HIV is the Only Cause of AIDS: The Potential for Journalism to Impact the Public Health
It seems that the so-called experts on AIDS have done a poor job of convincing the public that HIV is the sole and unequivocal cause of this dread disease. The case should be an easy one. After all, close to 40 million people worldwide are known to be infected with HIV, and AIDS is projected to become the world's leading cause of death within the next five years. Indeed, the press has done an excellent job at reporting that over four million children in developing countries have already been orphaned because of the loss of a parent to the AIDS epidemic, and that approximately 1,600 HIV-infected babies are born each day because the virus has been passed on to them by their infected mothers before or during birth.
Yet, in spite of extensive knowledge, and, indeed, considerable scientific progress in the field, it seems as though the press is often anxious to present dissenting views to the effect that HIV does not cause AIDS, and stories appear in reputable newspapers virtually every week that make this point. Often spokespersons for fringe groups, with little or no scientific training or credibility, are asked to provide quotes on the subject.
Take, for example, the case of an actual 37-year-old Canadian woman, identified here as Ms. X, who has been battling authorities over custody of her three-year-old HIV-infected son, because his doctors want to treat him with anti-HIV drugs. The woman has refused to allow her son to be treated, and has repeated arguments that HIV is not the cause of AIDS and that the drugs used to treat AIDS are toxic.
Why do journalists decide to do stories on these cases, and to present the so-called antiestablishment case, i.e., that HIV does not cause AIDS, as though it merited respect? After all, would these same journalists do stories on groups that advocated that cigarette smoking does not cause cancer or that a high cholesterol diet does not put one at risk for cardiovascular disease? Surely not, and if they tried, their editors would stop those stories from being printed. In general, responsible journalists understand that there is a public health dimension to every medical story they write, and that they have an ability to participate in the prevention of disease.
In contrast, HIV educators, physicians, and scientists must constantly wage battle in support of the HIV causality of AIDS. How tragic, when one considers that the notion that HIV does not cause AIDS is most likely to resound well with the least educated and most vulnerable members of society, including street kids, the urban poor, drug users, and members of aboriginal communities.
A Pediatric Case in Point
Had Ms. X, knowing that she was HIV-infected while pregnant, elected to take antiretroviral drugs three years ago during her pregnancy, it is virtually certain that her son today would be both HIV-free and healthy. The second conference on Global Strategies for the Prevention of HIV Transmission from Mothers to Infants, held in Montreal, Canada, in September 1999, reported that the use of just a single anti-HIV drug, nevirapine (Viramune), toward the end of pregnancy could reduce the transmission of HIV from infected pregnant women to their babies by at least 50%. [Ed. note: Long-term data will be presented this summer at the International Conference on AIDS, along with many other studies of antiretroviral prophylaxis to prevent HIV transmission from women to infants.]
The experience in the U.S. has been even better, with government statistics indicating a drop in the birthrate of HIV-infected babies by as much as 90% during the past decade, as virtually all HIV-infected pregnant women are now advised by their obstetricians to take a combination of anti-HIV drugs during pregnancy. Fortunately, the vast majority of HIV positive women in our society have decided that the recommendation is sound. Perhaps women like Ms. X are in denial because they are riddled with guilt, having failed to heed doctors' advice on this subject. Perhaps they now have no choice but to deny the HIV/AIDS link in order to maintain some semblance of emotional stability. Or perhaps Ms. X refused to take antiretroviral drugs during her pregnancy because she had read a newspaper article that gave credence to the notion that HIV doesn't cause AIDS.
The reality is that antiretroviral drugs have worked so well that the epidemic of new cases of pediatric AIDS in the U.S. has been virtually eliminated. The fact that these drugs work only by blocking the replication of HIV constitutes one scientific proof among many that HIV indeed is the cause of AIDS (see "HIV Causes AIDS"). By all means, the attitude of health-care practitioners toward people like Ms. X and their families should be one of compassion. However, it is clear that those who deny the HIV/AIDS link are mistaken and might cause harm to themselves and others. Should anyone really care what the so-called AIDS experts and members of the "AIDS establishment" have to say if a good story opportunity comes up that entails giving equal credibility to the other side of this unfortunate debate? Too many journalists anxious to publish these stories seem to think that the public health consequences of their articles are none of their concern.
Mark A. Wainberg, Ph.D., President of the International AIDS Society, is a Professor of Medicine at McGill University in Montreal.
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