HIV “Dissidents” and Demand-Side Conspiracy

“HIV dissidents” or “denialists” are people who doubt or reject the fact that AIDS is caused by HIV. This view often results in the death or illness of its believers, and occasionally in the deaths of children who have no say in the matter.

One of the fascinating things about HIV denialism is that the primary cause is not irrationality, or rhetoric, or fear of institutions. When researchers looked at why people deny, the overwhelming reason was that people didn’t want to accept the personal implications of the truth. The other stuff – global conspiracy, corrupt medical industry, etc. comes as a result of needing to do or believe something else that is incompatible with the truth.

An example? Well, there are a lot of people that have HIV and have had unprotected sex with others, sometimes partners. HIV is less contagious than we originally thought, but it is still contagious, and to believe HIV is the cause is to come to terms you have put people you love at risk — even if you are being safe now. Similarly, some people don’t want to undergo retroviral treatment because of side effects and so need to convince themselves that they don’t really need to go on meds; they tell themselves that being HIV-positive means nothing.

You’ll see this pattern in a lot of places. My wife’s stepdad passed away recently. He was a smoker, and he believed in all these crazy supplements. Why? Because he wanted to believe there was a way to counteract the ill effects of smoking without quitting smoking. Vaccine denial comes easy to parents who worry that they may have done something wrong during pregnancy or early life that triggered autism, or that the genetics of one of the parents may have played a role – a vaccine link calms that fear and puts it on the medical industry. I’m even willing to bet that some of the Sandy Hook deniers were moved deeply by those class photos of smiling and now dead kids over those horrible days (even now, typing this, I still shudder and tear up, remembering). But that emotion is perceived as incompatible with a belief in looser gun control laws, so something has to go.

Once you adopt a tenuous belief for pragmatic reasons, conspiracy quickly follows. Here’s an old testimonial from an “HIV Dissident” from the turn of the 20th century:

I can still remember the night (these things always seem to happen when it’s dark out) when I realized that if I, a regular person with no particular scientific training, could figure out there was something terribly wrong with the HIV-AIDS paradigm, then the people at the top had to know, too. I mean the people that fudge the numbers so it seems like the problem is always growing, the people who know that the antibody tests are not specific and that scientists have never used actual isolation to affirm their accuracy, the people who obscure the side effects of the drugs…

Take a look at the order of operations there. A person is diagnosed with HIV, and doesn’t want to get on the drugs (demand). They look online and find communities (even then) that say this is a myth (supply). That’s the rationale they need. The adoption of the conspiracy comes last, as they realize their newfound belief requires a conspiracy to stand up.

This isn’t a total narrative of the way people come to these things, of course. Not hardly. There are many reasons why people come to conspiracies, and why people stay in them. And it is the case that people with a lot to lose engage in online activism that impacts people with very little to lose (e.g. parents with autistic kids pull parents of non-autistic kids into the anti-vax community). I’ve talked about some of those other reasons before. So I don’t want to overemphasize. But the truth is that many people believe in conspiracies because the truth of the matter has a big, not small, impact on their life. They adopt these because the outcome is more personal to them, not less. And what the researchers found with HIV dissidents is as soon as that route of action they were defending became untenable (their symptoms got too bad, and retrovirals were necessary) the conspiracy fell away. The conspiracy died when you killed demand by making peace with the outcomes.

What does this tell us here? Eh. I don’t know. But its a reminder that the demand side of conspiracies is worth looking at. People believe in global warming conspiracies because they don’t want to give up their SUVs, health conspiracies because they don’t want to give up smoking, Sandy Hook conspiracies because they don’t want to see that a gun culture that they love can have terrible consequences on people for which they feel a deep and painful empathy. The conspiracy for these people is an attempt to be rational while making a pretty heavy lift against the science or inconvenient facts.

What the research into HIV denialism suggests, in part, is that to prevent conspiracy adoption, you have to deal with people’s fear of change and their guilt. Tell people that most people on retrovirals are actually quite happy. Put them in contact with happy people on retrovirals so they can see that. Minimize the fear of the impact. Tell people who may have infected others that it wasn’t the smartest thing, but it happens, and what’s important is what you do today. Reduce demand for the conspiracy by showing the other options are more palatable.

I’ll say that while I was a smoker, I was very prone to denialism myself. I had to be. So for a while I believed that smoking wasn’t as bad as it was said to be, that secondhand smoke didn’t harm my wife, and those secondhand smoke studies were cooked up, and that smoking cigarettes without chemical additives (Natural Spirit) dramatically reduced chances of cancer compared to other cigarettes. That was the demand. On the supply side, Big Tobacco supplied me with enough media stories and research showing doubt that I could continue to not come to terms with my actions. The biggest thing that turned me around was the birth of my first daughter, but the rhetoric that helped me the most was those commercials which said things like “One year after smoking, your heart attack risk is almost back to normal” etc. (I can’t remember the exact claims). It allowed me, for a period of time, to embrace change rather than fall into depression about what I had done to my body for ten years. And once I quit, all the denialism fell away within a year or two (though interestingly, not immediately).

Similarly, allowing a lot of people to say they were “duped” by the government on Iraq’s WMDs allowed people to accept the fact those weapons weren’t there, even though that route was a bit of a cop-out. Many people guessed right on the WMD issue of course; if you were duped, you partially duped yourself. But if what matters is going forward, letting go of the guilt, temporarily, can be useful. Years after I quit smoking, I could finally say that I had been an idiot. But it took time to accept that guilt.

It’s something to think about with other forms of conspiracy. Supply-side is incredibly important. But address the fear of change or the guilt, and you cut the demand side of the equation as well.

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