Aug 27 2007

HIV Denial on the Internet

Last week Tara Smith and I had our paper on HIV Denial in the Internet Era published in PLoS Medicine, an open access online peer-reviewed journal. The article combined Tara’s knowledge (as an infectious disease specialist) of HIV, AIDS and the denial thereof, with my long term interest in denial as a particular type of pseudoscience. Tara asked me to collaborate on the paper, in fact, after reading this article I had published for the NESS.

The point of the paper was not to rehash all the scientific arguments that establish HIV as the cause of AIDS or to rebut all the claims of HIV deniers. This has already been done quite thoroughly. Rather, it was to focus on the intellectual strategies employed by HIV deniers and how they are propagated in the modern internet era.

The original version of the paper we submitted, in fact, drew specific corollaries to creationism/intelligent design as evolution denial. However, the resulting paper was quite long and the PLoS editors asked us to remove the specific evolution denial references to both maintain a narrower focus for the paper and to shorten the length.

I completely understand that editorial decision, but it did water down the thrust of the paper, which was to talk about HIV denial in the context of denial as an overall pseudoscientific strategy. My original paper does this more specifically, but it is now over 5 years old and due for an update (I’ll just add that to my list of things I don’t have time to do.)

The reaction to the paper has been extensive and interesting. I was happy to see the many kind and positive reviews by our fellow science bloggers. (See the links at the bottom of this entry.) I was not at all surprised, also, to see the negative reaction from the HIV Denial community. Tara and I clearly threw down the gauntlet in a very public forum, a response was inevitable.

As always, I am heartened to see that the criticism of the article from the HIV denial community is as vacuous and logically flawed as their denial of HIV. For example, “Truthseeker” wrote on the Science Guardian the following in response one section of our paper in which we pointed out the dangers of HIV denial:

“Or, please join us in assuming that what is being questioned is true without question, so that high level review can be politically repressed as “pseudoscience” rather than answered with science, and there will be no danger that patients question the need to take extremely dangerous drugs.

The only problem with this line of paradigm defense, of course, is that the serious paradigm debunking has in fact occurred in peer reviewed scientific literature at the highest level, and has gone unanswered there at the same, peer reviewed level, in the same journals. Instead, the defense team has abandoned ship and gone to lower levels, where peer review does not handicap bad argument and misleading assertions, where “fact sheets” can be quoted in response to peer-reviewed critique, and where lay critics can be answered with politically charged prejudice (”dangerous” “pseudoscience”) and smearing (”not scientifically legitimate” “denialist” (similar to Holocaust denialists) “conspiracy theorists” motivated by “profit”) and so on.”

Truthseeker got everything wrong. Tara and I never called for the acceptance of a scientific conclusion “without question.” Rather, we gave specific references to summaries of the evidence for the claim that HIV is the cause of AIDS and a refutation of denialist arguments. Again, we see the characterization of quality control in science as being “politically repressed as ‘pseudoscience.’” All pseudoscientists characterize the exclusion of their substandard science as “repression.”

Truthseeker also appeals to patient empowerment with the statement that we are trying to prevent the “danger that patients question the need to take extremely dangerous drugs.” No where in the paper did we say categorically that patients should not be well informed, should not participate in their healthcare decision making, or that they should not question any treatment that is being offered to them. What we advocate is that patients be informed by solid science, and not misinformed by denialist nonsense.

I also love the phrase “paradigm defense.” There does seem to be a positive correlation between invoking “paradigm” as a negative connotation as defending pseudoscience. Truthseeker then goes on to make a somewhat specific claim – that the HIV “paradigm” has already been debunked “in peer reviewed scientific literature at the highest level.” However, he provides no references. This claim is utter nonsense – nothing but propaganda. The literature stands in solid support of the HIV causes AIDS “paradigm” and there is no serious research that calls this basic claim into question.

Truthseeker goes on to make some lame and pointless attacks against Tara. I was a little disappointed that he did not go after me. He tries to take Tara to task for criticizing Gary Null – in an attempt to make the point that she was wrong about Null and so will be proven wrong about HIV denial. I find it sweet when one pseudoscientist defends another. Tara, if anything, was kind to Null, who is (in my opinion) a quack of the worst sort. Truthseeker seems to defend Null because Null has added HIV denial to his long list of pseudoscientific claims he uses to sell his dubious products.

I also found it ironically humorous that Truthseeker made the taunting point that:

“In the long run, Tara Smith and Steven Novella will learn the biggest danger of the Internet, which will eventually emerge as its dominant long run characteristic: its permanence.”

You bet. I count on the permanence of the public record, including the internet. It is an important part of science and of intellectual discussion generally that arguments of the past are not erased from memory or history.

For my part I do not fear this permanence at all. This is not because I believe I am correct on every stance I take or that future knowledge or arguments will never find error in anything I have written. Humans are error-prone machines. The point of science and scholarship is not to be error free, but to engage in an ongoing process that openly admits error and corrects it as necessary. So as long as I am open, sincere, and reasonably prudent in my scholarship I have nothing to fear from my critics – even presumed future critics.

I am also happy to unflinchingly plunk down my nickel and place my bets. I have come to the firm conclusion that the current evidence overwhelmingly supports the conclusion that AIDS is caused by HIV. There are many interesting wrinkles to the science of HIV, and we will likely learn some surprising things in the future, but this core fact will likely remain unchanged. I am also confident in my conclusion that the arguments of HIV deniers are not valid and fall into an overall pattern of pseudoscientific denial.

I have routinely put my credibility and reputation on the line by making such conclusions, and supporting them with logic and evidence. I welcome future judgment which can only help me. Either it will vindicate my position or it will expose error, and that will enable me to improve my knowledge and my arguments. That’s a win-win.

The only ones who have to fear are those who cling to discredited arguments, poor logic, and dubious claims and who refuse to change in the light of evidence. Like, for example, HIV deniers.

Other Blogs about this article

Aetiology by Tara Smith

Scientific Blogging

Denialism by Mark Hoofnagle

Inalienable Rights by Duwaye Brayton

Educated Guesswork

Pharyngula by PZ Myers

Respectful Insolence by Orac

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