HIV/AIDS denialism versus science

As a skeptic and a blogger, my main interest has evolved to be the discussion of science-based medicine and how one can identify what in medicine is and is not based in science. Part of the reason for this is because of my general interest in skepticism dating back to my discovery that there actually are people who deny that the Holocaust ever happened, which led to a more general interest in pseudoscience, pseudohistory, and other non-evidence-based and non-science-based viewpoints that now includes quackery, anti-vaccine nonsense, 9/11 “Truth,” creationism, and anthropogenic global warming denialism, among other topics. Part of the reason is because, among various forms of pseudoscience, quackery and anti-vaccine views arguably have the potential to do the most direct and immediate harm to people. Teaching creationism will harm our nation in the future as it erodes the ability of young people to have a good grasp of biology that will have deleterious effects on our science effort years from now, and AGW denialism is likely to cause harm in decades to come if nothing is done to mitigate climate change, but quackery kills–and kills now. All of this is why, no matter how far I might stray from medicine from time to time, be it for a change of pace or just a desire to indulge my other interests for a while, I always eventually come home to discussing pseudoscience in medicine.

Among the various forms of pseudoscience in medicine, the two most potentially harmful are probably anti-vaccine beliefs and HIV/AIDS denialism. I write a lot about anti-vaccine pseudoscience here, but only occasionally about HIV/AIDS denialism, even though the latter has arguably done more concrete measurable harm to real people, particularly in Africa where, for instance, it was estimated that government policies in South Africa based on HIV/AIDS denialist beliefs have contributed to the preventable deaths of 330,000 people. Anti-vaccine activists haven’t been responsible for that body count–yet–at least in the modern era (but give them a chance). In any case, HIV/AIDS denialism is an excellent example of how the same sorts of arguments made for pseudoscience can, when applied to a subject like treating and preventing AIDS or vaccines, go from being curiosities that we skeptics like to dissect as intellectual exercises to being deadly threats to public health. At least, that was what I was thinking as I read a post I had come across by HIV/AIDS denialist Henry Bauer, who turns right into left, up into down, hot into cold, and intelligence into stupid with a post entitled HIV/AIDS exemplifies scientific illiteracy.

Yes, you read that right. Bauer thinks that the well-established, scientifically well-supported hypothesis that HIV causes AIDS exemplifies “scientific illiteracy.” In actuality, if he inserted the word “denialism” after “HIV/AIDS” he would have been a lot closer to the truth. But denialists are known for nothing if not for their utter lack of self-awareness when it comes to the pseudoscience behind their arguments, and that utter lack of self-awareness is very apparent in Bauer’s screed right from the very first passage:

HIV was never shown to have caused AIDS.

Nevertheless, during three decades huge arrays of people and organizations have become engaged in a variety of activities based on the mistaken belief that HIV is an infectious immune-system-killing virus that caused and continues to cause AIDS.

That such a mistake could metastasize so massively seems incredible to the conventional wisdom, which regards it as impossible that “science” could go so wrong — after all, this is a scientific age in which all manner of technological marvels are accomplished all the time; and science itself can’t go wrong because it uses the scientific method and is self-correcting.

Note that here, as in the rest of Bauer’s post, no evidence is provided to back up his assertions. Indeed, this is argument by assertion at its baldest. At its core, however, Bauer’s tactic is far more about casting doubt upon science itself than it is about providing actual evidence and doing actual science to demonstrate that the current scientific consensus about HIV causing AIDS is in serious error. In this post, Bauer is not about demonstrating that the evidence for the current consensus is seriously flawed or lacking and that the evidence supporting an alternative hypothesis is compelling enough to cast serious doubt on the current paradigm as the strongest explanation for how AIDS develops. He’s about misrepresenting science itself.

For example, Bauer seems obsessed with the self-correcting nature of science, but in the reverse direction. In other words, he’s obsessed with trying to convince readers that science is not self-correcting and consequently it’s wrong about HIV/AIDS and won’t let go of that hypothesis:

The conventional wisdom can hardly accept that it’s wrong about HIV/AIDS so long as it doesn’t realize that it’s wrong about science. It needs to be understood that

  1. Science is not self-correcting.
  2. Science is not done by “the scientific method”.
  3. Scientists are not the appropriate experts to explain science to policymakers, the public, or the media. On the whole*, scientists know only the technical intricacies of what they do; they don’t understand the epistemology and sociology of science and they are ignorant of or mistaken about the history of science.

In fact, Bauer repeats the very same three points in almost exactly the same way a little later in his post. OK, already. We get it. You don’t think that science corrects itself or that scientists actually use the scientific method. I’ll get back to that in a minute. What interests me is his other assertion, namely that for some reason scientists aren’t the appropriate experts to explain science to the public or the media. You know, whenever I hear someone say something like that I wonder to myself: If not scientists, then who? Who is “most appropriate” to explain science to non-scientists? The communication of science and medicine to lay people has been a major theme in this blog, one that I come back to periodically time and time again. It’s also not as though scientists themselves don’t ask how better to communicate science to the public and media. To some extent, science journalists and science writers can fill that role, but they can’t do it all any more than scientists can do it all. One reason is that non-scientists by their very nature will never attain the deep understanding of science and scientific issues that people who have devoted their lives to science at the very highest level will, and often that is what is require, particularly when trying to communicate science to the media and to policymakers. I can’t help but suspect that part of Bauer’s motivation in arguing this is that he hopes that scientists will instead cede the field to him and his fellow propagandists of pseudoscience.

As for the claim that science is not self-correcting, Bauer simply asserts that more than once and claims that there is a “massive consensus” on this point. Really? Among whom? Bauer and his fellow denialists? Anti-vaccine loons? Creationists? Of that I have no doubt. But among scientists, those who study science, and historians of science? Not so much. Is science perfect? No one claims that, least of all me. As I’ve said many, many times before, it might be very messy, and it often takes a lot longer than scientists would like to admit, but eventually science does correct itself when it goes astray. And, yes, sometimes hypotheses hang around far longer than they should, especially in medicine, but in the end the evidence. However, as I’ve also said many times before, if you want to dethrone a hypothesis in medicine or science, you have to have the goods. In other words, you have to be able to produce evidence of such quality and quantity that, when weighed against the evidence supporting the current hypothesis, it casts enough doubt that other hypotheses must seriously be considered. I hate to point it out to Bauer (well, no I don’t, actually, I don’t), but HIV/AIDS denialists, like anti-vaccine activists and creationists, have never been able to do that. Bring us compelling data instead of self-pitying B.S., and maybe you’ll be taken seriously.

Of course, as all anti-science cranks do sooner or later when they’re on a roll, Bauer can’t resist making a certain analogy that never fails to annoy the crap out of me because it’s so off base:

What’s understood in and about the humanities and social sciences is not understood with respect to science and medicine. The experts consulted and cited about matters of science and medicine are scientists and doctors; they are supposed to explain to the rest of us what science and medicine are about, what they mean to our culture and our society, how we should use what they produce. Scientists and doctors represent Science and Medicine in the same way as priests represent Religion: as unquestionable authorities.

Ah, yes, the comparison of science to religion and scientists and physicians to priests! Where have we heard that cliche before? Actually, I’ve read it on so many anti-science websites and blogs that I long ago lost count, and it’s a common misconception (or outright lie) that frequently needs to be refuted. Religion, after all, requires belief in things that, by its adherents’ own admission, can’t be proven; indeed, religion is all about strong (or even absolute) belief without evidence. This is in marked contrast to science, which is all about tentative, provisional belief only after there is adequate evidence. More importantly, science is about subjecting those tentative beliefs based on evidence to further testing and overthrowing the ones that can’t stand up to that testing. The difference between science and religion couldn’t be more stark.

Finally, Bauer retreats into another favorite canard of the anti-science crank, namely trying to paint the scientific process as being hopelessly tainted with dogma, politics, and ideology, making the ridiculous assertion that HIV became accepted as the cause of AIDS based on politics and social factors rather than based on science, concluding:

The science relating to HIV and to AIDS has never supported the mainstream assertions. Vested interests determined the course of events: careerism, political exigencies, empire-building in government agencies, financial benefits for companies and individuals. Once an activity commands billions of dollars of annual expenditure, mere scientific findings can exert little if any practical influence.

If there’s a substantive difference between this sort of nonsense and the “pharma shill gambit,” I’m hard pressed to find it. Replace the phrase “the science relating to HIV and to AIDS” with “the science relating to vaccines and autism” in the passage above, and this post would be right at home on the anti-vaccine propaganda blog Age of Autism, so much so that it would not look the least bit out of place. Of course, that’s because HIV/AIDS denialism is, at its heart, no different than anti-vaccinationism. It’s pure pseudoscience and, more than that, it’s utterly hostile to science because science doesn’t support its conclusions.

But worst of all, HIV/AIDS denialism is, like anti-vaccinationism, deadly. It’s a perfect example of how pseudoscience can kill.