AIDS in Boston – The Other AIDS Debate Interview


– A great town.

“If you don’t have confidence in your lab, then you can’t have confidence in your test results.”HIV doctor on HIV testing, Boston.

In 2003, I researched, read, investigated, walked, talked, thought, wondered, pondered, argued, took interviews for, sketched, drew, stitched, typed, lived, breathed, ate and drank the medical and social literature on AIDS to produce a three-part series for a small Boston weekly newspaper – “The Weekly Dig,” the editor who let me do my thing, Joe Bonni, the piece, “The AIDS Debate“. It was exciting and invigorating work, challenging, sleep-depriving but immensely stimulating and rewarding, and of course, blowback-producing and tree-shaking.

I interviewed a number of doctors, writers and activists for hours each, some for multiple interviews, reading more and more and still more as a result. You read the pros and the cons, the Gallos and the Duesbergs and the Papadopouloses, the Malans and the Youngs and the Schmidts, the Weisses and Turners, the Montagniers and Rasnicks and Fialas, the WHO and CDC and NIH, and whatever else someone sticks in front of you saying, “What about this? Have you read this? Have you seen this?” And it’s really never ended. You read everybody above, below and in-between. (One of my favorite bits of reading at that time were the massive debates at the British Medical Journal ‘Rapid Response’ section on two AIDS articles Here and Here).

In the process of forming the pieces that became the AIDS Debate series, I spoke with everyone I could, everyone around, about the work. I bothered friends, acquaintances, colleagues, family, and on occasion, garrulous strangers about the topic. In a town of Ph.D.s, M.D.s, and two hundred thousand college and grad students, plus Boston’s home-grown salt and sea wisdom, I received a variety of street-level stories, and indoctrinated academic opinions, both interesting and valuable.

I did make an effort to talk with mainstream AIDS specialists, and at that point, some actually agreed to speak with me. (AIDS is a scientism, not a science, and so when you come with hard questions, the high priests shut the temple doors to you).

Below is one of those conversations, a 2003 interview with Dr. Dan Cohen, M.D. of Boston’s Fenway HIV/AIDS Clinic. You don’t have to guess where the clinic us located – no, not in Newton or Wellesley, home to the beautiful (straight) people. Yes, the clinic sits at the gateway to the beautiful and gentrified South End where a majority of young, urban, successful, working gay men make their homes and living.

The images you see interspersed are not parody ads created for this post – this is the face of Fenway Health’s public relations outreach/propaganda for its community. Talk about targeting a population….

Liam Scheff: What’s the process at the Fenway when someone tests positive for HIV?

Dr. Cohen: When someone is tested positive, they get counseling before and after, regarding the test process, they’re counseled regarding the possibility of getting a false negative when they’re really HIV infected.

Liam Scheff: How do they get a false negative?

Dr. Cohen: The HIV test is testing for antibodies, not for the presence of the HIV virus itself.

Liam Scheff: How does that equal a false negative?

Dr. Cohen: If a person has become infected recently their body might not be making antibodies yet. This a problem if someone has become infected in last several weeks.

Liam Scheff: Do they get counseling regarding false positives?

Dr. Cohen: Well, this is less of a problem than it used to be because of the way the test is conducted. The first test is a regular screening test, called the ELISA, which is looking for antibodies against HIV. It is fairly specific, but not 100 percent. None are 100 percent.

Liam Scheff: I’ve read that ELISA tests are as much as 80 percent nonspecific.[1]

Dr. Cohen: Well, new tests seem to better. If the ELISA is positive, then they‘re retested again with the ELISA. If they test positive a second time, they move to a more specific test called Western Blot, which more specifically tests against certain antibodies against the HIV virus.

Liam Scheff: You’re diagnosing HIV based on two tests, the ELISA repeated twice and the Western Blot. If it’s a faulty test, what’s the purpose of repeating it?

Dr. Cohen: Sometimes it might turn up positive for reasons that don’t have to do with the test, such as human error.

Liam Scheff: But if the test itself is faulty – I’ve read that the ELISA test reads blood only after it’s been diluted 400 percent. But if it tests undiluted blood, then everybody’s blood tests as HIV-positive.

Dr. Cohen: Yeah, that’s the way the test works.

Liam Scheff: I’ve read that the Western Blot is faulty, and that it picks up many nonspecific antibodies.

Dr. Cohen: If it’s conducted by a lab that knows what it’s doing, it’s not likely to be a false positive.

Liam Scheff: What if the lab doesn’t know what it’s doing?

Dr. Cohen: Then anything is possible. If you don’t have confidence in your lab, then you can’t have confidence in your test results.

Liam Scheff: The Massachusetts Department of Public Health records the number of HIV-infections in the State last year [2002] at 3,184. Their report states that “327 people reported with AIDS in Massachusetts died.” [ed – The report adds that this number includes deaths from motor vehicle crashes, drug overdoses, and suicides.] [2]

Dr. Cohen: That’s absolutely correct. I think a lot of people have an inflated idea of the impact AIDS is still causing today. But that doesn’t mean we should dismiss it.

Liam Scheff: No, we shouldn’t dismiss it. But we‘re constantly told that it‘s an epidemic. Why do we call it an epidemic?

Dr. Cohen: We shouldn’t be focusing our view on the U.S. because worldwide, AIDS is killing millions.

Liam Scheff: What do you think of the amfAR ads on buses which say “1 million treated – 40 million to go.” Is this part of the reason people have an ‘inflated idea of the impact AIDS is still causing today?'[3]

Dr. Cohen: Just because people have an inflated idea of AIDS today, doesn’t mean it’s not a huge problem.

Liam Scheff: You said it’s not.

Dr. Cohen: But AIDS disproportionally affects young people.

Liam Scheff: The majority of people infected in Boston are in their 30’s in 40’s.

Dr. Cohen: But the majority of people who are going to be infected are in their teens and twenties.

Liam Scheff: How do you know that?

Dr. Cohen: Because we’re seeing increasing number of other STDs in this young population, and it’s only a matter of time before HIV appears. That‘s especially true among people of color. That’s the reason it’s an emergency. The most important thing, just because we’re not seeing the numbers, doesn’t mean that we shouldn’t pay attention. It’s lurking beneath the surface; we must continue with the prevention message and strategies.

Liam Scheff: What are good prevention strategies?

Dr. Cohen: Condoms are the most important strategy. There are many people at risk who won’t use condoms. Avoiding anal sex without a condom would be another. Limiting the number of partners. Getting tested regularly for other STDs and getting tested for those will reduce the incidence.

Liam Scheff: What do you say to scientists who question the validity of the HIV=AIDS hypothesis?

Dr. Cohen: I’ve heard this HIV not equal AIDS message for years. I’m satisfied that the virus Montagnier’s and Gallo’s virus causes AIDS.

Liam Scheff: Montagnier disagreed. He’s stated that HIV, on its own cannot cause AIDS.

Dr. Cohen: I respectfully disagree; I’m satisfied that every who gets AIDS is infected with HIV but not everyone who has HIV will get AIDS.

Notes:

[1] HIV tests are non-specific and poly-reactive (they react with proteins produced from dozens to hundreds of conditions (the list is ever-expanding), including poverty-related ailments, TB, malaria, vaccination, and pregnancy. [Read more about ’em]

[2] Massachussetts Department of Public Health HIV/AIDS Statistics 2002 [Link]:

“In 2001, 327 people reported with AIDS in Massachusetts died. Seventy-two percent of these deaths were among men, 47% were among people of color, and 55% were among people who had injected drugs. By comparison, the profile of people recently diagnosed with HIV infection (1999-2001) is comprised of 70% men, 58% people of color, 24% among injection drug users.

One should note that the death data presented in this analysis include all deaths among people reported with AIDS in Massachusetts. This includes deaths from non-HIV related causes such as motor vehicle crashes, drug overdoses, and suicides. Therefore, the total number of annual deaths reported here will vary slightly from the number of HIV-related deaths reported in Massachusetts Deaths by the MDPH Bureau of Health Statistics, Research and Evaluation.”

There were 14,499 AIDS-related deaths in the US in 2001. In 2000 it was 16,765. AIDS is not in the top 15 causes of death in the US. Total AIDS-related deaths since 1981 [as of 2002/2003] were 467,910.] By comparison, in 2001 alone, 699,697 people died of heart disease, 553,091 of cancer, 71,252 of diabetes and 97,902 of unintentional injuries.

[3] AIDS figures in Africa: HIV testing for sub-Saharan Africa occurs almost exclusively at antenatal clinics. Left-over blood samples from pregnancy clinics (where young women are being screened for syphilis) are tested with a single ELISA or rapid antibody test, and the results are extrapolated to the national population by algorithm.

UNAIDS gets its Africa figures through a computer modeling program called EPI-model; the organization has repeatedly been forced to retract estimates from its computer modeling program for Africa, EPI-Model, because its numbers are pure mathematical inventions, with no basis in reality.

Liam

3 Comments

  1. I was going to commend you on those hilarious Ask Dr. Cox cartoons, thinking they’re your new ones, since you’ve drawn some great ones in recent history, but to my dismay and consternation, finding them actually being used by Fenway Health, is an altogether different matter. You’d think that Fenway should have at least a budget for a hot young strapping porn star and a high end photographer if they’re seriously interested in growing their business, because at 3 or 400 people with AIDS in all of Massachusetts, those patients must be extremely hard to come by.

  2. Well done for the interview of 1993, Liam!
    What is impressive in this case is that it could have been taken last year.
    Nothing changed since 1993!
    The image has frozen…

    • Hi Maria,

      2003, it was…some 7 years back. But I think the image has been frozen since about 1983, in most minds…

      lots o’love,

      Liam

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