replication of the HIV virus, to speeding the debilitating and deadly progression of the disease.1

A medical trial published in the journal AIDS in 2009–monitoring HIV progression by the need for antiretroviral drugs (ART)–saw “the risk of becoming eligible for ART was almost 70% higher in women taking the pills and more than 50% higher in women using DMPA [Depo-Provera] than in women using IUDS.”2

The first reference is an open cohort study that examined HIV1-seronegative female sex workers attending a single clinic in Mombasa, Kenya. Basically, it found that among women who seroconverted, oral contraceptive use was associated with the acquisition of a more complex viral population, a higher HIV-1 plasma viral load, and a faster CD4 cell decline. Of course, as regular readers of this blog know, correlation does not necessarily equal causation, and this study didn’t definitively show much of anything, although its implications are admittedly concerning.

The second study was from 2009 and a bit different. You can tell this from the title: HIV disease progression by hormonal contraceptive method: secondary analysis of a randomized trial. Note the word secondary. That means what is being looked at is was not a primary endpoint of the trial. Basically, the investigators made a post hoc hypothesis and then tested it using already collected data. This is always a dicey proposition, as confounders that weren’t necessarily envisioned in the original trial design can easily creep in. In any case this study examined HIV-positive women in Zambia from a previous randomized trial of IUDs versus hormonal contraception in women infected with HIV whose objective was:

The purpose of this study was to determine whether the intrauterine contraceptive device (IUD) is effective and safe among women who are infected with the human immunodeficiency virus (HIV).

In the results, the investigators observed faster progression in women who used hormonal contraception and concluded:

Women who used hormonal contraception were more likely to experience clinical disease progression than were women who used the IUD. Although this provocative finding is by no means definitive (it was not an a priori hypothesis), if borne out in further investigation, it could have large public health implications.

However, this trial had weaknesses, including the fact that condom use was not recorded, although women’s partners were allowed to use condoms. In any case, it is not at all surprising that the followup study using secondary analyses found the same thing. In fact, it would be surprising if it did not. Moreover, although progression to the point of being eligible for anti-retroviral therapy was worse in women taking oral contraceptives, the risk of death was no higher during the study period. In essence, the study was worrisome but by no means definitive.In fact, the same could be said of both studies. In other words, there is reason to do more research, but there is no “smoking gun,” at least not yet.

PRI next engages in a bit of confusing correlation with causation that would make J.B. Handley blush:

…sub-Saharan Africa has endured decades of contraception-focused population control programs and countless hormonal-contraceptive trials. “Among the six [African] countries hardest hit by the HIV/AIDS epidemic … two in three users in the six countries rely on the OC (oral contraceptives) or injectables,”6 said Iqbal Shah of the World Health Organization.

Likewise, Thailand, praised for a contraceptive prevalence of 79.2% in 2000 and upwards of 70% today, is a land where, “More than one-in-100 adults in this country of 65 million people is infected with HIV.”7 Among Thai women, “Oral contraception is the most popular method.”

On the other hand, Japan’s HIV rate is, at 0.01%, one of the lowest in the world. In this context, it is important to note that the birth control pill was illegal in Japan until 1999, and even today only 1% of Japanese women use oral contraception. Similarly, the predominantly Catholic Philippines, with a longstanding popular resistance to contraception, boasts an HIV “prevalence rate of only 0.02%.”

Gee, you don’t think that maybe–just maybe–there might be confounding factors unaccounted for that could much better explain the differences in HIV prevalence between these different countries, do you? In fact, given the huge differences between the nations compared by PRI, it would be shocking if there were not. For instance, what is the rate of condom usage in Japan? Are there perhaps other factors in African nations that account for the high HIV prevalence other than choice of contraceptives by HIV-positive women? The above passage reminds me, more than anything else, of Generation Rescue’s cherry-picked “data” that ignored nations whose data did not jibe with GR’s predetermined conclusion. Just take a look, for example, at this listing of HIV prevalence by nation. Note how the vast majority of nations with high HIV prevalence are in Africa. However, there are some African countries with rates comparable to North America, countries such as Libya and even Somalia. Why are there such huge differences? One thing we can say is that, absent a lot more convincing evidence encompassing many more nations, it’s ridiculous to blame differences in oral contraceptive use for ten- or hundred-fold differences in HIV prevalence.

Of course, to PRI, it’s all a horrible conspiracy by pro-death, anti-children forces to lie to HIV-infected women so that they use a product that makes them die faster:

Yet population control groups continue to lobby for more contraception, not less. Take Dr. Willard Cates, president of the Institute for Family Health of Family Health International (FHI), one of the major purveyors of hormonal contraception to the developing world. Wrote Cates to the Journal of American Medical Association, “Preventing unintended pregnancies among HIV-infected women who do not currently wish to become pregnant is an important and cost effective way of preventing new HIV infections of infants. … More must be done to ensure access to safe and effective contraception for HIV-infected women.”

Obviously, FHI’s concern here is less to prevent the infection of preborn infants, than to continue to contracept as many women as possible with your tax dollars and mine. What the organization refuses to admit, however, is that by doing so it is arguably contributing to the spread of the HIV virus.

How many lives are being lost because we continue to ship boatloads of hormonal contraceptives to a continent and to countries laboring under an HIV/AIDS pandemic? Isn’t it time that we stopped?

Actually, what we should stop doing is spreading misinformation and exaggerations designed to frighten women.

Right there–right in this the above passage–you see the conspiracy mongering mindset. It is not enough to accuse physicians of doing something that may increase the rate of AIDS progression in women, but they have to be doing it not just to prevent maternal-fetal transmission of virus but because they want to “contracept as many women as possible,” damn the cost. Never mind that having a child as an HIV-positive woman is very risky to the child if antiretroviral therapy is not readily available. Avoiding pregnancy is a very sensible thing for an HIV-positive woman to do under most conditions. It may well be that hormone-based contraception may increase the risk of HIV progression, but the picture is nowhere near as clear as PRI would lead you to believe. Indeed, a review article in Endocrine Reviews from this year by an author of the Zambia studies concludes:

The data summarized here suggest that hormonal contraception may exert a significant effect on the susceptibility to HIV-1 infection as well as on the progression of the ensuing disease. However, the epidemiological data obtained so far are inconclusive. More detailed and comprehensive studies are needed to provide information as to which type of contraception should be used by HIV-1-infected women and women at high risk of infection. Optimally, these studies should involve large numbers of subjects at high risk of HIV-1 exposure; employ randomized, controlled, and safe administration of defined doses of contraceptives; and control for other confounding factors such as genital infections. Although such studies may be financially demanding, their cost is justified by the importance of the question and the potential impact on the spread of HIV-1 epidemic. Importantly, data obtained in the nonhuman primate model strongly suggest that estrogen enhances the natural protective properties of the female genital tract tissue and decreases its susceptibility to virus transmission.

In other words, the data are conflicting, and what can be said is that progesterone-based OCPs may increase the risk and estrogen-based OCPs may decrease the risk of HIV transmission. There’s no conspiracy to hide this data, either. It is clearly an active area of investigation. Of course, if, as PRI has, you’ve already made up your mind, no further investigation is necessary.

The next example of right wing “science” makes the above nonsense look like Albert Einstein, Watson and Crick, and Louis Pasteur all rolled into one.

Oh, noes! The fetal DNA in vaccines is giving the kids teh autism!

There is a definite right wing strain in the anti-vaccine movement. True, there are plenty of stereotypical “natural” granola-crunching, hemp-wearing liberals who don’t vaccinate, there are also a lot of right wing, “health freedom” types, and there are also a bunch of normal people without strong political views who are often colleged educated and, in the arrogance of their ignorance, think that they can interpret the science better than scientists. There are also those who don’t know a lot but have become alarmed at the claims of the anti-vaccine movement and been, in essence, frightened out of vaccinating. However, as pseudoscientific and ridiculous as the anti-vaccine movement, it takes the grafting of fundamentalist religion onto anti-vaccine beliefs to produce pure IDiocy–I mean idiocy this time.

See this story on LifeNews.com entitled Study Confirms Link Between Autism and Use of Cells From Abortions in Vaccines, this story on American Life League entitled EPA Study Confirms Change Point in Autism Disorder Rate; Correlates with Aborted Fetal DNA Introduced in Vaccines, and this blog post by Jill Stanek entitled Vaccines made with fetal cells causing autism? What is causing this disturbance in the anti-abortion Force? Apparently, it’s this “study” presented in the April 2010 newsletter of the Sound Choice Pharmaceutical Institute (SCPI). We’ve encountered SCPI and its thermonuclear burning stupid before. In brief, SCPI is an anti-abortion organization that promotes the idea that vaccines using human cell lines derived from aborted fetuses over 40 years ago is akin to having aborted those fetuses yourself and injecting their ground up remnants into your child.

Let’s see how these wingnuts confused correlation with causation in a manner so flagrant that even Generation Rescue would hesitate to use it. Indeed, Age of Autism has yet to mention this study, and that should tell you something. SCPI explains right here:

The 2010 publication from the US Environmental Protection Agency analyzed a subset of worldwide autism disorder incidence data and identified 1988 as a critical ‘change point’ in the rate of rise of autism. Our internal analysis, utilizing data from the US Department of Education, from the California Department of Developmental Services, as well as all of the data analyzed by the Environmental Protection Agency. Computational line fitting methods, called hockey-stick analysis, identify 3 clear change points in US autism disorder trends; 1981, 1988 and 1995. Prior to 1980 US autism rates were below 5 per 10,000 children and the slope of the line connecting each year was close to zero. From 1981 to 1988 the slope of the line rose to 0.7, from 1988 to 1997 the rate of rise rose to above 2.0, and by 2002 the slope of the line connecting each year had risen again to 3.5.

What happened in the US in 1980, in 1988 and in 1995 that may be associated with these points at which autism disorder incidence began to rise and then to rise more rapidly? Among suggested culprits are watching too much TV, playing too many computer games, microwave ovens, cell phones, a glut of child psychiatrists and psychologists, financial incentives to diagnose children with autism, internet communications and mercury in vaccines.

The study being examined was published by McDonald and Paul a couple of months ago in Environmental Science & Technology and can be found here. Basically, the investigators looked at the incidence of autism using three studies: (1) Honda and coinvestigators for Kohoku Ward, Yokohama, Japan; (2) Lauritsen and others for Denmark; and (3) the California Health and Human Services Agency, Department of Developmental Services (CDDS) for California. In Denmark, Japan, and California, McDonald and Paul found what they considered to be changepoints for cumulative autism incidence in 1987 for California and Denmark and 1988 worldwide. There was no changepoint in the Japanese study; autism incidence increased continuously over the study period. Yet somehow that didn’t stop the authors from lumping all three studies together to produce an overall changepoint. In any case, it’s unclear just what this changepoint means, if anything. One interesting point that was made in the paper was that broadening of the diagnostic criteria for autism did affect the cumulative incidence in California and Denmark, but that the Japanese study used a uniform criteria set for the whole study period. Guess which study showed no changepoint? In any case, McDonald and Paul don’t even mention vaccines, much less fetal DNA.

Not satisfied, though, apparently SCPI did its own “internal analysis,” which resulted in this graph, apparently of the California data:

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The changepoints claimed by SCPI are 1980, 1988, and 1995. SCPI also claims that its changepoints were verified by McDonald and Paul but provide no evidence that this is so. There is a superscript, but it leads to nothing that I can find. No real description of how this “internal analysis” was carried out is provided, other than calling it “iterative hockey stick analysis.” If there’s one thing about iterative analyses of these types, they are prone to artifacts and false positives.

So what happened in 1980, 1988, and 1995 that caused these “changepoints,” you wonder? I think you know what the answer will be. It’s the vaccines, of course! But not just any vaccines, evil vaccines containing ground up fetal parts. Well, not ground up fetal parts, but vaccines in which cell lines derived from human fetuses over forty years ago are used to grow the vaccine viral stock. But it’s the nasty DNA, which must somehow “remember” the trauma of abortion from so long ago. Either that, or the DNA is indelibly tainted with the evil of abortion. Or so it would appear that the argument goes, because there’s really no plausible reason to postulate that incredibly tiny amounts of degraded DNA that might remain from those cells–if any remains at all–could somehow cause autism.

Of course, apparently the tainted DNA from ground-up murdered babies is so powerful in causing autism that it can do so immediately. What do I mean? Look at the graph. These changepoints correlate within a year to the changepoints. The rubella vaccine was approved in the U.S. in 1979, and the first changepoint detected was in 1980. The second dose of the MMR vaccine was added to U.S. recommendations in 1988, and in 1988 there is a changepoint. Then the chickenpox vaccine was recommended in 1995, and there was a changepoint in 1995. No delays, even though autism is usually diagnoses between the ages of 3 and 5. Particularly amusing is that the second dose of MMR is usually given between ages 4-6 years, which is after when most autism is diagnosed. Damn the power of that fetal DNA! It can go back in time to give children autism preemptively, apparently knowing that the U.S. immunization schedule would expand to include a second dose of MMR in 1988! Of course, looking at the graph I don’t find these changepoints to be particularly convincing. The authors claim they see similar “changepoints” in Denmark, the U.K., and Canada that correlate with “the introduction of human fetal DNA contaminants in childhood vaccines,” but they show no data. My guess is that the “quality” of their analysis for these countries is just as dubious and that their confusing correlation with causation just as hilariously off-base.

If you want to get a flavor for just how hysterical SCPI is, check out this passage:

Wouldn’t you want to know if the vaccines your child is receiving were produced using aborted fetal cells? Wouldn’t you want to know if the vaccines your child is receiving contain residual aborted fetal DNA? Sound Choice is working with other nonprofit organizations, with state medical societies, and with state legislators to introduce Fair Labeling and Informed Consent, requiring that parents be informed when vaccines are produced using aborted fetal cells and that they be clearly informed of alternatives available to them.

And wouldn’t you want to know if evil humors had been introduced into your vaccines? Wouldn’t you want to know if there’s formaldehyde in your baby’s vaccines? Oh, wait, there is formaldehyde in vaccines, but your baby’s body makes more formaldehyde from normal metabolism in a day than any several vaccines contain. That example aside, if you want pure intellectual dishonesty, look at this passage:

Wouldn’t you want to know whether the introduction of fetal DNA to our childhood vaccines is safe? As the FDA authors of a 2008 paper about the cancer dangers of residual human DNA state “Whether this residual cell-substrate DNA can induce tumors in vaccine recipients and thus represent a risk factor has been debated for over 50 years without resolution.” (Biologicals 2008 vol 36 pages 184-197). After 50 years of debate about the dangers of using human fetal cell lines for vaccine production, isn’t it time we did the studies to determine whether this is safe or not?

It doesn’t get more intellectually dishonest than this. The article is not about vaccines against childhood infectious diseases but rather about cancer vaccines in clinical trials as strategies for the prevention and therapy for cancer. Cancer vaccines use plasmids to make proteins, usually oncogenes, as targets for the immune system and an immune reaction. The reason, of course, is that the idea behind such vaccines is to try to get the immune system to attack proteins that drive the cancer cell’s growth. This is a very different thing from even a significant contamination with fetal DNA, if there even is measurable contamination with fetal DNA in these vaccines, but SCPI conflates the two as though they were comparable.

Either SCPI is clueless or lying. Take your pick. And idiots like Jill Stanek fall for it, hook, line, and sinker:

The conspiracy theorist in me wonders if the same sort of ideological culprits we see covering up the abortion-breast cancer link are also involved here.

Funny she should mention the “ABC” link. It’s so appropriate. In fact, the ideological culprits who push the ABC link based on no convincing evidence are very much like the anti-vaccine loons pushing the dreaded “fetal parts” in vaccines.

When the religious engage in denialism

The two examples above are prime examples of favorite techniques of denialism, only placed on steroids. They’re taken to an extreme, so much so that they are in essence unintentional parodies, examples of burning stupid so intense that they could melt diamonds. In the case of the claim of contraception causing an increased susceptibility to HIV/AIDS, there is a germ of truth there, but the opponents of contraception turn a reasonable potential scientific concern that progesterone-based OCPs might increase the risk of HIV transmission and progression into the complete certainty that all oral contraceptives will cause women at risk for HIV infection to contract HIV and have it rapidly progress until it kills them. Ironically enough, Jill Stanek’s mention of the abortion-breast cancer (ABC) claim was appropriate, just not in the way that she thinks it is. Proponents of the ABC claim take what may once have been somewhat reasonable concern (that abortions might increase the risk of breast cancer) but for which multiple studies have provided no evidence of support, strip it of all nuance to make the claim that if a young woman has an abortion she will almost certainly develop breast cancer that will killer, and then ignore the bulk of evidence that doesn’t support a link between abortion and breast cancer. The result is, more often than not, a conspiracy-laden rant about how physicians want to cause more breast cancer by aborting more babies.

The claims that fetal DNA in vaccines cause autism are different from ABC fear mongering in that they are not only nearly completely implausible based on science (not as implausible as homeopathy, but working on it). In fact, there is evidence of astounding intellectual dishonesty in the claim that fetal DNA in vaccines is somehow responsible for the “autism epidemic.” There is bad science there, to be sure. There is the torturing of facts and the twisting of reason into a pretzel, no doubt. But there is also the comparison of a study that has nothing to do with vaccines against infectious disease and misrepresenting it as being relevant to the claims that DNA from aborted fetuses somehow cause autism–and that’s just one example of the breathtaking intellectual dishonesty behind this claim. Truly, it’s JPANDS-worthy, and I predict that’s exactly where this will be published.

Religion is a powerful thing, as is far right wing ideology. When the two are combined, it is a logic distortion field reaches a strength that can only be likened to a field formed by a black hole of stupid, a field, which appears able to suck any last vestige of thought from otherwise intelligent people and draw it irrevocably beyond its event horizon. Fundamentalist religion leads such people either to ignore science or, unable to ignore it, to try to torture science into submission, damn the price. Who cares if HIV-positive women forego contraception? Who cares if women think that abortion somehow raises their risk of breast cancer to a near certainty? Who cares if parents stop vaccinating?

None of it matters. Only “proving” one’s ideology does. The results, sadly, are often unintentionally hilarious, although the victims aren’t laughing.