There are times I read pseudoscience online, and it causes my blood pressure to go through the roof. Of course, maybe life would be easier if I just accepted that everything written in the interwebs is accurate and THE TRUTH™. Today I read some comments about the new iPad where global warming denialists used junk science to support their ramblings. How the article moved from the new iPad to global warming is beyond the ability of me to describe.
I have a lot of smart people who I follow on Facebook and Twitter. Very few are actual friends or family, most are just like-minded people who entertain me with rational discussions on a wide range of topics. And sports.
Then one of my Facebook friends posted 10 Reasons Why Black People Should Not Take The HIV Tests! by Curtis Cost, a well-known member of the anti-vaccine gang. I thought it might be some racially charged article that I’d read and ignore, but it’s some of the worst AIDS-denialist junk that I’ve ever read. He makes these 10 points without one bit of evidence, completely violating the “extraordinary claims require extraordinary evidence.”
1. None of the manufacturers of the HIV tests guarantee the accuracy of their tests. Debunked: A large study of HIV testing in 752 U.S. laboratories reported a sensitivity of 99.7% and specificity of 98.5% for enzyme immunoassay, and studies in U.S. blood donors reported specificities of 99.8% and greater than 99.99% sensitivity.
2. There are about 70 different things that can trigger a false positive result on HIV tests. Debunked: False positives do occur, but the immunoassays used in current tests are highly sensitive to HIV antigens. When a positive result occurs without supporting clinical history, the results are then retested by the even more accurate (>99.9%) western blot assay. Furthermore, the few things that may cause a false positive, such as hypergammaglobulinemia or lupus, are extremely rare, and very serious. In fact, the HIV test may eventually lead to the diagnosis of these diseases.
3. Test results vary over time. Debunked: According to Testing Window Period:
…the timeframe between when you are exposed to HIV to the time you test positive for HIV antibodies can be up to 3-6 months. This period of time is called a “window period” for HIV testing. On average, you may need to wait 2 to 8 weeks from the time of possible exposure to get an accurate test result, because it takes at least that long for the immune system to develop enough HIV antibodies to be detectable.
In other words, the test results do not vary. If you are outside of the “window period,” you may get a false negative, that’s why if the clinical history supports the possibility of an HIV infection, then a repeat test at a later date will rule out (or not) a false negative. This is not variability of the test, just the appropriate timing to confirm a diagnosis.
4. Test results vary between hospitals. Debunked: I’d provide a link, but there’s no evidence that this is actually true.
5. Test results vary between countries. Debunked: Again, it is difficult to debunk an argument without any support whatsoever, but since almost all tests are based on the same principle, an ELISA test, which is highly specific and accurate, the variability between countries would be limited.
6. Test results vary depending on which test kit is used. This means that an ELISA test could indicate that you are positive, but a Western Blot test or PCR test could indicate that you are negative. Debunked: This is just a repeat of point #2. The western blot test is much more accurate, but it is used only to confirm or deny a false positive. Since the ELISA test is 99.7-99.99% sensitive, the western blot is only necessary if you’re in that 0.001-.03% potential false positive AND there’s no underlying clinical history.
7. The HIV tests do not look for HIV in your body. The tests just look for chemical reactions which have never been proven to have anything to do with HIV. Debunked: All tests for viruses, which are too small to see without complex electron microscopy, rely upon the antibody-antigen reaction, which is a known immunological process. Of course, there are dozens of articles that support the accuracy of these tests in detecting HIV, including
…these results suggest that a combination of highly sensitive and specific commercially available monospecific ELISAs is a reliable and cost-effective strategy for type-specific serodiagnosis of HIV-1 and HIV-2 infections in HIV-seropositive persons and therefore represents a recommended strategy in areas where both HIV-1 and HIV-2 are endemic.
8. The personal information you give at a testing facility will have a big impact on how they interpret the test results. Debunked: this is a strawman fallacy combined with a bit of a non-sequitor. The fact is ALL medical diagnosis is based upon a combination of testing, patient history, and, sometimes, the instinct of the physician. As mentioned several times above, this matters especially if a false positive is reported and there is no patient history (if that history is available and accurate). However, based on the accuracy and specificity of HIV tests, there is a lot of weight placed on the HIV test.
9. If you are told you are HIV positive this will have a devastating emotional impact on you and your family. Even worse, if you start taking drugs like AZT, DDI and protease inhibitors you will be poisoning yourself and most likely die a slow horrible death. Debunked: Well, partially debunked. I will agree that it is a devastating diagnosis, but it’s no longer a death sentence like it was years ago. Today, the HAART, or Highly Active Antiretroviral Therapy, is the standard of treatment. Of course, there are adverse effects, some of them severe. All medical procedures, medications, and devices have some risks. It’s the benefit that matters, as long as it outweighs the risk. And according to the New England Journal of Medicine,
the routine use of increasingly intensive antiretroviral therapies has resulted directly in dramatic declines in morbidity and mortality among HIV-infected patients with advanced immune depletion.
10. No HIV virus has ever been isolated. Debunked: There is overwhelming evidence that the isolated HIV virus causes AIDS. The HIV virus has been isolated, and it is has been conclusively shown to be the cause of AIDS.
There can be only one simple and supported conclusion that HIV testing is the gold standard for diagnosis of AIDS:
This type of post from an AIDS denialist does a disservice to the US African-American community. It does a disservice to anyone who is afraid of the results of an HIV test. But mostly, it does a disservice to people who can get tested and treated early, so that they may live a long and happy life.