Map of life expectancy at birth from Global Education Project.

Wednesday, April 30, 2008

It's all a plot

No, HIV was not developed in a secret U.S. government laboratory as a method of wiping out black people and other undesirables. However, the good Reverend is far from alone in thinking so. According to a survey done in 2002-2003 by Laura Bogart and Sheryl Thorburn, 30.5% of African American men and 24.5% of African American women agreed that HIV was produced in a government laboratory; and 21.3% of African American men agreed that it was specifically created to control the black population. This study is in the JAIDS behind the subscription wall, but you can read WaPo summary here. The response rate to this telephone survey was acceptable, but the substantial number of refusals suggests to me, anyway, that the results actually understate the prevalence of belief in these statements.

(These authors also considered it a "conspiracy theory" that "There is a cure for AIDS, but it being witheld from the poor," a proposition with which the majority of both men and women agreed. Although there is no cure, there are effective treatments, and it is absolutely true that poor people, particularly outside of the United States, do not have proportionate access to them, so I can see why many well-informed people might have agreed with that. Since this is the most widely endorsed "conspiracy theory" in their survey, it does tend to undermine their other conclusions. But I digress.)

Since this purports to be a science blog, I should mention that there has been extensive research into the origins of HIV, well summarized for lay readers here. It is pretty well established that the virus first developed in chimpanzees, who acquired two related viruses by eating monkeys. These viruses then swapped genetic material to create HIV. (The process of gene transfer among viruses that co-infect an animal is common. It's one way in which new strains of influenza emerge, for example.) People then acquired it from chimps, probably in the process of butchering them for food. This undoubtedly occurred multiple times, at least as early as the 1950s and likely considerably earlier, although HIV disease was not recognized until the early 1980s.

Barack Obama, obviously, is not responsible for Rev. Wright's beliefs. But it's important to recognize how prevalent they are among African Americans, and to try to understand why this is so. It reveals widespread distrust of government, and of other important institutions in society, notably in this case the medical institution. ("Institution" in this case is a social science term of art that does not refer to a single hospital but to a component of society.) That white people seem to have such a hard time understanding why this is so is just as big a problem. Note my parenthetical paragraph above, about the researchers' idea of what constitutes a "conspiracy theory." Maybe it's not so parenthetical after all.

Update: A few responses to comments.

Yes, there are other infectious diseases which are more prevalent among poor people, and among black people. The death rate from septicemia -- i.e., toxic shock, massive bloodstream infection -- is higher among black Americans, as are STD rates generally. While I suppose people will take the latter as proof that black people are all wildly promiscuous, the truth is that both facts are probably a consequence of lack of access to health care, and inferior care when people do get it. Your risk of STDs depends on their prevalence among the people you are likely to have sex with. Since the main STDs are curable with a shot, people who are part of communities where most people get good quality, regular health care are unlikely to be exposed.

There was indeed a great deal of denial in the early years of the HIV epidemic, particularly in minority communities -- notably African American, Latino and Haitian -- who felt themselves stigmatized by an alleged association with HIV, and which also are characterized by conservative social norms and strong stigmatization of homosexuality. Many preachers in these communities gave counterproductive sermons, and political leaders did not want to confront the reality of the epidemic either. I think the conspiracy theories were in part a response to the feeling that these communities were being blamed and stigmatized, so people reactively turned the blame back on the government scientists who they felt were doing it.

We've come a long way since those years. Nowadays support for nonjudgmental educational and behavioral interventions in African American communities is pretty strong. A lot of clergy have changed their judgments and their approaches. The same is true among Latinos and Haitian-Americans, although stigmatization of homosexuality continues to be a problem in all three communities.

Although HIV is a natural phenomenon, it has functioned as a particularly nasty kind of social experiment. It's revealed a lot about our culture and others, and brought out both the worst and the best in people. The social history of epidemics is usually pretty interesting, but this one is the ultimate. It's probably time for somebody to write the next book.

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