HIV denial: alive and well in 2014 [UPDATED]

Everything old is new again. For years on this blog, I wrote about HIV denial and the few fringe scientists and journalists who espoused it. I attracted a host of trolls, some of whom repeatedly attacked my credibility, my appearance, even showed up at my academic office. One of the most prolific of these was Henry Bauer, who posts long-debunked ideas on HIV/AIDS (and the Loch Ness Monster to boot).

That was, oh, 2007-ish and prior. In that same year Steven Novella and I co-authored an article on HIV denial for PLoS Medicine. In 2008, a leader of the denial movement, Christine Maggiore of "Alive and Well AIDS alternatives," died of AIDS. In 2009, books were released from Seth Kalichman  (Denying AIDS)  and Michael Specter (Denialism), both further outlining the reasons why HIV denial is so, so, so incredibly flawed and dangerous. Seth still runs his blog, and HIV denial hasn't gone away, but it's lost some prominence in recent years--at least in the US.

For whatever reason, this week has been a hotbed of it.

First, MD/blogger Kelly Brogan had a post in support of HIV denial , specifically addressing pregnant women (currently taken down but yay for Google cache).

Now even worse, Frontiers in Public Health, an actual, peer-reviewed journal, has published a paper that is straight-out, unvarnished, HIV denial. Full stop. This journal is part of the "Frontiers in" series, that many readers will probably be familiar with. FPH claims that

Each Frontiers article is a landmark of the highest quality, thanks to genuinely collaborative interactions between authors and review editors, who include some of the world's best academicians. Frontiers is well aware of the potential impact of published research both on future research and on society and, hence, does not support superficial review, light review or no-review publishing models. Research must be certified by peers before entering a stream of knowledge that may eventually reach the public - and shape society. Therefore, Frontiers only applies the most rigorous and unbiased reviews, established in the high standards of the Frontiers Review System. Furthermore, only the top certified research, evaluated through the democratic Frontiers Evaluation System, is disseminated to increasingly wider communities as it gradually climbs the tiers of the Frontiers Tiering System from specialized expert readership towards public understanding.

Except, no way in hell is that accurate after the publication of this manuscript: "Questioning the HIV-AIDS hypothesis: 30 years of dissent," by a professor at Texas A&M University named Patricia Goodson. Goodson's qualifications appear to be in health education, including sexual health (and many publications related to abstinence-only education and to abortion), but nowhere do I see any publications or training relevant to epidemiology or virology.

The paper itself consists entirely of the old claims that have been debunked time and time and time and time again, using tactics we defined in our paper: quote-mining, cherry-picking evidence, moving goalposts, citing prominent deniers and denial groups, and more. There is nothing of value here, and the only real nod she gives to orthodox opinions on HIV are to cite Kalichman's book ever-so-briefly and dismissively (characterizing it as "a harsh critique of unorthodox views and of Duesberg in particular"). 

And who is behind the curtain? Well, for one, Henry Bauer, who appears immediately in the comments of the paper, pimping his list of HIV denial resources. Goodson comments (click to embiggen):

Goodman and Bauer

So how in the world did this paper make it into a peer-reviewed journal with the stamp of approval of the Frontiers line and backing of Nature Publishing Group?  (EDITED via comments: Grace Baynes of NPG notes that Frontiers journals are editorially independent from NPG; see my response below). The two reviewers, Preeti Negandhi and Lalit Raghunath Sankhe are also apparently both members of the FPH editorial board, despite almost no academic record. Neither has experience in HIV/AIDS , but the latter appears to be the editor,  Sanjay P Zodpey's go-to reviewer, while the former only has one publication listed on the FPH page, co-authored with Zodpey on public health capacity development in India. No publications are listed on Sankhe's page, but there was one I could find which may possibly be associated with this name. Other than that, zero record in PubMed.

Why were these people, who clearly have as little background in this area as Goodson does, chosen as reviewers? This is, at the best, a pathetic excuse for peer review and editing, and completely unprofessional and unacceptable. Did Zodpey, who does appear to have some background in HIV, even read the article before passing it along to two unqualified reviewers? This type of review makes a mockery of the entire system and makes us all look bad.

Even worse, papers like this are clearly dangerous. I wrote not even a week ago about the deadly distrust so many have in our medical system, and cited HIV denial as an example. South African policies regarding HIV (and the denial that the virus was behind AIDS) led to an estimated 330,000 premature deaths from AIDS, and 35,000 infants born with HIV infections that could have been prevented in that country alone.  This is what Goodson and Bauer (among others) are supporting. Frontiers and Nature, do you really want to be a part of this as well?

(Tip o' the hat to Kenneth Witwer and Brian Foley for bringing this to my attention.)

UPDATED 9/26 The Frontiers Editorial Office has posted a Statement of Concern on their site regarding the paper:

Statement of Concern: The article "Questioning the HIV-AIDS hypothesis: 30 years of dissent" (Goodson 2014), was accepted for publication on the 7th September 2014. In its duty to publish responsibly, and in light of numerous complaints received about the paper, Frontiers has launched an investigation, the outcome of which will be made public once all adequate procedures have been completed. September 26, 2016. Frontiers Editorial Office, Lausanne, Switzerland.


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This is a classic example of "zombie science" , or as Langmuir put it "pathological science"
It is wrong, it is demonstrated to be wrong, but it rises regularly from the dead and has to be repeatedly knocked back.

By Dave Fernig (not verified) on 26 Sep 2014 #permalink

Did anyone actually read this paper in order to see what, specifically, the author was proposing? If so, you most likely saw this text from the author:

"It is important to note that my purpose is not to review the state of the science regarding HIV/AIDS, nor to persuade readers to reject the mainstream hypothesis. Instead, I aim to expose readers to the persisting controversies, and to motivate them to raise questions of their own."

You are correct that the denialists have lost prominence, but they have not gone away; just changed tactics. They have taken their battle into the courts and are using the tactics you mention above to manipulate the courts to advance their agenda. Clark Baker and his dubious HIV Innocence Group (which is not a group, just him) claim to defend those with HIV accused of reckless or intentional infection of another. He has sued me in Federal Court in Texas because I prove with my site HIV Innocence Group TRUTH that he is less than truthful about his supposed successes and the tactics he claims to achieve these "wins". I beat him in arbitration, his Federal suit was dismissed but he has appealed to the 5th Circuit Court. This article by Ken White at Pope Hat describes Clark Baker and his intentions very well.…

"Academic," indeed, I saw that. The problem is, none of these are "persisting controversies" in the least, which makes the paper incredibly dishonest and unworthy of publication.

Tara, On behalf of Nature Publishing Group, I'd like to clarify that Nature Publishing Group does not have any editorial involvement in content published in Frontiers journals, they are editorially independent.

Grace Baynes
Head of Communications, Nature Publishing Group

By Grace Baynes (not verified) on 26 Sep 2014 #permalink

Thank you, Grace. I'll add that clarification into the post. Nevertheless, I'd think that your partnership with them would still mean that what reflects badly upon them would also reflect badly upon you.

"Academic," of course everyone read the I'm-just-covering-the-controversy" passage. We also read the rest of the paper, where the author exclusively presents one side of the supposed controversy, the side with the self-published books and other dubious sources that populate the citations. While presenting that one bizarre set of unsupported viewpoints, the author repeatedly forgets that she's supposed to be reporting someone else's views and...oops...makes flat-out statements that can only be interpreted as hers. The real science is "vexing," "concerning," while the deniers are "meticulous," their concerns "significant." The author also selectively answers the question about the original "voices." Where are they? Mostly dead (of AIDS, tragically) or they've changed their tune as the evidence came in. Surely the author knows their names?

By StandardED (not verified) on 26 Sep 2014 #permalink

I'm curious, if "Nature Publishing Group does not have any editorial involvement in content published in Frontiers journals," and "they are editorially independent," who selects the editor(s) of the journals? The editorial board members etc? What's the process like?

By Adam Etkin (not verified) on 26 Sep 2014 #permalink

Great commentary, Tara! You've pulled no punches!

By Anne Wallis (not verified) on 26 Sep 2014 #permalink

I frequently get requests to review manuscripts that, while they might be in the same field as some paper on which I was a junior co-author, are so far outside my area of expertise that I could never say anything meaningful about most of the methods or about whether relevant literature had been adequately and honestly summarized. These requests seem - I mean no offense but it's a readily observable pattern - to come most often from editors based in India. I am happy to say no, but those who feel obliged to say yes to everything, or who are eager for even a small item to put on a CV (i.e., those who are least experienced), probably accept the assignment and then basically have to okay any manuscript that has been prepared well enough to look plausible, since they probably wouldn't notice even major flaws.

You probably think this paper is a special case because every educated person, whatever his field, ought to be aware that it's now well established HIV causes AIDS. Still, if someone with zero knowledge of the field's literature is faced with several pages of apparently legitimate citations arguing the opposite, his only basis for rejecting it out of hand would be that it questions current dogma. The fact that current dogma in this instance is definitely true doesn't change the fact that people who aren't capable of doing more than checking to see whether a manuscript reflects popular opinions aren't capable of reviewing it. The same people might be asked to review manuscripts relating to mainstream HIV research and would do an equally bad job of it, but the flaws that thereby made it into print wouldn't be so huge and risible as to attract Internet attention.

I suspect that outside the higher-ranked journals in each field, having manuscripts reviewed by people who are ignorant of the subfield in question is a very widespread problem. Good, knowledgeable and careful reviewers are limited in number, and you can't demand too much of them. Anyone who serves as a journal editor these days knows that many people don't even respond to requests to review, while others agree to review and then sit on the manuscript forever. There are too many journals now, perhaps, receiving too many manuscripts, and there is little if any professional reward for reviewing, so there just aren't enough good reviewers to review them all. Thus many manuscripts are necessarily reviewed by people who are not competent to do so. Further, I suppose there is a vicious cycle in which journals that start letting junk get through find it harder to line up good reviewers (who are not interested in wasting time on manuscripts that will never be better than awful) and as they use weaker reviewers, they will attract more and more junk because authors who sense that their work is weak look for journals with low standards. Thus the peer review system, like so much else, is beginning to collapse under its own weight.

Good greif! Talk about a collection of zombie hypotheses. Here's how completely dead and buried Duesberg's "poppers" theory is: it was used (with data) in my MPH epidemiology class as an example of confounding. We opened up the same data set and when you consider HIV status as a confounder for drug use and dying of AIDS, oh look, the association goes away!

Publishing this paper is horrendously irresponsible by *any* person in Public Health, let alone a major publication. Are they seriously trying to undo decades of hard work?

By JustaTech (not verified) on 26 Sep 2014 #permalink

Note also that Goodson has herself a study goin' on. Well, actually, it seems to have been going on since 2012. One wonders how many subjects she's managed to enroll.

Jane, I don't really blame the reviewers as much as I do the editor. They clearly are scientists without many pubs; I assume junior. I agree, they were out of their depth. BUT that's why the editor should have recruited qualified reviewers, especially for something like this that clearly was going to be controversial.

She kind of looses all credibility early on by insisting that antibodies are only associated with a previously occurring infection that the body has resolved - or some other similar nonsense... then by calling it RNA PCR ... I had to click the citation she cited because after 20 years in molecular biology I have never heard of " RNA PCR – ribonucleic acid polymerase chain reaction"... even the title of the paper she cited says RT PCR. YIKES. She can't even copy from her cited source.

and Academic;

" I aim to expose readers to the persisting controversies". Just like climate change. Among real credentialed, peer-review publishing microbiologists and immunologists THERE IS NO PERSISTING CONTROVERSY REGARDING THE ETIOLOGY OF AIDS. Full. stop.

Or the "protein particles (called microvesicles)" (nope!) that contaminate viral preps. Sure, if this is 1994 before iodixanol gradients.

By StandardEd (not verified) on 26 Sep 2014 #permalink

Yes, it seems clear that Henry Bauer has played a prominent role in this fiasco, as he did in similar episodes when his group tried to publish their nonsense in Medical Hypotheses (2009) and later in the Italian Journal of Anatomy and Embryology (2009-2011).

Does James Chin know that his name has been included on a list of "select critics of the HIV-AIDS hypothesis"? He seems to be the only one on that list who has actual clinical or research experience with the disease.

Co-opting the names of reputable scientists without their knowledge to lend credence to idiocy in this way is dishonest, unethical and contemptible. So it should be no surprise to learn that it is standard practice among HIV/AIDS denialists:

By G. Martino (not verified) on 26 Sep 2014 #permalink

I’m curious, if “Nature Publishing Group does not have any editorial involvement in content published in Frontiers journals,” and “they are editorially independent,” who selects the editor(s) of the journals? The editorial board members etc? What’s the process like?

NPG took a majority stake in Frontiers in 2013. I don't know how they go about starting a new journal, but it seems to be a top-down process for "Field Chief Editor" (to which position one can apparently be "promoted") and the more salient "Specialty Chief Editor," a solicitation for which is quoted here by Jaime A. Teixeira da Silva.

Hi Jane and Tara,

One problem is that we have far too many new “journals” being published. I receive at least one invitation per month to become an editor of some new “journal” – more often than not; I have no expertise in the focus of the new “journal”. Many of these “journals” state that they have a clinical focus. I have no clinical training – but, since my appointment is in a clinical department – I get these invitations.

To understand how such inexperienced editors reviewed the paper and how it was published you have to understand that Frontiers is a multilevel marketing scheme like Amway. The way you move up in the chain of reviewers, editors, chief specialty editors, chief editors, etc, is provide grist for the mill, and, of course, there are page charges.

By Eli Rabett (not verified) on 27 Sep 2014 #permalink

Yes, it seems clear that Henry Bauer has played a prominent role in this fiasco, as he did in similar episodes when his group tried to publish their nonsense in Medical Hypotheses (2009) and later in the Italian Journal of Anatomy and Embryology (2009-2011).

One of the other co-authors of the IJAE paper was Marco Ruggiero, who had earlier managed the rare feat of getting his own 2009 AIDS-denialism paper retracted from Med.Hypotheses.
These days he and his colleagues are mainly publishing about magical cancer-curing probiotic yogurt, through quackademic vanity-press journals. But I was concerned when his name turned up earlier this year on a paper in Frontiers in Human Neuroscience.

It reports a method of detecting autism by detecting brain abnormalities with ultrasonography, and can best be described as 'contentious'. There are several issues with the paper. First, the co-author is James Bradstreet, a serial recipient of Respectful Insolence from Orac (due to his autism-cure scams). Second, an integral component of the process is to process the ultrasound output in Photoshop for image inhancement. But also important, to my mind, is that the reviewers of the paper -- and the reviewers of a later Commentary paper which recommended the original one to any readers who missed it the first time (and was written by one of those reviewers) -- are research / business associates with one another. What was the editor thinking?

By herr doktor bimler (not verified) on 27 Sep 2014 #permalink

Your blog was the first place I ever encountered a "germ theory denialist" - I had not even imagined such people existed before then. I remember your comments section as just a nightmare of HIV denialists.

DrdrA, I think she loses credibility at the moment she appeals to authority using Kary Mullis, who hasn't published a data paper in 20 years. (Actually, looking at her table of "experts" - good grief, none of these people have published anything except HIV denialism in years to decades.)

By gingerest (not verified) on 28 Sep 2014 #permalink

@Dr Bimler, Yes, the Conflict of Interest Statements by Bradstreets's co-authors in that paper do seem to be a bit sketchy.

For example, neither Marco Ruggiero nor his wife Stefania Pacini think it relevant to mention that he is the "scientific director" of a business marketing a number of products and services claimed to "eradicate" autism (and a host of other conditions including "Chronic Herpes, Chronic Acne, Chronic cirrhosis of the liver, Chronic kidney disease, Chronic depression, Colitis, Crohn’s, Fibromyalgia, Hepatitis, Herpes, LMBBS, ME/CFS, Osteoporosis, Periodontal disease, Psoriasis and various types of Immune dysfunction including allergies", and that "can halt deterioration in Parkinsons, multiple sclerosis (MS), dementia and ALS."

Such claims are supported not so much by clinical trials or regulatory approval of their use in these conditions, but rather by an aggressive public relations effort through social media and direct-to-consumer sales over the internet.

Some in the scientific community might regard such therapeutic claims as "contentious", and relevant background to Dr Ruggiero's and Dr Pacini's claims to have discovered a "useful screening technique for children at potential risk of ASDs".

By G. Martino (not verified) on 29 Sep 2014 #permalink

The main thing I learned from the Bradstreet-Pacini-Ruggiero "transcranial ultrasonography" paper is that if someone gets to decide which subjects are autistic and which ones aren't, and that same person then decides which subjects display the particular quality of graininess in their ultrasound scans (by adjusting the image-enhancement and contrast of the scans in Photoshop), then the degree of agreement is quite high.

What intrigued me most was Siniscalco's later Commentary in Frontiers, telling readers how good the original paper was, the author not bothering to inform the readers that he's (a) a reviewer of that original paper, and (b) a collaborator and business colleague of its authors. In fact Siniscalco flatly denies having "any commercial or financial relationships that could be construed as a potential conflict of interest", despite being aboard Ruggiero's GcMAF gravy train.

That Commentary was in turn reviewed by Siniscalco's colleagues / co-aiuthors. Frontiers is not doing the concept of "peer review" any favours.

By herr doktor bimler (not verified) on 30 Sep 2014 #permalink

and a host of other conditions

Don't forget, one of the conditions which Ruggiero promises to treat with GcMAF is HIV. Despite his denial that it's the cause of AIDS.

By herr doktor bimler (not verified) on 30 Sep 2014 #permalink

Thanks for the link to the Kelly Brogan piece.
The incorrect and dangerous statements by a seemingly well educated physician are so astonishing as to make it difficult to read. Of the many, perhaps this is the most incredible-
"That drug toxicity associated with AIDS treatment may very well be what accounts for the majority of deaths"

Wow. Wonder how she explains the millions of deaths in Africa from AIDS, where many patients do not receive antiviral therapy of any sort? This sort of ignorance must be countered. Thanks for doing your part.

By Don Taylor (not verified) on 30 Sep 2014 #permalink

This piece by Kelly Brogan is equally wrong, and perhaps more dangerous, regarding flu vaccine. In it she claims flu vaccine is ineffective and harmful and claims a recent study suggests that the vaccine isn't saving lives.…
The study she references suggests that in cases of flu vaccine failure, the vaccine does not affect severity of disease (as measured by rate of hospitalization). It emphatically does not suggest that flu vaccine "is not saving lives". It suggest the opposite- "This suggests that influenza vaccination prevents serious outcomes by primary prevention of influenza infection."

The paper:
16 January 2014, Vol.32(4):453–457, doi:10.1016/j.vaccine.2013.11.060
Open Access, Creative Commons license
Influenza vaccination and risk of hospitalization among adults with laboratory confirmed influenza illness ☆
Huong Q. McLeanJennifer K. MeeceEdward A. Belongia…

By Don Taylor (not verified) on 30 Sep 2014 #permalink

I read the headline. And thought of something as I read the article. If these people really believe this, and were offered an Ebola survivors blood as treatment for Ebola, let's say, in a dystopic and unrealistic future....would they accept a blood donation without HIV testing?

They've continued to die, one by one. Even their queen, Maggiore, was taken out - gutted by a virus she claimed didn't exist 'cause the virus didn't give a damn about her conspiracy theories or complete lack of scientific understanding. Hoards of other deaths have followed, including Kim Bannon, Karri Stokely, Tommy Morrison, Maria Papagiannidou (and her denial-activist husband Gilles keeps at it) and, frankly, too many to count. I don't even care anymore. We need a society with higher IQ's of those who favor empirical evidence over fantastical conspiracy theories. They died of stupidity, long before HIV finished them off. Good riddance.