AIDS and Behavior

, Volume 14, Issue 2, pp 237–247 | Cite as

AIDS Denialism and Public Health Practice

  • Pride Chigwedere
  • M. EssexEmail author
Review Paper


In this paper, we respond to AIDS denialist arguments that HIV does not cause AIDS, that antiretroviral drugs are not useful, and that there is no evidence of large-scale deaths from AIDS, and discuss the key implications of the relationship between AIDS denialism and public health practice. We provide a brief history of how the cause of AIDS was investigated, of how HIV fulfills Koch’s postulates and Sir Bradford Hill’s criteria for causation, and of the inconsistencies in alternatives offered by denialists. We highlight clinical trials as the standard for assessing efficacy of drugs, rather than anecdotal cases or discussions of mechanism of action, and show the unanimous data demonstrating antiretroviral drug efficacy. We then show how statistics on mortality and indices such as crude death rate, life expectancy, child mortality, and population growth are consistent with the high mortality from AIDS, and expose the weakness of statistics from death notification, quoted by denialists. Last we emphasize that when denialism influences public health practice as in South Africa, the consequences are disastrous. We argue for accountability for the loss of hundreds of thousands of lives, the need to reform public health practice to include standards and accountability, and the particular need for honesty and peer review in situations that impact public health policy.


HIV/AIDS denialism Antiretroviral drugs South Africa Mortality Accountability 



We wish to acknowledge Professor George Seage who critiqued and helped refine the arguments on causation of AIDS in an earlier version of the argument.

Conflict of Interest

We declare that we have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Harvard School of Public Health AIDS Initiative and Department of Immunology and Infectious DiseasesHarvard School of Public HealthBostonUSA

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