Re: Re: See what one wants... 14 April 2005
Previous Rapid Response Next Rapid Response Top
Nicholas Bennett,
Infectious Disease Postdoc/Clinician
Department of Pediatrics, University Hospital, Syracuse NY

Send response to journal:
Re: Re: Re: See what one wants...

Marcel Giroidan can be forgiven for not realising that I've previously mentioned psychological factors in HIV progression, in particular depression. I've discussed these briefly in several posts last year.

The simple fact is that psychological impacts on phsyical health, while real, don't result in pneumocystis pneumonia and KS! The other important fact is that people are, sadly, still presenting to doctors in end-stage AIDS. Their first medical visit may be with pneumocystis (typically) and CD4 counts under 100. It seems odd that to explain pre- diagnosis AIDS the dissidents use drug use or lifestyle factors, and to explain post-diagnosis AIDS they argue stress or antivirals. It seems simpler to invoke a single cause, common to all cases - HIV infection as judged by culture, viral load and serology in repeated matched cohorts (i.e. tests were either consistently negative or positive, as one would expect if they were all detecting the same thing in different ways).

Which neatly moves onto the point raised a few days ago about the aim and nomencalture of AIDS dissidents. The term is arguably mis-applied, similar to "religious fundamentalists" but has been in use for considerable time. More recently some have preferred the term "denialists" to more accurately reflect their approach to HIV/AIDS science. In the same vein the conventional view has gone from being referred to as "the orthodoxy" to "AIDS apologists".

The name "dissident" has been taken up as a battlecry by some groups, such as the one previously mentioned several months back which waged a campaign to shut down HIV/AIDS support groups online (Dissident Action Group). The core dissenting website refers to those who question the conventional view as "heretics" "skeptics" and "dissidents" (virusmyth.com). It seems as if the name is entirely appropriate and accepted by both sides.

The view however that these people somehow have a common way of thinking is greatly misplaced. Some agree that HIV exists, some go further and say it has been isolated. Some refuse to accept either. Some admit the antibody tests reflect a risk factor but disagree that it is HIV. Some consider the antibody tests useless predictors. Some think the antivirals help due to non-HIV related effects, some that they do more harm than good. Some do seem to genuinely believe they are preventing a health catastrophe, some seem hell-bent on _causing_ a health catastrophe.

There is no consistent view or aim, reflected in the regular confused posts from newcomers to the dissident discussion boards. Practically the only thing uniting them is a refusal to accept the conventional thought.

That's how it appears to me from this "side" at least.

Nick Bennett njb35@cantab.net

Competing interests: None declared