Re: [Rollei] HIV/AIDS

[TrueBadger]

In a message dated 1/3/2004 12:49:23 AM Eastern Standard Time, pswango   writes:

> 
> 
> I was hoping to sit the AIDS topic out but I've decided to chip in my two
> cents worth.  From 1985 to 1993 when I retired from the NIH I worked in the
> epidemiology of HIV/AIDS.  Specifically, I was principal investigator of
> the oral disease component of a study of HIV infection in 1,000 military
> personnel conducted at the Walter Reed Army Hospital in Washington, DC.  As
> a dentist and oral epidemiologist, I'm not an expert on HIV transmission,
> but I'll share my perspective anyway.
> 
> First, G. King and Marc are correct that the HIV epidemic in the US has
> been substantially limited to specific risk behavior groups.  The table G.
> King referenced (from the CDC) shows about 4.5 times more cases in the two
> main risk groups (male homosexuals and drug abusers) than in population
> groups without these risk behaviors (~720,000 vs ~156,000).   IMHO, the
> reason HIV has been relatively restricted to these groups in the US is
> twofold:  first, HIV is not transmitted by casual contact (like the flu)
> but through specific well-documented risk behaviors, and second, US health
> authorities were able to employ infection control measures that kept the
> virus out of the blood supply and minimized the chance of widespread
> infection through contamination in health care facilities (including dental
> clinics).  In other words, you're unlikely to contract HIV in the US if you
> avoid the specific risk behaviors.  OTOH, there are those 156,000 in the
> table who weren't so lucky.
> 
> As several others have noted, the situation in the third world is vastly
> different, and G. King's comment seemed to suggest a cavalier attitude with
> respect what has become a truly devastating epidemic in Africa, and
> increasingly, in Asia.  The same CDC website referenced above documents
> about 40,000,000 cases worldwide.  In the third world, the epidemiologic
> situation is entirely different from the US, and much if not most
> transmission is by heterosexual contact and perinatal transmission.  And
> once the virus is widespread in the general population, almost anyone can
> be at risk.
> 
> Now to address G. King's original statement: that HIV hysteria was due to
> junk science.  I have to say I don't agree with that - at least I'm not
> aware of any junk studies that predicted widespread transmission outside
> the relevant risk groups.  I do think, however, that some people in the
> media contributed to the hysteria by misinterpreting data from legitimate
> studies.  I can remember reading in the press that HIV infection had
> increased twofold (or some such) in heterosexual women, when what happened
> was the risk increased from some infinitesimal proportion to twice that
> proportion, though still infinitesimal.  If that's what G. King was
> referring to then I agree.  One thing to keep in mind, though, is that back
> in the late eighties no one was sure what direction the disease would take,
> and some "hysteria" was probably understandable.  It's easy to pontificate
> in retrospect.
> 
> Since I have also worked in oral cancer epidemiology, I should go on record
> to say that smoking and other tobacco use is a significant risk factor in
> developing oral and pharyngeal cancer, which afflicts about 30,000 persons
> annually in the US and kills 8,000.  Environmental smoke has never been
> suggested as a risk factor, to my knowledge.
> 
> And finally, to Greg, and the "AIDS isn't cause by HIV" theory - there are
> better sources of information than what some doctors said after a few
> drinks.  At Walter Reed I worked with some of the best infectious disease
> docs in the business and participated in innumerable seminars in which HIV
> transmission was extensively documented and discussed.  
> Trust me, it's
> caused by the virus.
> 
> EOR (end of rant)

> 
> Phil Swango


Phil:

I don't see it as a rant at all, it's a very fair statement of the situation.

I'm a little reluctant to re-visit this, because of the sparks it strikes, and because I am pretty sure I will be accused of revisionism of what I previously said, but to hell with it, here goes.

Very early in my life I did intsrumentation for an outfit called IBR .. Institute for Behavioral Research, then affiliated with Walter Reed via the sponsorship of a Col Joe Brady, and also under the sponsorship of the University of Maryland.  The then director was one Charles Ferster, and an occasional visitor was Ferster's mentor, B.F. Skinner.  

The lab was located near the WRAIR Forest Glen Annex, and later became notorious with the incident of the "Silver Spring Monkeys", although that was long after I had moved on.

I then spent a few years doing instrumentation for Hazleton Laboratories, and after that was an independent  rep selling multiple lines of instrumentation to Walter Reed, NIH, BNM, and all the universities and most of the government lab facilities in three states. 

I do not criticize much of the research that is done in places like WR or NIH, nor in most universities. Even if poorly done, it is for the most part, intellectually honest.

That done by labs for hire, however, or by grant-seeking "institutes", can have a large marketing component, and is often designed, contrived, and even finagled, to show the encouraging results that will secure the next grant.

Deny it all you want, I've been there, I've seen it, and I've designed (or modified) the instruments to assist in the process, mainly in the behavioral area, (studies in support of various hypothese in respect to drug addiction, educational theory, etc, etc) but also in some early (1960's) smoking related experiments paid for by tobacco companies.

Then there is the fact that the term "Junk Science" refers not just to the experiment itself, but of the spin that is put on the resulting data and how that data is massaged to support the message a particular group (sponsors or opportunists) want to put on it.  In this the media may be culpable as well, but I'd put the blame more on interest groups, which may include some agency seeking a larger budget. 

I'm not going to address "Dry Labbing" or other truly dishonest practices, although I've seen those also. They are not frequent, and are not tolerated when discovered. I however, do not assume that they always ARE discovered.

G. King

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