Health & Medicine / HIV & AIDS

In the November issue of DISCOVER we reviewed the controversial book Serious Adverse Events: An Uncensored History of AIDS (Melville House, $16.95) by journalist Celia Farber. Covering the territory of so-called AIDS dissidents—people who question the relationship between HIV and AIDS, the mainstream treatments of the disease, and the scientific establishment's communications about AIDS to the public—Farber has been on the AIDS beat for two decades. In a Web exclusive, DISCOVER editor Susan Kruglinski interviewed Farber.

Your writing is considered controversial. What kind of reaction did you get when you first started writing about this and how has it changed over the last 22 years?
My work on this began in 1986. When I started researching AIDS, I was at SPIN magazine at the time as a research assistant. We eventually developed a monthly AIDS column called Words From the Front. And that was Bob's idea [Bob Guccione Jr., now CEO of DISCOVER]. He said AIDS is the Vietnam of our generation. The second column was an interview with Dr. Peter Duesberg. At the time we thought we were doing very straightforward journalism, but there was an immediate powerful reaction. We soon were made aware that we had touched across a major taboo. And the taboo was to question any of the orthodox—any of what's called the catechisms of AIDS.

I didn't actually stay on the story like a total obsessive for 22 years. Rather, what happened was I helped birth the story into the mainstream media, and it started to grow and grow and grow and grow. And it just has a life of its own. And that, I guess, was in a sense my original dream.

It's changed in that so much of what the orthodoxy proclaimed has not come true. The paradigm has failed miserably on virtually all counts. So the orthodoxy right now is particularly venomous and vicious against anybody who is what they call an AIDS denialist.

What are the failures of the paradigm?
The chief one is what used to be called the heterosexual AIDS explosion, which was the model. It was the core of the HIV theory—that there was a virus that was lethal, that was transmissible via unprotected sexual intercourse, needles, and other methods of transmission—blood-to-blood transmission. What they actually said was that there was a model of tertiary transmission. So anybody who sleeps with anybody who sleeps with anybody who's ever slept with anybody who ever was a drug addict, et cetera. It was a very terrifying model.

And one of the studies that the so-called dissidents have been drawing attention to is a study by a Berkeley researcher named Nancy Padian. Her study looked at transmission between couples where one was positive and one was negative. They had unprotected sex. They watched them over a period of 10 years. And there was not one single transmission in the whole group [during the 10-year study]—not one. [From the research paper: "Overall, 68 (19%) of the 360 female partners of HlV-infected men (95% confidence interval (Cl) 15.0-23.3%) and two (2.4%) of the 82 male partners of HlV-infected women (95% Cl 0.3-8.5%) were infected . . . transmission occurred prior to entry in the study. . . . Over time, the authors observed increased condom use (p <0.001) and no new infections."]

So what does that mean? Well, there's been a ruckus, a wild debate about this all over the Internet. At the very least, it means that the spread of HIV is extremely difficult, which is quite different than the terror, dread, bubonic-plague model we were given. That's just the first piece. The piece that I am most personally alarmed and upset by is the AZT piece of the history. When we were doing our most focused reportage in SPIN, it was during the peak of the AZT-mania years. AZT was given in extremely high doses. It is a chemotherapy that was developed in the '60s. Very crude, very toxic—some people say the most toxic drug ever given to human beings. And at the 1800- and 1200-milligram doses that were given in the first few years of the AZT craze, people died very clear AZT deaths. And there were some people around at the time who were saying, "That's AZT killing those people." And most people, by far, were saying, "That's crazy. It's the virus that's killing those people." That was where the first real war lines were drawn over AZT. AZT killed them—not the virus, not the illness, but the drug itself.

So what remains? Their great white hope is the cocktail therapy. And those cocktail therapies, protease inhibitors and so forth, definitely are a vast improvement. They are far less toxic. And, yes indeed, people stopped dying at the same rates they used to be dying. There are also broad-spectrum antibiotics and antimicrobials. So people have indeed been brought back from these complex immune disorders with those drugs.

So you don't feel AZT extended lives? You wouldn't compare it to chemotherapy or radiation therapy, which initially extended lives but had to be modified over time to work better and have fewer toxic side effects?
Here's what's strange about AZT's history. On a cellular level, AIDS is the opposite of cancer. Cancer is a proliferation of cells. And AIDS is a decimation of the cellular system. The first drug that was offered was a drug that decimates the cellular system. Why? Why treat an immune suppression with a powerful immunosuppressive drug? It makes sense in cancer. It does not make sense in AIDS. So that is a mystery I cannot answer. I do not think that they [the medical establishment] wanted to kill people. I chalk it down to the terror of the time. The terror of the virus has dissipated greatly. They basically used to say you'd fall down, bubonic-plague style, in the middle of the street. It was an irrational fear, and it was in advance of data. And it was drawing on cohorts of people who were very sick and were dying very fast.

AZT was approved, I think, in 17 weeks. The drug approval process itself was revolutionized to accommodate the approval of this ghastly drug. And that's one of those things that you can't go back from. I am not a believer in rapidly sped up drug-approval processes. But the only idea out there now, in the post-post AZT era, is that faster is better—this whole idea of drugs coming down the pipeline and that it's okay to test drugs in human populations.