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Vladimir_M comments on Open Thread, September, 2010-- part 2 - Less Wrong
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In my last post on Health Optimization, one commenter inadverntently brought up a topic which I find interesting, although it is highly contraversial - which is HIV/AIDS skepticism and rationality in science.
The particular part of that which I am interested in is proper levels of uncertainty and rationality errors in medical science.
I have some skepticism for the HIV/AIDS theory, perhaps on the level of say 20-30%. More concretely, I would roughly say I am only about 70% confident that HIV is the sole cause of AIDS, or 70% confident that the mainstream theory of HIV/AIDS is solid.
Most of that doubt comes from one particular flaw I in the current mainstream theory which I find particularly damning.
It is claimed that HIV is a sexually transmitted disease. However, the typical estimates of transmission rate are extremely low: 0.05% / 0.1% per insertive/receptive P/V sex act 0.065% / 0.5% per insertive/receptive P/A sex act
This data is from wikipedia - it lists a single paper as a source, but from what I recall this matches the official statistics from the CDC and what not.
For comparison, from the wikipedia entry on Gonorrhea, a conventional STD:
So it would appear that HIV is roughly 100-500 times less sexually transmittable than a conventional STD like gonorrhea.
So in my mind this makes it technically impossible for HIV to be an STD. These transmission rates are so astronomically low that for it to spread from one infected person to an uninfected partner would take years and years of unprotected sex.
If you plug that it to a simulation, it just never can spread - even if everyone was having unprotected sex with a random stranger every single day, it would still require an unrealistic initial foothold in the population by other means before it could ever spread sexually.
And of course, if you plug in actual realistic data about frequency of unprotected sexual intercourse with strangers, it's just completely impossible. Bogus. It doesn't work. It can not be an STD.
As gonorrhea (and I presume other STDs) are hundreds of times more transmissable than HIV, their low rates in the population place bounds on HIV's sexual transmission.
Finally, these rates of transmission are so low that one should question the uncertainty and issues with false positives - how accurate are these numbers really?
A few years ago, I entered an online discussion with some outspoken HIV-AIDS skeptics who supported the theories of Peter Duesberg, and in the course of that debate, I read quite a bit of literature on the subject. My ultimate conclusion was that the HIV-AIDS link has been established beyond reasonable doubt after all; the entire web of evidence just seems too strong. For a good overview, I recommend the articles on the topic published in the Science magazine in December 1994:
http://www.sciencemag.org/feature/data/cohen/cohen.dtl
Regarding your concerns about transmission probabilities, in Western countries, AIDS as an STD has indeed never been more than a marginal phenomenon among the heterosexual population. (Just think of the striking fact that, to my knowledge, in the West there has never been a catastrophic AIDS epidemic among female prostitutes, and philandering rock stars who had sex with thousands of groupies in the eighties also managed to avoid it.) As much as it’s fashionable to speak of AIDS as an “equal opportunity” disease, it’s clear that the principal mechanism of its sexual transmission in the First World has been sex between men, because of both the level of promiscuity and the nature of the sexual acts involved. (And it may well be that HIV among heterosexuals would be even rarer if it weren’t constantly reintroduced into the heterosexual population via women having sex with bisexual men, let alone if the sexual transmissions from intravenous drug users were also absent.)
On the other hand, when it comes to African AIDS, it’s hard to say anything reliably. The public discussions of First World AIDS are full of nonsense, but at least there are enough reliable raw data to make some sense out of the situation; in the case of Africa, however, we don’t know anything beyond what we’re told from people with highly suspect interests in the matter, either careerist or ideological, and even if there are some truthful and reasonable voices in the whole mess, it's impossible to filter them out in the sea of misinformation.
Also, here’s a pertinent comment I left on OB in a thread about the recent Medical Hypotheses affair: http://www.overcomingbias.com/2010/05/rip-medical-hypotheses.html#comment-447400
Quite interesting. I didn't really know much about Medical Hypotheses until I posted a link in another thread (as a minor side point) to an article my dad wrote which happened to be in that very journal, and someone pointed out what it was. Strange connection.
A long while ago I found Duesberg's papers and entered into some online debates taking his position. The end result of all that reading moved me into a position closer to yours, but more uncertain. I just went and re-read Duesberg's most recent 2003 paper and noticed it still has a noticeable pull on me after reading it, but after going back and forth several times between the two camps I usually end up somewhere lost in the middle.
Duesberg, even though probably ill-fated in his main quest, has I believe shown that the orthodox establishment has gone wrong at least in part. The history of the whole affair seems like it should be a lesson that we should learn from, a lesson that somehow results in learning and moving towards a more rational scientific establishment, more cleanly divorced from politics. That may be an interesting discussion to have here, if it hasn't already been discussed much. Deusberg suggests a jury process to replace the current peer-review system, which he is highly critical of. That could be an interesting rationalist angle on this.