The last year has been filled with frustration as we dealt with COVID-19 deniers and Fox News, but many forget that those who reject science have been present throughout numerous epidemics in the world, not only COVID. A couple of weeks ago, I visited a rural clinic in Kenya with my family. As I stared at the count charts on the walls, I was reminded of another epidemic that continues to affect millions of people across the globe: the HIV/AIDs epidemic.
This epidemic has its roots both in the developed and developing world, with some blatantly denying science and others simply lacking the education to make informed decisions regarding an HIV/AIDS infection. There are some key arguments made by HIV deniers that I will discuss to set the stage for the current situation regarding HIV denialism.
Methods of Denialism
To start, the HIV denialism movement began around 1987 and peaked from then up to the 90s. This was a time period where research and treatments for HIV/AIDS were still in their preliminary stages, allowing many to deny the scientific credibility of the virus and the medications. There was also much fear regarding HIV/AIDS built out of the ignorance surrounding the topic. This then allowed for HIV deniers of the time, notable ones being Peter Duesberg and Celia Ferber, to capitalize on this fear and ignorance with self-made theories regarding the epidemic.
Despite newer science and advocacy campaigns improving treatment rates significantly, HIV denialism still remains a problem to this day in many parts of the world. As recently as 2010, one survey of 343 adults (predominantly African American) found that 20% of adults still didn’t believe that HIV could cause AIDS and a total of 33% of adults still thought that the correlation between HIV and AIDS is up for debate.
This method of denialism is particularly dangerous because it acknowledges the existence of AIDS but denies the causation of AIDS by the HIV virus, then allowing for all scientific evidence and treatment methods that follow this line of thought to be rejected. Instead, alternatives such as drug usage and environmental toxins are proposed as causes of AIDS, with privately produced remedies proposed as solutions to these issues often for a profit.
In the same year, another study found that adherence to highly active antiretroviral therapy by those prescribed it was less than 62%. Antiretroviral therapy is characterized by the use of a cocktail of antiviral medicines to control the HIV infection. It keeps the viral load low in the bloodstream thereby decreasing infection symptoms. Inconsistent usage of the medicines can lead to the virus developing drug resistance and this drug-resistant strain then transmitting to others as well, then requiring newer and stronger drugs to treat the infection.
This inconsistent usage of medication can stem from a rejection of the role of medications in effectively treating HIV. The justification is typically arguing against the scientific community’s credentials or expressing distrust against people in positions of authority in general. Sometimes, “alternative medicines” are promoted instead, typically sold by a “doctor” denying the effectiveness of professional antiretroviral treatments.
HIV Denialism in Rural Areas
While at the Kenyan clinic, the doctor shared with me the struggles the clinic faced treating the numerous HIV patients in the area. Many of these struggles were centered around HIV denialism in the tribal communities, leading to many foregoing or pausing HIV/AIDS treatment. In America, under the law, children with HIV have to be treated whether their parents want them to receive treatment or not. However, in Kenya there is no such rule, allowing children born with HIV/AIDS to remain susceptible to serious infection and even death if their parents are HIV/AIDS deniers.
Much of the denialism in rural areas and ethnic communities is born out of strong adherence to religion and tradition and a lack of education. In Kenya, this included a belief in illness being a result of witchcraft. Many living in rural areas also turn to herbal remedies instead of medication, sometimes even refusing HIV testing itself, due to both ignorance and traditional beliefs.
Community stigmas in rural areas only add to the culture of HIV/AIDS denialism. In some communities, HIV is associated with the LGBTQ+ community and drug usage - both of which are extremely prone to be looked down upon by conservative cultures that usually cluster in rural areas.
A study conducted in rural Maharashtra, India found the existence of a sociocultural myth that married women could not contract HIV and that HIV only comes from participation in immoral sexual behaviors (specifically women having sex out of marriage is looked down upon but the same doesn’t apply for men). As a result, women ended up hiding their diagnosis and delaying treatment to avoid a reputation of immoral behavior regardless of whether they participated in such activities or simply contracted HIV from their husbands.
Rural communities are also typically close-knit, making it difficult for people to acquire treatment in privacy if social stigmas are present. This can then decrease the willingness of individuals to get tested and continue treatment, both of which can further spread the virus and disease.
HIV Denialism Extremes in South Africa
Similar to how the American South has proved an experiment for COVID denialism, South Africa was once the country facing the most severe effects of HIV/AIDS denialism. President Thabo Mbeki, who began his term as president in 1999, was an HIV denier. He believed that HIV didn’t cause AIDS, motivated by a political dislike of the West’s science, and pushed out negligent HIV/AIDS policies. He “delayed launching an antiretroviral (ARV) drug program, charging that the drugs were toxic and an effort by the West to weaken his country”.
Mbeki also halted government programs that focused on preventing mother-child transmission, including the administration of drugs such as nevirapine. As a result, a shocking 330,000 babies died prematurely in South Africa between 2000 and 2005 from HIV/AIDS. The health minister at the time also continuously promoted herbal remedies, specifically beetroot, garlic, and lemon, instead of advocating for scientific treatments.
By the time Mbeki went into office, 20% of adults in South Africa already had HIV/AIDs. This percentage only grew during Mbeki’s time in office, decreasing only once Mbeki’s successor pushed for massive antiretroviral therapy campaigns to address the HIV/AIDS epidemic. Though this campaign was highly effective, it was too late to address the issue. Transmission rates have decreased but still remain high despite this campaign, with a 19% adult HIV prevalence still being reported as of 2019. What happened in South Africa remains a lesson to the rest of the world about early action in controlling epidemics and the dangers of denying science.
The HIV/AIDS epidemic hasn’t ended and it's important to keep the discussion going about the current state of the virus. However, it is equally as important to continue looking back at this epidemic and learning from past mistakes to address HIV/AIDS and even creating parallels with the current COVID-19 pandemic. Breaking down the culture of medical denialism is something that starts with education and remains an important issue to continue addressing in the modern-day.
Medical Denialism in the Era of HIV
Sad I didn't know about denialism. But HIV/AIDS research and medication has come a long way, thank goodness.
This is such an informative and interesting post! I wish everyone could come to together and fight HIV like they are with COVID. Thank you for sharing.
Soffy / https://alittlecupofus.com/