|Should I get PEP
Mar 7, 2008
Dear Dr. Frascino,
I had sex earlier this evening with my HIV positive friend and performed unprotected oral sex on him for a long while (maybe 10 minutes), during which the head of the penis touched the back of my throat several times. He didn't cum in my mouth, but he had a lot of precum. About fifteen minutes afterwards, I tasted blood in my throat and remembered that I've had a slight cough/scratchiness in the throat for months--I've had it so long that I forgot about it. It's been a few hours now since we had sex, and I'm reading about PEP. Do you recommend it for this exposure? I don't know which drugs my friend is on. Should I ask him for a dose and see a doctor tomorrow?
Thank you for answering the other question I asked you about Gary Null. With your help I was able to convince my friend not to stop using condoms and not to stop his meds. I read about your foundation and made a donation about a week ago.
Thanks for your help.
| Response from Dr. Frascino
This unfortunately is one of those gray areas where there is no complete back or white type answer. Generally speaking, PEP in this situation could be offered, but would not be recommended. So what does "offered but not recommended" mean? Good question! Glad you asked. Basically it means your HIV risk is exceedingly low, but not completely nonexistent, and that the risk of taking PEP would outweigh such a minimal risk. However, since we know that your partner is confirmed to be HIV positive and that there may have been some trauma to the back of your throat with possible bleeding, the potential risk of viral transmission exists. Some patients who are extremely anxious about any degree of potential or even theoretical risk of acquiring HIV may opt for PEP, despite the inconvenience, cost and risk of side effects/toxicities associated with it. Others may assess the risk-benefit ratio and decide to forego PEP in favor of HIV testing only. Each case needs to be evaluated individually. Personally, if you arrived at the Frascino Medical Group, we would take a more detailed history before providing you with our opinion. For instance, we would want to evaluate the degree of oral trauma from the tonsil hockey-penis Popsicle event and also any throat problems resulting from some chronic infection/inflammation that might have made viral transmission more likely. Second, we would try to determine if the owner of the penis Popsicle knew what his viral load was. If the plasma HIV viral load is suppressed on antiretroviral medications to the undetectable level, the risk of HIV transmission decreases significantly. So if for instance his penis did just "touch" the back of your throat and his HIV viral load is undetectable, we would suggest you forego PEP. On the other hand, if he had listened to Gary Null, stopped his HIV mediations and had a sky-high viral load and if you sustained some throat trauma or inflammation, we would encourage a course of PEP. I hope that helps. If still in doubt, you can check with a local HIV specialist who I am confident would proceed with an evaluation similar to what I described above. You might even check with the penis Popsicle's doctor. He would already know the answer to the viral load issue and perhaps be willing to follow you if PEP is undertaken.
Finally, I'll reprint the Gary Null post for the edification of our readers.
The Gary Null approach!!!! Sep 2, 2007
Iam wondering what is yur thoughts on Gary Nulls approach.
Response from Dr. Frascino
My thoughts about Gary Null and his approach haven't changed. See below.
My HIV+ friend believes AIDS denialist, Gary Null Apr 12, 2007
He recently attended a Gary Null seminar (delivered before a full auditorium) and says he is convinced that HIV is not sexually transmissable, AIDS has nothing to do with HIV, and that his medication is a hoax created by the pharmaceutical industry. Reinforcing these fantasies are three facts: 1) At one time, he stopped taking his meds for two months and showed no sign of relapse (the same meds that had originally brought him back from the brink of AIDS). 2) His girlfriend at the time he was diagnosed wasn't infected (his viral load at the time was extremely high, and they had tons of unprotected sex). 3) The pharmaceutical industry is driven by greed and has influence over what doctors prescribe. My friend is 34, so he went to school before they started teaching kids what is known so far about HIV. He didn't take school seriously, didn't go to college, never reads, so he may not be equipped to recognize a fake scientific argument. I tried to talk the issues over with him, but the conversation didn't last long before he told me that if I want to remain friends with him, I will never talk to him about it again. I referred him to TheBody.com's section about AIDS denialists, but I'm afraid that even if he does take a look at it, it won't do much good. Everything I've read so far in that section has been written for an audience that has already considered and rejected denialism. He likes this website, though, and your forum especially. Could you please explain to him, not to me, why Gary Null's argument amounts to nothing? I know that responding to denialists is probably not your favorite thing, but I'm concerned about my friend and anyone else with HIV who isn't savvy enough to spot a fake. Denialists may not earn the respect of the scientific community, but they are appealing to people who want desperately to believe that they're not going to get AIDS.
Response from Dr. Frascino
If indeed your friend likes my forum, he must then realize I am HIV positive, the direct result of an occupational needle stick and laceration I sustained while performing a medical procedure on a patient with advanced-stage AIDS in January 1991. This was documented by serial HIV tests that demonstrated my seroconversion from HIV negative to HIV positive. This experience alone completely negates Gary Null's (and all AIDS denialists') fantasies about HIV/AIDS. Gary Null is an opportunist, not a scientist. I'm sure there is a special place in Hell reserved for folks like Mr. Null who willfully promote myth to make a profit, all to the detriment of desperate individuals in search of hope and/or driven by fear.
I'll reprint a few articles that discuss Mr. Null's lunacy. If your friend continues to believe fantasy over fact, he does so at his own risk. You can lead a horse to water, but getting him to do a backstroke is another thing altogether.
Critical Look at Gary Null's Activities and Credentials Stephen Barrett, M.D.
Gary Null (1945 ) is one of the nation's leading promoters of dubious treatment for serious disease. He hosts radio and television talk shows; writes books and magazine articles; delivers lectures; and markets products through his Web site. According to an article in East West magazine, Null became interested in nutrition during his twenties while working as a short order cook in New York City, where he now resides. He researched the subject and wrote The Complete Guide to Health and Nutrition, which was published in 1972 and sold briskly after Null appeared on a succession of prominent talk shows. He began hosting radio shows around that time and eventually got his own show on WABC, the flagship radio station of the ABC network. Later he moved to WMCA, which broadcast Null's show on Sunday nights to many stations across the United States. For many years, he also hosted a daily show on WBAI and a Sunday evening program on WEVD in New York City. I have been tracking his activities since the mid-1970s.
Null is prone to see conspiracies behind many of the things he is concerned about. One of his targets has been the pharmaceutical industry, which, he says, "cannot afford to have an alternative therapy accepted." He promotes hundreds of ideas that are inaccurate, unscientific, and/or unproven. He calls fluoridation "deadly" and has spoken out against immunization, food irradiation, amalgam fillings, and many forms of proven medical treatment. His series on "The Politics of Cancer," which was published in Penthouse magazine in 1979 and 1980, promoted unproven methods that he said were being "suppressed" by the medical establishment. His lengthy series, "Medical Genocide," began appearing in Penthouse in 1985 with an article calling our medical care system a "prescription for disaster" and claiming that modern medicine has had virtually no effect on heart disease, cancer, and arthritis . Other articles in the series promoted chiropractic and homeopathy, claimed that effective nutritional methods for treating AIDS were being suppressed, claimed that chelation therapy was safe and effective for treating heart disease, and endorsed several treatments for cancer that the American Cancer Society recommends against. His Web site contains a huge amount of misinformation and bad advice.
Over the years, Null has marketed a variety of supplement products. In the mid-1980s, his catalog included: Guard-Ion (an antioxidant formula claimed to help protect athletes from free radicals the body can't control), Gary Null's AM-PM Vitamin-Mineral Formula (a "revolutionary breakthrough in vitamin preparation" that provides the nutrients needed at the best times for the body's anabolic and catabolic activities), Candida Complex (to bolster the body's defenses against yeast infection), Endurance Factor (containing "all the nutrients and enzymes that have made Bee Pollen famous"), Energy Plus (a royal jelly tablet), Rebalancer (a "cleansing formulation" for adults exposed to air pollutants, pesticides, or preservatives, or who have "internal metabolic imbalances"), CoEnzyme Q10 ("may reverse deficiencies and improve organ function, especially in the heart), Sport DMG (an N,N Dimethylglycine product to "improve cardiovascular function and to enhance the body's natural immune response system), and Gary Null's Immune Nutrients ("to nourish and stimulate immune function, not merely at a marginal level of preventing disease and degeneration, but a positive level of striving for wellness and excellence, for optimal health"). A 1991 flyer distributed at Null's booth at a health expo described Null's annual "Spring Cleansing, Rebuilding, Stress Reduction Program" at a ranch near Dallas, Texas. The week-long program included aerobic exercise, various sports activities, a fitness assessment, beauty and skin-care treatments, cooking classes, acupressure, applied kinesiology, herbal body wraps, massage, brain-wave stimulation, facials, aromatherapy, reflexology, and loofah apricot scrubs. Null sold the ranch in 1994 . In 1992, Null appeared in a bee pollen infomercial whose producers subsequently were prosecuted by the Federal Trade Commission. During the program, Null falsely claimed the human body ages because it doesn't produce enough enzymes, and that "you can't get any better food than bee pollen" because it is "loaded" with enzymes," but the FTC did not charge him with wrongdoing. According to the infomercial company's president, the interview was taped for another purpose, was dubbed into the infomercial without Null's knowledge or consent, and was deleted from the infomercial after Null demanded its removal .
Null's recent offerings include the followingeach followed by a bracketed comment from me:
Brainy II"Power packed with Phosphatidyl Serine, herbs, amino acids, anti-oxidants and B-vitamins to help you achieve optimal brain function." [How has he determined that the product can help people improve brain function?]
Anti-Aging Program"Every flavorful sip of the "Aromatic Shake" contains seven of my most successful formulas for promoting age-reducing properties directed at maintaining nutritional and total wellness. [What is an age-reducing property? What is total wellness? Can any product maintain total wellness?]
Detox Formula"A gentle, highly comprehensive balance of botanicals used in traditional Western and Asian herbal systems to aid the body in its internal cleansing" [What is "internal cleansing"?]
Eternal Herbal Supplement"A potent rebalancer and herbal tonic for both men and women." [What gets "rebalanced"? How can people tell whether they are "out of balance"?]
Gary's Green Stuffthe product of the low temperature dehydration of green chlorophyll-rich foods that are also sources of phytonutrients, essential fatty acids, amino acids, anti-oxidants and trace minerals. Available in powder or capsule form. Awarded a Seal of Approval from the Diabetes Resource Center. [People can and should get the phytonutrients they need from foods. Chlorophyll has no health-related value for humans . The Diabetes Resource Center , which was operated by a woman who had no health-related credentials, ceased operations in 1998.]
Null-Trima powdered mix containing protein from both soy and rice sources, carbohydrates and other nutrients such as guar, chromium, gamma oryzanol and lipoic acid which make this formulation ideal for weight loss or exercise programs. [I see nothing among the ingredients that I believe is useful for weight-loss or exercise programs.]
Null says he holds an associate degree in business administration from Mountain State College in West Virginia, a bachelor's degree from Thomas A. Edison State College in New Jersey, and a PhD in human nutrition and public health sciences from The Union Institute in Cincinnati, Ohio. Two papers he co-authored during the early 1980s identified him as Gary Null, M.S," but I have seen no information about the source of that credential.
Edison State is a "nontraditional" school with neither campus nor courses. It is accredited but awards accredited bachelor's degrees based on career experience, equivalency exams, and courses taken at other schools. In the late 1980s, a prominent college guidebook described it this way:
Thomas A. Edison State College, established in 1972, administers an external degree program that enables qualified students to earn or work toward a college degree without attending college in the usual way. There is no resident faculty, no campus, no classrooms, and no library. Administrative officers in Trenton evaluate college-level learning achieved through work or life experiences, self-study, college courses taken previously, industry-sponsored education programs, military instruction, etc. The college administers its own examinations in the liberal arts and sciences, business, and radiologic technology under the Thomas Edison College Examination Program .
The Union Institute is also accredited, but its degree requirements and standards for health-related doctoral degrees differ greatly from those of most traditional universities. Students design their own program, form and chair their own doctoral committee, and are required to attend only an introductory colloquium and a few interdisciplinary seminars. Null's thesis, entitled "A Study of Psychological and Physiological Effects of Caffeine on Human Health," was approved in in August 1989. The approval document states that his PhD committee was composed of a "core faculty member," three "adjunct professors," two "peers," and a "second core reader." The "core faculty member," Peter Fenner, was a well-credentialed academician whose expertise (in geologic sciences) was not related to Null's topic. One of the three "adjunct professors" was Martin Feldman, MD, a "complementary" physician (and "clinical ecologist") who has pinch-hit for Null as a radio host, and helped develop some of Null's books and supplement formulations. The other two were Philip J. Hodes and Elayne Kahn. When I asked a school official about their background or location, he replied that information was in storage and was too difficult to obtain. In 2005, I located mention of "Dr. Philip Jay Hodes, Ph.D, Ed.D., Practitioner Holistic, Health Detoxification & Orthomolecular Nutritionist, Consultant" on a Web site that sells "natural tropical herbal medicines."  I also discovered that Elayne Kahn is a psychologist in New York City who coauthored a book with Null that was published in 1976 .
Traditional universities require that research for a doctoral degree in a scientific discipline make a genuine contribution to the scientific literature. Null's thesis made no such contribution. The stated purpose of his project was to evaluate (a) caffeine's effects on "adrenal function determined by a medical examination," (b) "its perceived psychological effects as recorded in a questionnaire and daily diary, and (c) "the anabolic effect of caffeine according to a theory proposed by Dr. E. Revici." (Emanuel Revici, MD, was a physician in New York City whose methods were disparaged by the American Cancer Society. State licensing authorities placed Revici on probation in 1988 and revoked his license in 1993 after concluding that he had violated the terms of his probation.) The first part of Null's thesis summarized information about caffeine published mainly in scientific journals. The data for the report of his study were obtained by observing two groups of volunteers. One group contained eleven chronic caffeine users who stopped their caffeine intake for a week and then took caffeinated tea for a week. The other group contained six nonusers who drank caffeinated tea for one week and then drank decaffeinated tea. The total number of participants is unclear. Null's thesis states that six others who began in the first group and five others who began in the second group dropped out of the study because they were uncomfortable. It also states that "at least thirteen" other users were disqualified for noncompliance.
The "medical evaluation" included two tests. One compared each volunteer's blood pressure when lying down and when standing up. The other was a chemical test for the amount of sodium and chloride in the urine. Null claims that these tests can detect "diminished adrenal function." Unfortunately for his thesis, they have no practical value for this purpose. The method Null used to determine "the anabolic effect of caffeine" involved measurement of the specific gravity, pH (acidity), and surface tension of single samples of the urinea test used by Revici. Null noted that the theory behind the test "is still the subject of debate and has not yet gained wide scientific support"which is a rather strange way to describe a test that is utterly worthless for any medical purpose and could never gain widespread scientific acceptance. The specific gravity of urine reflects the concentration of dissolved substances and depends largely on the amount of fluid a person consumes. The acidity depends mainly on diet, but varies considerably throughout the day. Thus, even when these values are useful for a metabolic determination, information from a single urine sample would be meaningless. The surface tension of urine has no medically recognized diagnostic value.
Following 41 pages of findings, calculations, tables, and graphs, Null concluded that "chronic caffeine users tend to have diminished adrenal function, which he blamed on "exhaustion" of the glands. "Fortunately," he added, "there are non-drug nutritional programs which have the ability to repair or rebalance weakening adrenal glands toward normal." The program consisted of "diminishing stressors," implementing strategies to diminish anxiety, and taking doses of five vitamins and three other products. In January 2005, I received a threatening letter from attorney David Slater, General Counsel for Gary Null & Associates, Inc., who demanded that I remove a previous version of this article from Quackwatch. One part of the letter complained:
You also attack Mr. Null's Ph.D. thesis, written over 25 years ago, on the negative effects of caffeine on human health. You say that it "contributes nothing." Despite your assertion that the thesis was meritless, two updated versions of the paper were accepted for publication in the Journal of Applied Nutrition (Volume 33, No.1, 1981) and the Journal of Orthomolecular Psychiatry (Vol. 13 1st Quarter 1984). We understand that only a small percentage of Ph.D. theses are actually accepted for publication in a peer reviewed scientific journal, and Mr. Null's thesis was published in two different ones. Moreover, Mr. Null's original clinical and laboratory work demonstrating the deleterious effects of caffeine on the human body became a catalyst for subsequent research on the topic by other scientists. Based on his original findings about caffeine, Null's advocacy against caffeine has now become a major public health position. Accordingly, it is inaccurate for you to state that Mr. Null's Ph.D. thesis about caffeine contributed "nothing." 
After comparing the articles to Null's PhD thesis, I made the following observations:
Since Null's thesis was published in 1989, I don't see how "updated versions" of it could have been published in 1981 and 1984.
The 1981 and 1984 articles have multiple authors [9,10]. Null is not listed as lead author of either one. The papers give no indication of who contributed what to the paper.
The 1981 article was a summary of published information about caffeine that was similar to the summary in Null's thesis.
The 1984 article reported a study of 11 volunteers which is similar to the one reported in Null's thesis. It is not clear whether the thesis was based on the same data or whether Null did a second study.
Neither journal has much of a reputation. As far as I can tell, neither one is indexed by MEDLINE.
My MEDLINE search for "Null G" found only one article that was coauthored by Null and appeared in a pharmacy magazine . When I asked Slater to clarify the time frames and to tell me where Null got the "M.S." degree listed after his name in the articles, he replied: "My client has instructed me to cease all further communications with you. He repeats his demand that you remove the offensive and libelous material from your website or face legal action." 
Additional questions remain. Has Null completed any science-based courses related to nutrition and public health? If so, (a) what did he take, (b) when did he take them, (c) did any of them involve classroom attendance, and (d) were any of them related to his degrees? I also wonder when he enrolled in The Union Institute. In response to these questions, Slater replied that Null will not provide further information about his transcripts, coursework, or other details related to his degrees and that he regarded my request as intrusive and an invasion of his privacy . Why do you suppose he said that?
References 1. Null G. Prescription for disaster. Penthouse Magazine, Sept. 1985.
2. Slater DM. Letter to Dr. Stephen Barrett, Jan 25, 2005.
3. Barrett S. Gary Null and the bee pollen infomercial. Quackwatch, March 1, 2005.
4. Lowell JA. Amazing claims for chlorophyll. Nutrition Forum, May 1987.
5. Barrett S. The Diabetes Resource Center: What does it's "seal of approval" mean? Quackwatch, Feb 4, 2005.
6. Peterson's Four-Year Colleges, circa 1988.
7. Yodel Inc. Home Page, accessed March 3, 2005.
8. Null G, Kahn E. Wholebody Health and Sex Book. New York: Kensington Publishing Corp., 1976.
9. Bolton S, Null G, Pressman AH. Caffeine: Its effects, uses and abuses. The Journal of Applied Nutrition 33(1):3553, 1981.
10. Bolton S, Feldman M, Null G, Revici E, and Stumper L. A pilot study of some physiological effects of caffeine. Journal of Orthomolecular Psychiatry 13(1):3441, 1984.
11. Bolton S, Null G, Troetel WM. The medical uses of garlic: fact and fiction. American Pharmacist Aug 1982, pp 4043.
12. Slater DM. E-mail message to Dr. Stephen Barrett, March 2, 2005.
Quack record Bestselling health and fitness guru Gary Null weighs in on AIDS. Almost all of what he says is useless, dangerous and just plain wrong. By Peter Kurth May 21, 2002 | Before I get down to discussing Gary Null, Ph.D., and his massive, irresponsible and nearly unreadable book, "AIDS: A Second Opinion," I need to confess my bias. I've been infected with HIV for a long time -- since 1983, by my own calculation. For 13 years, since I first discovered my sero status, I've been taking anti-retroviral medications, the so-called AIDS cocktail, in various strengths and combinations. I haven't been off the pills in all that time. Apart from neuropathy in my hands and feet, I'm in good health, with no detectable virus and T-cells in the normal range -- in other words, my immune system is functioning as it should. By contrast, a friend, infected for as long as I've been, died a few days ago of "AIDS-related complications." This was someone who worked out, lifted weights and once walked the length and breadth of the state of Vermont to raise money for AIDS and prove he could do it. In recent years, two sero-positive friends have dropped dead of heart attacks after embarking on healthful, "life-enhancing" diet and exercise regimes. I can't be impartial about Gary Null's book. I am also not an idiot, which I think Null takes me for.
Null -- a nutritionist, lecturer, broadcaster, "educator" and "one of America's leading health and fitness writers and alternative practitioners," according to his publicity -- is the author of more than 100 books, treatises and tracts on stress-free living, anti-aging, proper eating, "springtime cleansing," "lifetime dieting," "healing with magnets," "juicing," weight management and "life changes." Gary Null, Ph.D., isn't just a man but an industry, whose Web site offers for sale not just "Gary Null's Friendly Fiber" -- "easy come, easy go" -- but a whole Sears catalog of pricey Gary Null products ("Gary's Incredible Green Stuff!" "Great New Videos Every Week!"), along with live chats, sermons, Web links and Null's philosophical musings on "world issues." In addition to his role as a fitness guru, Null is the kind of pop-psych P.T. Barnum, never absent in a crisis, who will "help you find answers" to those really tough questions: "What rules don't I want to obey anymore?" "Who in my life is toxic?" "What can I do without a lot of money?" (Answer: "Pay attention to the oft-ignored simpler, non-materialistic side.") He's also a longtime AIDS denialist, or "dissident," as they're called, part of a loose fraternity of scientists, patients and (mainly) quacks who insist that AIDS is a false epidemic; that HIV either doesn't cause it or doesn't really exist; that the medications normally taken to fight the virus are pure poison, foisted on a frightened population by the pharmaceutical industry -- and other claims, not all of them wacky, along this basic line. Generally, an AIDS dissident is one who rejects the accepted formula "HIV=AIDS" and proposes an alternative model -- and thus alternative treatments -- for a condition many doctors and their infected patients are now routinely calling "HIV disease." Null himself has been beating the anti-AIDS drum since at least 1994, when he wrote a column for Penthouse magazine titled "AIDS Is Not a Death Sentence," and introduced four "survivors" with stories of natural healing -- one through "hypothermia," another with "bitter melon," a third "holistically" or with dinitrochlorobenzene (DNCB), a briefly faddish "immunity booster," long ago proved, like the others, to be useless in defeating the virus. None of these therapies can be demonstrated to have worked for anyone. Then as now, Null subscribed to a discredited "cofactor" theory of AIDS, which held that HIV couldn't and wouldn't spread far beyond the high-risk groups in which it was first observed -- intravenous drug users, homosexual men pursuing "a promiscuous, fast-track gay lifestyle," hemophiliacs and others unlucky enough to have needed "blood transfusions and blood-factor products," people whose immunity, Null baldly asserts, is likely to be compromised in the first place. "Unfortunately," Null reported in Penthouse, "both blood transfusions and such products as Factor 8, taken by hemophiliacs, can cause immune suppression and make one more susceptible to any infection, including HIV." There was no knowing at the time he wrote the column how the burden of infection worldwide would shift increasingly to women, or how many healthcare workers, with one hapless prick of the needle, would experience the same course of illness as any promiscuous, fast-track lowlife. But now we do know, and Null still hasn't changed his tune. In last year's primer, "Seven Steps to Perfect Health," Null recommended what he does to everyone, all the time, whether or not they're infected with a killer virus: a strict vegetarian diet; no processed foods; no dairy products, sugar, preservatives, coffee, tea or cola, etc.; multiple glasses every day of fresh fruit or vegetable juice -- preferably squeezed from a $249.95 "Gary Null Juicer"; whole grains; nuts; seeds; seaweed; enemas; exercise; stress reduction and "pure water," without fluoride or any other chemicals in it. You might want to look at your "environment," too, Null suggests, for dust, mold and the residue of poisonous household cleansers. But above all, "embrace change," get rid of those cynical, "toxic" attitudes and move forward to your goal! Next page: No scientist will read it except to mock or dismiss it Now, in "AIDS: A Second Opinion," Null promises "to bring both establishment and dissenting views of the AIDS crisis into one volume," to expose "half-truths" and provide "an unbiased, unflinching discussion of all sides" of the AIDS issue, "in clear, jargon-free prose." Don't you believe it. From his windy introduction -- "The first half of the book will run through many of the championed ideas of the establishment ... and show that, brought to the bar of objective science, they are found wanting" -- to his final remarks about "African ontology" and the prominent role of his fellow AIDS dissidents at the last International AIDS Conference in Durban, South Africa, you know exactly which side Null will come down on, if you didn't know it already. His book concludes with a slew of appendices, each offering an "AIDS Protocol" for natural healing, and each involving supplemental chemical, nutritional, herbal and vitamin therapies that would break the bank of most people with HIV in half an hour. You can take my word for that. For years, at least until the Durban conference, it was largely the policy of AIDS researchers -- medical and service bodies alike -- not to engage the so-called dissidents in point-by-point debate. This has changed. The National Institutes of Health maintains an "Evidence that HIV Causes AIDS" fact sheet on its NIAID Web page along with up-to-date statistics about the worldwide spread of HIV that ought to curl Null's hair. But they won't.
When even Sen. Jesse Helms, long an opponent of foreign aid in any form, recommends an American appropriation of $500 million to fight AIDS in developing countries, Null's blithe disregard of the evidence seems less blinkered than criminal. "It is a life-changing experience to go [to South Africa] and confront physically what it means to have 22 million people HIV positive without any drugs, without any real infrastructure to deliver drugs," says Helms' unlikely ally in the global AIDS fight, House Minority Leader Richard Gephardt. "We went to a hospital in Johannesburg and we went through pediatrics wards, and we learned that about half the babies born in the hospital are HIV positive. I asked, 'How long will these children live?' Some were in preemie incubators. And they said, 'Less than a year.'" The strangest thing about "AIDS: A Second Opinion" is that it takes no account of real time, never mind real research, real statistics and real results. Some of the same "survivors" from Null's Penthouse days are quoted again here, but we're given no clue as to their current fate. At least, I couldn't find any, despite 73 pages of notes in the back of the book. And when the late Michael Callen is quoted as if he were still alive, I nearly jumped out of my skin. (Callen, once famous as a long-term survivor of AIDS and adamantly opposed to the use of AZT, has been dead since 1993.) Every effort has been made to trick out Null's book as a scientific volume, which it's not; no scientist will read it, I predict, except to mock it or dismiss it wholesale. With the help of his co-writer, James Feast, Null does manage to lurch through the 20-year history of the AIDS epidemic in a more or less straight line. Here's perfidious Dr. Robert Gallo, snatching prizes and glory -- and money -- from his French rival, Dr. Luc Montagnier. There's Margaret Heckler, Ronald Reagan's secretary of health and human services, declaring that a vaccine for HIV would be ready in two years. The AZT controversy is rehashed to the point of madness, as if AZT monotherapy were still prescribed for anyone except expectant mothers, where its efficacy in preventing transmission of HIV from mother to child has been amply proved. As for the promised "jargon-free prose": "By now I imagine that you may be thinking something that can be put like this: 'Gary, you claim to be even-handed, willing to seek positive approaches to health wherever they may be found, even, you have said, in the camp of the most rigid orthodoxy ... But when it comes right down to it, you are nothing but a sourpuss naysayer, who seems to condemn every bright idea the establishment comes up with, from vaccines to AZT. Now I suppose you will have something bad to say about drug cocktails.'" Yes. I was thinking exactly something that could be put like that. It isn't my place to tell anyone with HIV how and from whom they should get their treatment. Not that it matters much: The same people who can't afford milk thistle extract, L-Carnitine, olive leaf and human growth hormone can't afford $35, either, for a book that effectively directs them to spend more money. Null's book is also so thick with misinformation and specious reasoning, so badly written and so very long, it squashes even the few sound points he has to make -- namely, that a complete overhaul of the American healthcare system is needed, that the pharmaceutical giants are, indeed, rapacious pigs, responsible for the deaths of millions, and that all patients need to be empowered for their own self-care: "Until AIDS patients are offered hope and nontoxic therapies, they must continue to follow their own intuition, do their own homework, and seek out help from like-minded individuals." To that alone -- and no more -- I say amen.
January 17, 2006
Interim General Manager Indra Hardat WBAI/Pacifica 120 Wall Street, 10th Floor New York, NY 10026
Dear Ms. Hardat,
We are deeply concerned that WBAI local station board member Steve Brown and a minority of others on the local station board are urging you to bring back former health programmer Gary Null to WBAI's airwaves. They claim that it would be a sound business decision and bring listeners back to the station. We in the AIDS Coalition to Unleash Power (ACT UP/NY) differ; we believe his return would be a huge mistake and violation of WBAI's social justice mission. ACT UP is a direct action AIDS organization dedicated to ending the AIDS crisis. We have chapters in many cities around the United States and in several countries and have successfully used nonviolent protest to pressure the US government and greedy corporations to stop dangerous policies that worsen the epidemic and to make life-extending treatments available to all people with AIDS who desire treatment. We have never taken drug company money.
Over the years, we have been repeatedly distressed about the life-threatening misinformation conveyed in Gary Null's programming on HIV/AIDS. Mr. Null is an HIV/AIDS denialist, meaning he denies that HIV is the cause of AIDS, in spite of a mountain of evidence to the contrary. In the four years prior to Mr. Null's cancellation, he brought these viewpoints about AIDS to the air dozens of times; in the overwhelming majority of cases, he did so in an unbalanced way. His repeated programming denying that HIV is the cause of AIDS is dangerous in a metropolitan area where HIV/AIDS is epidemic. Similarly, his broadcasts stating that AIDS is not spread to sexual partners of people with AIDS could lead people listening to him for advice to fail to use condoms or safer sex techniques, thus exposing themselves to a deadly infection. We believe that Gary Null should not be returned to WBAI's airwaves as a host.
AIDS: A Second Opinion, a video documentary made in the late 1990s, illustrates some of Null's problematic presentations on AIDS. He presents Christine Johnson, whom he identifies as a science writer, saying, "There is absolutely no AIDS epidemic anywhere. Unless you define an epidemic as a few cases trickling in here and there, which I don't. It certainly has never lived up to the gross exaggerations and hysteria that has been generated on the issue of AIDS."
But the facts of the matter show Ms. Johnson to be wrong. In 1995, AIDS became the eighth leading cause of death and the leading cause among all Americans aged 25 to 44, according to data from the Federal Centers for Disease Control and Prevention. According to a National Institutes of Allergy and Infectious Diseases (NIAID) fact sheet, at the end of 2000, 36 million people were living with HIV worldwide. Additionally, the fact sheet reports that in the United States, "as of December 31, 1999, 733,374 cases of AIDS and 430,441 AIDS-related deaths had been reported to the CDC. AIDS is the fifth leading cause of death among all adults aged 25 to 44 in the United States. Among African-Americans in the 25 to 44 age group, AIDS is the leading cause of death for men and the second leading cause of death for women." In 2005, UNAIDS, the UN agency charged with dealing with the AIDS crisis, estimated that 3.1 million people had died in that year alone, with more than 40 million infected. Even when the documentary was made, the facts clearly showed Mr. Null's guests to be wrong, and since then, the evidence is even stronger against his case.
Similarly, Mr. Null misrepresents the risks of HIV infection from sexual contact. In the same documentary, he presented Joan Shenton, director of Meditel Prod. saying, "There are so many things that are completely wrong about the HIV, the virus AIDS hypothesis. For example, if HIV is such a deadly infectious virus, why is it that the partners of people who are positive don't get HIV and don't get AIDS? It is very, very rare that anyone living with a person living with AIDS or HIV gets infected, so to speak, and the wives of hemophiliacs who are HIV/positive, a tiny proportion were said to have become infected, which was less than what you would normally expect in that group of people in the community as a whole." Yet there are many scientific articles, whose abstracts are available at http://www.pubmed.gov, written in the early and mid-1990s that refute this claim and instead demonstrate HIV transmission rates to female sexual partners of hemophiliacs of 10-20%. Rates of sexual transmission of HIV to uninfected male partners of men with HIV/AIDS are much higher.
Additionally, Mr. Null promotes the views of those who say HIV medications are dangerous. One of Mr. Null's guests says, "AZT and so-called antiviral therapies cause the very disease they are supposed to prevent." Yet the evidence is clear that these drugs, while having toxic side-effects in many, still extend lives and improve quality of life. In the first year these drugs became available on a widespread basis, mortality rates fell by 75% in the United States and by 85% in Europe, where access to health care is more available. Newspapers serving the gay community throughout the United States found a drastic reduction in the number of obituaries due to AIDS. For Mr. Null to present guests that overstate the problems with these drugs, in the context of an overall argument that HIV does not cause AIDS, encourages people with AIDS to not take their drugs.
Scientists and activists have been increasingly concerned about misinformation of the type spread by Mr. Null on HIV/AIDS because of its disastrous effect on public policy in countries such as South Africa that have large HIV/AIDS epidemics. The influence of these denialists on South Africa's President Mbeki caused that government to ignore the epidemic in the years in which it could have been more easily contained. Concerned scientists responded by making a public statement refuting the claims of the denialists. In July 2000, five thousand scientists and physicians working on HIV/AIDS signed the Durban Declaration, which was presented at the international AIDS conference held there and which stated: "The evidence that AIDS is caused by HIV-1 or HIV-2 is clear-cut, exhaustive and unambiguous. This evidence meets the highest standards of science. The data fulfill exactly the same criteria as for other viral diseases, such as poliomyelitis, measles and smallpox."
Over the years, Mr. Null brought his incorrect information to his listeners in a variety of ways. He brought on guests who promote these discredited views and also used the show to direct his listeners to his commercial website, where more inaccurate information is presented. Some of this so-called "information" is also available for purchase. He also uses his website to sell vitamins, which he says are important to treat AIDS. While vitamins are useful for people with HIV--scientists have documented that they slow the rate that people with HIV develop AIDS--the same scientists are clear that vitamins can't cure AIDS, nor treat advanced AIDS the same way antiretroviral drugs do.
WBAI's listeners deserve accurate information, especially about preventable, life-threatening diseases. Returning Gary Null to the air for financial reasons would be unethical profiteering, because he gives out information that can cause people to become infected with HIV or fail to treat the infection properly. For all these reasons, we think it is irresponsible for WBAI to return him to the air. We hope you will hold WBAI to its social justice mission and not let monetary motivations override public health concerns.
Sincerely, ACT UP/NY For more information, contact Eric Sawyer at 917-951-5758
13. Slater DM. Letter to Dr. Stephen Barrett, Feb 18, 2005.
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