BOOK REVIEW
AIDS denialism is not the same as
AIDS dissent
Denying AIDS: Conspiracy Theories, Pseudoscience
and Human Tragedy
Seth C Kalichman
ISBN-13: 978-0-387-79475-4, 201 pp
(eISBN-13: 978-0-387-79476-1)
Berlin: Springer Science þ Business Media LLC, 2009
US$ 25.00. Hard cover
‘Generally, the theories we believe we call facts, and the facts
we disbelieve we call theories.’
Felix Cohen
Denialists of any kind are irritating. AIDS denialists are doubly
irritating, since AIDS is an inherently contentious issue. A
common antidenialist response is anger. Hence, writing about
AIDS denialism presents a daunting challenge to any research-
er’s wish to be dispassionately objective. Seth Kalichman’s
assessment of AIDS denialism in his new book relies mostly
on the cerebral, rather than adrenal, cortex. But for one
notable exception, Kalichman succeeds in objectively describing
and analysing the history, principal actors, scripts, arguments
and shortcomings of what I dub the AIDS Denialism School.
Kalichman, a clinical psychologist and professor of social
psychology at the University of Connecticut in the USA, who
is also the editor of the behavioural science research journal
AIDS and Behavior, stumbled upon the AIDS Denialism
School by visiting one of its websites, confessing: ‘My reaction
was one of absolute outrage. I mean I was really angry. I was in
an emotional upheaval. I surprised everyone around me,
including myself, by my seemingly irrational reaction’. Prior
to this encounter Kalichman had, like nearly all other AIDS
scientists, ignored it, admitting that: ‘I was in denial about deni-
alism. I knew it was out there, but I pushed it to the back of my
mind’. To Kalichman the central tenet of the AIDS Denialism
School – that HIV does not cause AIDS – is not only an
affront to the depth and breadth of the empiric evidence that
HIV does indeed cause AIDS but, far more importantly, has
potentially serious health consequences for HIV-infected
patients who believe it. Such an erroneous belief can cause
at-risk persons not to be tested for HIV infection or, if tested,
to ignore a positive HIV test result; to reject scientifically mon-
itored therapies in favour of vitamin and nutritional sup-
plement regimens of unproven or much lesser efficacy; and
to facilitate downstream HIV transmission if denialists were
to dispense with safer-sex cautions. To Kalichman, AIDS deni-
alism is ultimately destructive because it corrodes trust in scien-
tific medicine and public health.
He describes, in substantial detail, the birth of the denialist
movement a quarter century ago, its chief protagonist, the
distinguished scientist Peter Duesberg and, in lesser detail,
disciples and congeners; Appendix B consists of nearly 20 bio-
graphical vignettes of what could be called The Rogue Gallery
of Principal AIDS Denialists. He devotes much space to probing
why denialists propagate ‘myths, misconceptions, and misin-
formation to distort and refute reality’. His sections on denialist
pseudoscience, proselytizing techniques and political strategies
make for genuinely interesting reading, as do the sections on
how to get out of AIDS denialism using the power of critical
thinking – in my view, always easier recommended than
done. That AIDS denialism may be more of a generic than
specific turn of mind is suggested by his pointing out that
AIDS denialists also frequently subscribe to irrational, even
paranoid (especially conspiratorial), points of view in other
fields of inquiry. Kalichman refrains from imputing evil
motives to denialists. From what is presented, readers will
have problems deciding whether, with denialism, one is
dealing with a heart of darkness or a mind of darkness or both.
The singular exception to Kalichman’s otherwise objective
assessment of AIDS denialism is his inclusion of two research-
ers (with whom I have published many papers) who should
properly be classified as AIDS dissenters. Denying the evidence
is not the same as interrogating it and Kalichman clearly con-
fuses the two when reporting on the probing scholarship of
Drs David Gisselquist and Stuart Brody. A careful and open-
minded assessment of their publications will show that the
basis for their questioning what is driving HIV transmission
in sub-Saharan Africa is grounded in epistemology (quality
and validity of evidence issues);1 on solid bench science find-
ings (healthy genital tract tissue in women could not become
infected by application of huge quantities of HIV);2,3 and on
empiric evidence that contradicts the mainstream view.1,4 – 6
Each of these evidentiary avenues leads, especially in light of
the many observed anomalies,7 to the legitimate questioning
of whether ‘heterosexual sex’ (an inherently fuzzy concept)
can account for the virtually 10 times greater efficiency of
HIV transmission in Africa than elsewhere. Rather than being
inappropriately subsumed under the ‘Pseudo-epidemiology’
section, Gisselquist and Brody should be classified, in
Kalichman’s own words, as ‘Legitimate dissidents in AIDS
science [who] should also have greater visibility’.
Kalichman, whose professional paradigm is clinical rather
than epidemiologic, accepts the received wisdom about what
is driving the HIV epidemics in Africa without according reco-
gnition to the existence of the considerable evidence undermin-
ing it and of its serious methodological shortcomings. He seems
not to know (recognize?) that the fundamental weakness of
mainstream epidemiologic studies in sub-Saharan Africa has
been its 20-year track record of dismissing non-sexual modes
of transmission as being insignificant, in the absence of
studies comprehensively assessing the contribution to HIV inci-
dence of skin puncturing (blood) exposures. He also uncriti-
cally accepts the current mantra that a special form of sexual
concurrency in heterosexual African populations accounts for
much of the observed HIV transmission when, in fact, the
empiric evidence for this idea is virtually non-existent.8 Not
automatically believing what the experts say when rational
methodological and empiric evidence undermines their view
is sound science, not pseudo-epidemiology or denialism. Au
contraire.
In summary, Kalichman’s treatment of AIDS denialism is a
good, if somewhat partisan, review. I also suspect that if he
carefully considered the arguments and evidence of legitimate
AIDS dissenters such as Gisselquist and Brody, rather than
indefensibly dismissing their work as pseudo-epidemiology,
Kalichman might well change his mind. From my
International Journal of STD & AIDS 2009; 20: 515 –516
516 International Journal of STD & AIDS Volume 20 July 2009
................................................................................................................................................

understanding of this book, I doubt AIDS denialists would,
which makes its reading all the more important for those inter-
ested in countering the denialists’ baleful influence.
J J Potterat
Colorado Springs, CO 80909-1020, USA
Email: jjpotterat@earthlink.net
DOI: 10.1258/ijsa.2009.009138
REFERENCES
1 Gisselquist D. Points to Consider: Responses to HIV/AIDS in Africa, Asia, and the
Caribbean. London: Adonis & Abbey Publishers Ltd, 2008
2 Greenhead P, Hayes P, Watts PS, Laing KG, Griffin GE, Shattock RJ. Parameters
of human immunodeficiency virus infection of human cervical tissue and
inhibition by vaginal virucides. J Virol 2000;74:5577–86
3 Dezutti CS, Guenther PC, Cummins JE Jr., et al., Cervical and prostate epithelial
cells are not productively infected but sequester human immunodeficiency
virus type 1. J Infect Dis 2001;183:1204 –13
4 St Lawrence JS, Klaskula W, Kankasa C, West JT, Mitchell CD, Wood C. Factors
associated with HIV prevalence in a prepartum cohort of Zambian women. Int
J STD AIDS 2006;17:607 –13
5 Brewer DD, Potterat JJ, Roberts JM Jr., Brody S. Male and female circumcision
associated with prevalent HIV infection in virgins and adolescents in Kenya,
Lesotho, and Tanzania. Ann Epidemiol 2007;17:217 –26
6 Deuchert E, Brody S. The role of health care in the spread of HIV/AIDS in
sub-Saharan Africa: evidence from Kenya. Int J STD AIDS 2006;17:749 –52
7 Brewer DD, Brody S, Drucker E, et al. Mounting anomalies in the epidemiology
of AIDS in Africa: cry the beloved paradigm. Int J STD AIDS 2003;14:144 –7
8 Potterat JJ. Attractive theory is not enough. Int J STD AIDS 2007;18:645– 6