A controversial research paper that argued “there is as yet no proof that HIV causes AIDS" and met with a storm of protest when it was published in 2009, leading to its withdrawal, has been republished in a revised form, this time in the peer-reviewed literature.

The reworked version of the paper, led by Peter Duesberg of the University of California, Berkeley, who is well known for denying the link between HIV and AIDS, was published in the Italian Journal of Anatomy and Embryology (IJAE) last month.

The manuscript was examined by two peer reviewers, one of them the journal's editor-in-chief, Paolo Romagnoli, an expert in cell anatomy at the University of Florence, Italy. But leading AIDS researchers and campaigners question how the paper could have passed peer review, and say that publishing it in a minor journal known to few does not give it scientific credibility or legitimacy.

"In my view this paper is scientific nonsense and should not have passed peer review. The thesis that HIV does not cause AIDS has no scientific credibility," says Nathan Geffen of the South Africa-based Treatment Action Campaign, who previously raised concerns about the article.

Romagnoli says he decided to review the revised paper because the original was withdrawn by Medical Hypotheses not for “flawed or falsified data” but for “highly controversial opinions” — which the IJAE's readers can make up their own minds about.

“Speculative conclusions are not a reason for rejection, provided they are correlated with the data presented,” he says.
Potentially damaging

The paper's initial publication in Medical Hypotheses caused a furore, with attention being drawn to the fact that the journal was not peer reviewed despite being listed in the MEDLINE citation database.

Retrospective peer review later led to the paper's permanent withdrawal from Medical Hypotheses. The grounds stipulated in the withdrawal notice were concerns over the paper's quality and that it contained opinions about the causes of AIDS “that could potentially be damaging to global public health.

The journal's publisher, Elsevier, revamped Medical Hypotheses to introduce peer review and fired editor Bruce Charlton, who resisted the changes. The University of California also bought charges of misconduct against Duesberg over the article's publication, but he was later cleared.

Duesberg says that the revised publication is a “new victory in our long quest for a scientific theory of AIDS”, adding that the new version of the paper was better documented and more up to date.

Although the revised version has been toned down, the article still makes many of the same points as the original — refuting the effectiveness of anti-retroviral drugs, as well as death-toll estimates from HIV and AIDS in South Africa put forward in a study led by AIDS epidemiologist Max Essex of Harvard University in Boston, Massachusetts3. “We deduce ... that HIV is not a new killer virus,” Duesberg et al. write, proposing a “reevaluation of the HIV–AIDS hypothesis”.

But Geffen says the paper "contains no new arguments or evidence about the South African data, and these arguments have been rebutted before".

Duesberg admits submitting the revised paper to more than four other journals before it was accepted by theIJAE, and only alerted his co-authors to the publication after he was sure it wouldn't be aborted at the last minute.
Dangerous distraction

"It is just so far out that it is hard to respond in an intelligent way," says Essex, adding that it is "unfortunate" to see Duesberg continuing on a "dangerous track of distraction that has persuaded some people to avoid treatment or prevention of HIV infection".

Yet whether the publication will be officially challenged remains to be seen. John Moore, an HIV researcher at Cornell University in New York, who lodged a complaint with Elsevier when the original paper was published, believes that the movement to deny the link between HIV and AIDS is on its “last legs”. Geffen, meanwhile, thinks the likelihood the paper will have significant impact — and therefore warrant challenge — is small.

“Duesberg's views no longer have significant political support, like they did in South Africa in the 2000s,” Geffen says. ”No one of consequence in government is likely to take any notice.”

AIDS Apathy is Fertile Soil for Denialism

Leading AIDS Denialist David Crowe once said “The world is getting bored with AIDS”.

And yet, as President of the Rethinking AIDS Society, Mr. Crowe refurbished the Rethinking AIDS website, hired a public relations person, and reinvigorated his propaganda campaigns. He also started daily updates on his other denialist website for the Alberta Reappraising AIDS Society.

Why would David Crowe and Rethinking AIDS do all of this if the world is bored with AIDS?

Because AIDS apathy is good for AIDS Denialism.

AIDS apathy means less attention to AIDS science, reduced information seeking, less critical thinking about AIDS, and fewer quality information resources. AIDS apathy may explain why 45% of Gay men believe “HIV does not cause AIDS” and 51% believe that “HIV drugs can harm you more than help you.” Apathy may also help explain the rise in AIDS conspiracy theories, where one in five men and women in Houston believe that “AIDS is an agent of genocide created by the US Government to kill of minority populations” and 43% of African Americans in the US believe that “People who take the new medicines for HIV are human guinea pigs for the government”.

The Kaiser Family Foundation just released a new survey of Americans that shows the public sees AIDS as less of a threat than in the past, even as new infections are on the rise. The proportion of Americans who see HIV/AIDS as the most urgent health threat facing the country has plummeted from 44% in 1995 to 17% in 2006 and 6% today. AIDS apathy was also greatest among those most affected by AIDS and those at greatest risk.

The study showed that the number of people who say that they have heard, seen, or read “a lot” or “some” about HIV/AIDS in the US in the past year declined from 70% in 2004 to 45% in 2009. Those who said they saw “a lot” about HIV/AIDS was cut about in half from 34 percent to 14 percent.

Americans who say that we are losing ground on the problem of HIV/AIDS has decreased from 36% in 2004 to 22% in 2009.

Sadly, we are actually losing ground in the fight against HIV/AIDS. An estimated 1.7 million Americans have been infected with HIV and 580,000 have died of AIDS. New HIV infections in the US are occurring at a rate of 56,000 a year, that means that every 9 ½ minutes someone in the US is infected with HIV. The District of Columbia has the worst AIDS problem in the country, with HIV infecting 3% of the city it rivals countries in West Africa as one of the most AIDS afflicted places in the world. All of this is happening while Americans are caring less about AIDS and AIDS Denialists spew ever more misinformation.

AIDS denialism claims that HIV does not cause AIDS, that HIV tests are invalid, and HIV treatments are poison. If our greatest hope for defeating AIDS Denialism is an attentive and educated public, we have a lot of work to do.