Acting as if this isn’t so causes people to die unnecessarily. HIV positive women will infect their infants at a predictable rate. Modern multidisciplinary health care can reduce that rate to near zero. This is all true in the real world, the world of consequences, where ships have to float and planes have to fly. Unfortunately, many people act as if they live in another world, a world where sincere belief (the President calls it his “gut”) is the sufficient condition for truth.
Christine Maggiore is a star in that other world (“Mother Courage,” Issue Two, The MotherHood, 2007.) She is an HIV positive woman who has been lucky enough so far to not have AIDS. Ms. Maggiore, who doesn’t know how she contracted the virus, has concluded that HIV does not cause AIDS and has, therefore, eschewed the known means of preventing transmission of HIV to her children, even going as far as to breastfeed them and refuse to have the children tested for HIV. Ms. Maggiore has become an iconic figure in the “HIV-denial community.” Her legend recounts a range of iconoclastic ideas—from relatively harmless anti-“mainstream” trendiness like giving birth under water, through potentially hazardous anti-“mainstream” irresponsibility like not immunizing her kids, to deadly anti-“mainstream” radicalism like denying the danger of HIV.
She is a major part of a small industry that has developed around this last idea, selling books, garnering media attention and gracing the covers of national and local parenting magazines. Her arguments for her belief, bolstered by very selective and misleading use of scientific literature, are apparently plausible to some; but they are considered ludicrous nonsense by virtually every expert in any related field.
People who comfortably dismiss the near unanimity of the scientific world on this issue have no appreciation for the breadth of scientific knowledge and the interconnectedness of scientific concepts or they suffer from an abnormal level of mistrust of authority, or (usually) both. A culture that will consider a person well educated despite an absence of even the most rudimentary grounding in any kind of science produces a lot of these people. These are the kind of people who believe that the “so-called Moon landing” was filmed in the Southwest desert, since escaping from earth’s orbit is physically impossible. It doesn’t occur to them how many other things must also be wrong if they are right. It also doesn’t faze them to believe in a conspiracy of all the physicists and scientific societies in the world, along with all the world’s governments. Of course, HIV deniers are doing the same thing. Look at the signatories of the Durban Declaration on AIDS to see the extent of the scientific consensus they dismiss. If a conspiracy this large and well disciplined actually exists, we have bigger problems than what blood test to get.
Ms. Maggiore’s public career, indeed her entire movement, should have come to an end when her three year old daughter died of complications of AIDS. But HIV denial, like other irrational beliefs, is immune to disconfirmation. If the world doesn’t end when you predict it will, you retire until you can recheck your math. If removing mercury from vaccines makes no impact on autism rates after six years, blame mercury from Chinese coal and the dental fillings of cremated corpses. If your beliefs about HIV lead to personal tragedy, you get professional witness Mohammed “HIV is a harmless virus”Al-Bayati to concoct a glib but nonsensical reinterpretation of an autopsy report, or you blame a conspiracy of lab technicians and a crooked medical examiner.
In the early twenty-first century a responsible citizen is confronted by many issues that require at least a little familiarity with science to be properly understood. In fact, the number, importance and complexity of such issues are rapidly increasing. At the same time that reliable information is becoming more vital, the creation and consumption of information are becoming more democratized via the Internet. With no Walter Cronkite to tell us how it is, the job of “editing”—that is endorsing or rejecting information—falls to more, and more varied, people. These are the opinion leaders, the influential bloggers, anyone with even a slightly privileged place in the public square. In an information society, where anyone’s opinion can reach millions of people instantaneously, the new “editors” increasingly share a function that used to be the province of a few well-known professionals. With this influence comes responsibility. Promoting irrational points of view distorts public discourse, leads to bad policy, harms individuals, and moves us backward as a society. Ignorance can no longer be accepted as an excuse. Anyone in a position to confer credibility on another must be mindful, lest they themselves lose what they would confer. For example, New Jerseyans are currently debating the risks and benefits of mandatory HIV testing for pregnant women. How far should the state go in protecting children when doing so may expose their parents to discrimination in insurance coverage, employment, etc.
A person who believes that AIDS is a “genocidal hoax” and that mandatory HIV testing is a means of mass mind-control (“the AIDS Trance”) has nothing meaningful to contribute to this debate and should not be given a special place at the table. A knowledgeable reader should realize immediately that these assertions can’t be true. (Try HEALAIDS.com and see if you agree with me. I will gladly stake my credibility on my position that this is bizarre fiction.)
In addition to their responsibility to understand the rudimentary science of an issue, consumers and “editors” of information must remember that extraordinary claims require extraordinary evidence. If you believe you have had sex with an alien, don’t expect much respect for your point of view until you give birth to a silicon-based life form. If you believe that HIV doesn’t cause AIDS, you have a lot of explaining to do.
Except in South Africa, where top officials joined their camp, the HIV denial movement is having a small but insidious effect on health care and public health policy around the world. This is not an essentially harmless irrationality like Astrology or Homeopathy (much more on the “memory of water” some other time.) In addition to furthering the larger agenda, Christine Maggiore boasts that she personally has convinced and supported at least 50 women to follow her example. Figuring two children per mother, that’s about two dozen AIDS babies. Her enablers in the media and elsewhere should consider whether they want to help add to that number.
Donald N. Cotler M.D., FAAP, practices fatherhood and unclehood in Maplewood, and pediatrics in Millburn. He may be
reached at themotherhood@comcast.net for comment.
