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DOI 10.1007/s12111-009-9098-1
BOOK REVIEW

Seth Kalichman, Denying AIDS: Conspiracy Theories,


Pseudoscience, and Human Tragedy
New York: Copernicus Books/Springer Science+Business
Media, 2009, 205 Pp, $25.00, ISBN: 978-0-387-79475-4

Anthony Lemelle

# Springer Science + Business Media, LLC 2009

Seth Kalichman (University of Connecticut) contributes a groundbreaking analysis


of the way some have denied the realities of AIDS. AIDS denial appears in different
forms from different segments of the population. However, Kalichman’s most
impressive accomplishment is to have globally understood the denial discourse. By
doing so, he joins with other major scholars like Cindy Patton, Inventing AIDS, and
Jacob Levenson, The Secret Epidemic: The Story of AIDS and Black America, in
offering a political sociology of postmodern fragmentation, dislocation, and perils of
struggles with life and death in the time of AIDS. The big lesson in this context is
that decisions made in one geographic region and at a given time has consequences
around the globe. Decisions affect others even when the global west makes
decisions; they affect the developing global south.
Denying AIDS includes six chapters. Chapter 1 develops the persistence of the
denial of science problem. In brief, there has been scientific history demonstrating
that the Human Immunodeficiency Virus (HIV) is the cause of AIDS. In addition,
science shows that exchange of bodily fluids transmits the virus. Moreover, social
and behavioral sciences have determined HIV more likely transmits under conditions
where the virus is prevalent, and where anal and vaginal sex and sharing hypodermic
needles are prevalent. In spite of this, many commentators about AIDS claim that
HIV is not the cause of AIDS and that the transmitting conditions are not
determinative. For example, some have suggested that lifestyle and poor environ-
mental conditions cause the body’s inability to resist disease. Others add to such
claims by suggesting that a class of individuals have an economic incentive for
demanding the HIV-as-cause narrative since those social strata gain profits from the
AIDS services industry.
One of the first to deny the HIV cause was physician Peter Duesberg. Chapter 2
presents succinct commentary on Duesberg’s biography and his declarations that

A. Lemelle (*)
Department of Sociology, John Jay College of Criminal Justice, 899 Tenth Ave., Rm. 520T,
New York, NY 10019, USA
e-mail: alemelle@jjay.cuny.edu
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HIV is not responsible for AIDS. Duesberg questioned clinical and epidemiological
findings that the mainstream medical community largely accepted. For example, he
castigated homosexuality and argued its lifestyle caused assaults on the immune
system from which it could not recover. In one instance, Duesberg proffered that
nitrate inhalants (poppers) used by some males who have sex with males to enhance
and prolong orgasm was a major culprit alone with malnutrition and stressful
partying lifestyle. Kalichman connects the Duesbergian narrative to an eventual
argument made by former South African president Thabo Mbeki of the African
National Congress party. President Mbeki questioned the HIV link to AIDS,
discussing instead the ravages of poverty and malnutrition in certain African
geographies marked by concentrated poverty. In response, Kalichman argues:
The annual number of registered deaths in South Africa rose by 87%, again
this was during a time when poverty rates were declining. Among those aged
25–49 years, the rise in deaths was 169%. Although more people may have
died simply because population growth was also occurring, population growth
is not a plausible explanation for the greatest increase in deaths occurring
among young people. In 1997, 25–49 year olds accounted for 30% of all
deaths, whereas in 2005 42% of all deaths occurred in this age group. These
population based statistics clearly support the corresponding HIV prevalence
statistics and reflect HIV as the obvious cause of AIDS. (pp. 126–127)
Chapters 3–5 take a closer look at denialism in science, journalism, and politics.
Chapter 6 presents Kalichaman’s prescription for combating denialism. He
recommends that we all become dissidents rather than denialists. For him, “a
dissident means listening to all sides and weighing the evidence” (p. 160). This
recommendation may prove to be naïve. Kalichman understands this since in this
chapter and his epilogue he admits denialism will not go away.
The Centers for Disease Control and Prevention (CDC) published the following
language:
According to the 2000 census, blacks make up approximately 13% of the US
population. However, in 2005, blacks accounted for 18,121 (49%) of the
estimated 37,331 new HIV/AIDS diagnoses in the United States in the 33
states with long-term, confidential name-based HIV reporting. Of all black men
living with HIV/AIDS, the primary transmission category was sexual contact
with other men, followed by injection drug use and high-risk heterosexual
contact. Of all black women living with HIV/AIDS, the primary transmission
category was high-risk heterosexual contact, followed by injection drug use.
Of the estimated 141 infants perinatally infected with HIV, 91 (65%) were
black (CDC, HIV/AIDS Reporting System, unpublished data, December
2006). Of the estimated 18,849 people under the age of 25 whose diagnosis
of HIV/AIDS was made during 2001–2004 in the 33 states with HIV reporting,
11,554 (61%) were black. (Centers for Disease Control and Prevention.
Revised August 2008)
In addition, one CDC study reported that among young African American men
who have sex with men, 46% are HIV infected (Centers for Disease Control and
Prevention 2005). The evidence is clear that most of the incidence among African
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American males is in men who have sex with men. Among African American
women, the most incidence is in those with injection drug use and abuse and
heterosexual sexual partners. Nevertheless, the interesting thing is that the trend line
for African American infection is on the increase and the trend line for Euro
American infection is on the decrease.
Why then have so many decided to focus on infections in the developing world,
the global south, while interest in U.S. infections decline? One answer to this
question is that Kalichman’s analysis of HIV-related denials only scratches the
surface. For example, there are two longstanding HIV-related denials. One is the
denial of substantive differences among racial and ethnic groups that create different
conditions for infections and require different prevention intervention strategies.
Another is the denial that structural power over the governance of HIV/AIDS
services industry could change; strategies to share HIV intervention prevention
decision-making power with communities of color could easily find implementation.
The CDC has done a great deal of work on health disparities vis-à-vis HIV. For
example, it diffused scientific based interventions. Among some of the leading
interventions is SISTA (Sisters Informing Sisters about Topics on AIDS). The aim is
to inform African American women about social-skills and it uses peer facilitators
among highest risk groups to reduce their risky sexual behaviors. Another is Many
Men, Many Voices (3MV), an STD/HIV prevention intervention for gay men of
color. POL (Popular Opinion Leader), identifies, enlists, and trains key opinion
leaders to encourage safer sexual norms and behaviors within their social networks.
Most of these interventions are translations of ones that white gay males used when
their populations were in crisis. While all of the scientific based interventions have
shown experimental effectiveness, the overall incidence and prevalence continues to
escalate among African Americans. In addition, practices associated with dominant
group authorization of credentials before professionals join the conversation and
influence decisions might preclude creative thought necessary for researchers to
conceive of more prevention that is effective. Such exclusionary practices and
denials would affect the spread of HIV among African Americans and Levenson
chronicled some of this history in The Secret Epidemic (2004).
HIV researchers could make greater effort to diversify their institutes, centers,
cores, and programs. Once they accomplish diversification, they could treat their
minority colleagues with respect and deference. To do so, it would be necessary for
them to seek diversity in thought among the minority colleagues. For example, they
could seek scholars that hold terminal degrees in social and behavioral sciences who
are also men who have sex with men and are HIV positive. These men likely know
the terrain where HIV transmission happens among African Americans. Such
scholars could bring a great deal to the table when it comes to denials. For example,
they might caution scholars not to engage in name-calling. Moreover, they might
stress the importance of avoiding condescending talk, particularly when they are
members of a group that conquered the minority group where the spread is
significant. Finally, they would likely ask research questions that members of
exogenous communities and cultures might not typically consider.
Kalichman’s book is a major accomplishment. He points us in the direction where
our work must go next. We must do as he recommends, confront our denials
knowing that we will never conquer them. However, we are capable of
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implementing harm reduction structures that require our work is evidence-based


knowledge. As far as AIDS is concerned, HIV causes it and under certain
conditions, it spreads more than it does under other conditions.

References

Centers for Disease Control and Prevention. (2005). HIV prevalence, unrecognized infection, and HIV
testing among men who have sex with men—five U.S. Cities, June 2004–April 2005. Morbidity and
Mortality Weekly Reports, 54(24), 587–601. Retrieved May 30, 2009 (http://www.cdc.gov/mmwr/
preview/mmwrhtml/mm5424a2.htm).
Centers for Disease Control and Prevention. Revised August 2008, “Fact Sheet: HIV/AIDS among African
Americans”, Retrieved May 30, 2009 (www.cdc.gov/hiv/topics/aa/resources/factsheets/aa.htm).
Levenson, J. (2004). The secret epidemic: The story of AIDS and Black America. New York: Pantheon
Books.