Pseudo-scholarship - inept and unconvincing (1 star)
The Origin, Persistence and Failings of HIV/AIDS Theory, by Henry
H. Bauer; McFarland & Company, 2007, AUD62
This book raises two important questions.
The first is, what sort of person writes a book about the epidemiology of an infectious disease without first familiarising himself with the basics of (a) the discipline of epidemiology and (b) the disease he is pretending to examine?
The second question is, what kind of "publishing editor" from an alleged "publisher of scholarly, reference and academic books" is too stupid to recognise an obvious crank who is entirely out of his depth with the subject matter he's writing about?
In Don't Get Fooled Again (Icon books 2008) author Richard Wilson writes:
Pseudo-scholarship gives the appearance of being based on logic and evidence, but relies instead on distortion, omission, fabrication, obfuscation, fallacy, emotive rhetoric and conspiracy theory. Quacks, cranks and fake historians seek to deceive by misrepresenting bad evidence as good, and using sham arguments to dismiss good evidence which conflicts with their own theories - often characterizing themselves as 'skeptics' in the process. (p. 212)
Bauer's HIV/AIDS argument is essentially based on epidemiology, a field he has no grasp of at all, and in which he appears to have made no effort to educate himself. He has simply made his methods up, and appears to have no insight into why this might be problematic. The end result is cringe-worthy.
For example, he tries to derive population-wide prevalence or incidence statistics from the ratios of positive and negative tests within quite specific subgroups and settings, without considering the criteria used to select the population under study, including the reasons for testing in the first place. He doesn't distinguish between prevalence and incidence, ineptly bundling the two concepts into his own neologism "F(HIV)". He compares the results of different cross sectional studies selecting completely different populations as if they were simply parts of the one longitudinal study.
He makes claims about the population-wide prevalence of HIV compared to AIDS that are completely at odds with official statistics: for example he claims that HIV and AIDS have completely different male to female ratios when the ratio for Americans diagnosed with HIV is 2.75 to 1 and incident AIDS is almost identical at 2.70 to 1.
He claims HIV cannot be sexually transmitted because of the age distribution of incident diagnoses, despite the fact it is almost identical to that of syphilis.
He falsely claims that HIV infection is diagnosed on the basis of an antibody response that is often transient. He claims that untreated HIV infection rarely leads to people getting sick. He misrepresents treatment studies. He doesn't have a clue about why opportunistic diseases such as Kaposi's sarcoma or tuberculosis might concentrate among people with a serious immune system disease.
He can't comprehend why an infectious disease whose incidence is highest among sexual networks of gay men and among injecting drug users might concentrate in larger cities. Or why HIV didn't spread much into the female population of San Francisco given the large number of eligible bachelors there with the infection.
He assumes that if the incidence of a sexually transmitted infection is relatively high in a particular population they must be proportionately more promiscuous, which is like claiming that the waterborne infection cholera is caused by people drinking proportionately too much water.
Not satisfied with completely botching his epidemiological "analysis", Bauer draws on his non existent knowledge of immunology to construct a vague and implausible fantasy about what the detection of HIV antibodies "really" means. It's, you know, like a non specific thingy response to umm, well, stress - like getting born, going through menarche, or living in a city. Seriously.
The second and third parts of the book are a rant about how scientists can sometimes get things badly wrong, and can be read ironically in the light of the woeful ignorance of his subject matter Bauer displays in the first.
I can recommend this book as a cautionary tale for epidemiology students, as it describes exactly what not to do. Those interested in the psychology of pseudoscientific crankery might also find it interesting. However, anyone hoping to better understand the complexities of HIV/AIDS can safely ignore it.
4 comments:
Nice one Snout!
Have you thought about asking one of the more 'mainstream' sites such as AIDSTruth.org to carry this? It seems a pity to restrict it to the currently limited audience here and, although it may indeed be effective in deterring some people from buying the book from Amazon, it could serve a valuable role as a concise criticism of Bauer's ridiculous claims if posted at such a site. I remember that Bauer's work was presented as the absolutely best evidence supporting the rethinker's (snigger) position, which is why your efforts here are so valuable and perhaps deserve to be made more public.
I do have one other comment about your piece though. You state:
He assumes that if the incidence of a sexually transmitted infection is relatively high in a particular population they must be proportionately more promiscuous, which is like claiming that the waterborne infection cholera is caused by people drinking proportionately too much water.
While I agree that there are many other factors that can account for higher rates of STDs in one population compared with another irrespective of 'promiscuity' (condom use, for example) it is also fair to say that, all other things being equal, higher rates of promiscuity will lead to a more rapid spread of STDs. I have always assumed (perhaps incorrectly) that the explosion of HIV infection that occurred in the gay communities of San Francisco and NYC in the early eighties was due, in part at least, to the 'bath house' culture of the time. Am I missing the point here, or are you leaving yourself open to the (obvioulsy incorrect) criticism that you don't believe that rates of STDs are affected by sexual habits?
Anyway, keep up the good work!
SteveN
P.S. The 'blockquote' HTML tag was not accepted. Is there an alternative?
Hi Steve.
Yeah, I thought the cholera comparison would be provocative, and I hope to go into more detail about what I mean in a later post.
It’s a response to Henry’s assumption that incidence rates of sexually transmissible infections run in direct proportion to the amount of unsafe sex that’s going on, and that comparing infection rates between different communities (or the same community at different times) can tell you the average number of notches on the bed post for each.
For example:
“These hand-waving generalities about behavioral norms and social mixing patterns cannot disguise that they are plainly racist, for their specific meaning is clearly this: Black Americans, and to a lesser degree Hispanics (but only in the East, not the West!), are supposed to be more intimately and constantly engaged in carelessly unsafe sex and sharing of infected needles than are whites or Asians or Native Americans… In every sector of society, black people are supposed to behave like that on average 5 or 6 times as often as white people.”(1)
Certainly the degrees of promiscuity in a community can influence the rate of spread of STIs, but it is far from the only factor or even the most salient factor, and two different communities with comparable levels of activity and partner change can end up with vastly different prevalences, especially after many years. Epidemics spread exponentially, and small differences in the effectiveness of control efforts early on can make a huge difference over time – higher prevalence begets higher incidence begets higher prevalence even if the level of actual risk behavior remains constant. These are basic public health principles.
One of the most important factors in the relatively low HIV seroprevalence rates in many communities has been timely public health efforts to break chains of transmission – prompt identification of new infections, testing, contact tracing, education. Treatment, perhaps, to some extent. My own belief is that it is these factors as they play out over time rather than assumed “promiscuity rates” which account for the major differences in HIV prevalence and incidence between communities.
Bauer’s argument that higher HIV diagnosis rates among US blacks is racist because it stigmatizes them as hypersexed or irresponsible vastly oversimplifies the actual phenomenon and I think misses the point – leaving aside the fact that blacks or not only diagnosed with HIV at 7 times the rate of whites but actually suffer premature deaths with AIDS at the same disproportionately high rates. To my mind, it’s failing to address the causes of those deaths that’s racist.
What makes matters particularly complicated with HIV is its mode or modes of spread. We’ve never been particularly good at leaving the psychological and moralising baggage behind when it comes to sexuality (or illicit drug use). HIV and AIDS provide a lightning rod for simmering prejudices, and I think Bauer’s race argument is designed to exploit those.
(1) “Demographic Characteristics of HIV: III. Why does HIV discriminate by race?”
http://www.scientificexploration.org/journal/jse_20_2_bauer.pdf
As for AIDS Truth, well they are welcome to use this if they want, but at the moment I'm treating these articles as a set of drafts for a shorter and punchier piece later on. I suppose doing it as a blog is just me thinking out loud, but it's great if other people are interested enough to read it and make comments.
In any case, I'm not sure of how much of a market there is for critical thinking about Bauer's ideas: his followers aren't likely to be genuinely interested, and pretty much everyone else ignores him. I suppose I'm doing him a service by at least taking him seriously enough to criticise.
Epidemics spread exponentially, ...
This basic fact appears to be lost on Bauer.
The basic reproduction number would be directlty proportional to the number of sexual contacts (amongst other factors).
If R0 in a population is < 1 then the prevalence will go down exponentially. If R0 in a population is > 1 the prevalence will go up exponentially.
The prevalence in a population is not directly proportional to the basic reproduction number.
A good example is herd immunity with vaccination.
Bauer even goes further with his false accusations of racism.
This official stance entails that African ancestry determines behavior. That’s wrong because genes don’t determine behavior so simply and directly.
This "official stance" is Bauer's invention. Nobody apart from Bauer (and perhaps the KKK) is talking about genes determining promiscuity.
Thanks for the long reply, Snout. I assumed that that was the point you were making but was concerned that your statement could be deliberately or mistakenly misunderstood and used against you. Your preemptive clarification is therefore useful to have here.
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