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PETER B. TODD
Kalichman, Seth. (2009). Denying AIDS: Conspiracy theories, Pseudoscienceand Human Tragedy. New York: Copernicus Books, Springer Science Imprint, pp.205, ISBN:9780387794754. Seth Kalichman's timely book exposes the destructive shadow of AIDS denialism in the manifest guises of pseudoscience and politics with candour and ludicidity. The homophobia and racism implicit in such denialist positions are unmasked in conjunction with obfuscation of such distinctions as those between necessary and sufficient conditions in determining the causality of HIVjAIDS. Like holocaust deniers, those who create doubt about whether HIV causes AIDS can be held accountable for much of the morbidity and mortality, especially in the developing world. As an account of the history of the HIVjAIDS pandemic and for consciousness raising, the book is an important contribution. Especially perhaps for those scientists and policy makers whose denial still results in the wish-fulfilling fantasy that HIV as one of the fasting evolving of all organisms is no longer a globally salient threat. As Kalichman himself acknowledges in his book, the adaptive mutation of HIV, together with mutant strains of tuberculosis, is a menace to the lives of millions of people. The analogy between holocaust and AIDS denial seems to me to be a particularly valid one. Kalichman dearly distinguishes between defensive denial of traumatic realities such as HIV seropositive status and mortality which can be construed as a short term coping strategy which is maladaptive in the long run and denialisrn, As a psychological defence, denial results in delay in seeking available treatments which are evidence based and other
destructive behaviour patterns such as engaging in unprotected sex. Exposing the HIV seropositive person to more virulent strains of the virus and others to infection. Denialism promotes myths and such malignant misinformation as Virologist Peter Duesberg's refuted daim that HIV is a "harmless" passenger virus which does not cause AIDS. Such denialism facilitates individual and collective defensive denial in vulnerable populations as do the spurious notions of AIDS causation associated with Duesberg and former South African President Thabo Mbeki who was metaphorically seduced by the Berkeley virologist who, incidentally, had never conducted HIVjAIDS research himself. These events, conspiracy theories, pseudoscientific intrigue and the need to debunk AIDS myths are explored at length in the first three chapters of Kalichman's book. These chapters may help to dispel the myth that empirical scientific inquiry is immune to contamination by extra scientific influences, induding those of an ideological and personal nature as well as homophobia and racism in the HIVjAIDS field. Briefly put, two groups became the proponents and opponents of the Durban Dedaration published in the journal Nature in July 2000. This paper was a response to an argument originally published by Peter Duesberg in Science twelve years earlier, provocatively titled "HIV is Not the Cause of AIDS". By the time of the XIII AIDS Conference in July 2000, South African President Mbeki had convened a panel induding many of the more prominent AIDS dissidents to fuel the controversy with mass media coverage. In an attempt to put down the revolt, 5,228 eminent medical and scientific signatories (induding a number of Nobel Laureates) to
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the Durban Declaration affirmed that on the basis of "exhaustive and unambiguous evidence, HIV is the cause of AIDS". Having been virtually excommunicated by scientific orthodoxy, Duesberg eventually acknowledged that his hypotheses had neither been empirically tested nor published in peerreviewed journals (Todd, 2007). Two of the criteria referred to by Kalichman as essential to scientific theories rather than pseudoscientific notions masquerading as science. Duesberg's claims had not run Popper's "gauntlet of scientific criticism" including the falsifiability criterion. As a professor of Psychology at the University of Connecticut, Kalichman has, I believe, traced the origins and explored the perhaps unintended consequences of AIDS Denialism meticulously. He has also provided a valuable elucidation of the distinction between dissidence resulting in Kuhnian paradigm shifts or scientific revolutions in explanatory theories on the one hand and pseudoscientific obscurantism on the other hand. This additional piece of illuminating writing renders the book even more worth reading for philosophers of science and researchers alike. However, one criticism of Kalichman's treatment of causality that I would offer is that it seems to lack any account of contemporary, multifactorial or biopsychosocial models of disease. In particular research into psychosocial factors, induding denial of HIV seropositive status, internalized homophobia, shame, depression, guilt and self reproach as responses to bereavement, as predictors of behaviour relevant to the risk of HIV infection and illness progression. Todd (2008, 2009) has attempted to provide a comprehensive account of relevant empirical research for social scientists, educators and health professionals working in the HIVjAIDS field. The conclusions are that in such areas as psychoneuroimmunology, a need exists for further prospective, longitudinal studies. Controlling for such confounding variables as substance misuse and stage of illness at the commencement of research with sample sizes large 130
enough to optimize statistical power. The simultaneous analysis of psychosocial factors, biological mediators including neuroendocrine, cytokine and immune system variables and HIV progression remains an important issue for future research. Far from being a harmless passenger virus, HIV transforms CD4+ T cells into destructive, narcissistic clones of itself through reverse transcription
Formerly research psychologist, School of Surgery, UNSW, then Neuropsychiatric Institute, Prince Henry Hospital, Sydney, then member, Biopsychosocial AIDS Project, University of California, San Francisco, USA, then Consultant, Department of Immunology, St. Vincent's Hospital, UNSW and Research Coordinator, Albion Street AIDS Clinic, Sydney. Currently, psychologist and psychotherapist in private practice. Email: Dto49976@bigpond.net.au
Todd, P.B. (2007).The neglected holocaust. Griffith Review, 16, 195-202. Todd, P.B. (2008). The psychoneuroimmunological database for psychological interventions in HIV infection. Gay & Lesbian Issues and Psychology Review; 4, 141147. Todd, P.B. (2009). Unconscious mental factors in HIV infection. Mind and Matte,", 6, 193-206.