The Consequences of Controversy
What degree and what forms of credibility had Duesberg garnered in 1987 and 1988? On one hand, Duesberg's name and ideas, along with those of other dissenters, continued to surface in a variety of media and contexts. The gay magazine Christopher Street (owned, like the Native , by Chuck Ortleb) promoted alternative hypotheses of etiology in several more articles in 1988, and Duesberg entered the left-wing press with a positive treatment in the news-weekly In These Times . In a segment on AIDS treatments shown on the MacNeil/Lehrer News Hour , a San Francisco correspondent interviewed Duesberg, along with adversaries such as Winkelstein and Don Francis of the CDC. Jack Anderson wrote another column, focusing on Duesberg, Joseph Sonnabend, and Michael Callen, describing a "raging debate" over what caused AIDS, which was being enacted "behind the scenes of the AIDS crisis." Duesberg was also featured in a lengthy article in the popular scientific magazine Discover , which noted that he "doesn't look like a troublemaker" and that "even the Presidential Commission on AIDS recently listened to his testimony."
Moreover, there were signs throughout 1988 that Duesberg's views resonated with a small but not insignificant popular audience, particularly some gay men in cities throughout the United States. Volunteers at the San Francisco AIDS Foundation information hotline reported a
"small but growing number of calls about alternative theories regarding the cause of AIDS." And a number of activists were speaking out about the need to keep an open mind on the question of etiology. Michael Hirsch, founder of an advocacy group for HIV-positive people called Body Positive, was quoted in Christopher Street : "Body Positive feels very strongly that all possible theories and treatments should be explored. … Putting all our eggs in one basket is dangerous, as in the situation with HIV. AIDS has taught us that we have to assume responsibility for our own health. … We need to know about people like Duesberg and [Stephen] Caiazza [a proponent of the syphilis theory of AIDS causation], but the media is not going to tell us about them."
Finally, "AIDS establishment" scientists were increasingly forced, however reluctantly, to acknowledge the existence of controversy. "What is the evidence that HIV-I is the cause of AIDS? It is late in the history of HIV-I to bring this point up for review," complained Gallo in an overview of "HIV—The Cause of AIDS" published in 1988 in the Journal of Acquired Immune Deficiency Syndromes . "However, in the past year or so, those of us in the United States have seen the HIV-I cause of AIDS conclusion repetitiously, though not always thoughtfully, attacked by a few colleagues." The acceptance of their views, warned Gallo, "may lead to an irresponsible, carefree spread of the virus and progressive decline in the credibility of scientists, physicians, and health care workers."
But the most authoritative public representations of knowledge about AIDS showed little impact of the so-called "raging debate" beyond, in certain quarters, a perceptible hardening of positions. The 1988 update to the National Academy of Sciences' Confronting AIDS is instructive. In 1986, the report had questioned whether the term "AIDS" was still adequate to capture the full spectrum of conditions associated with HIV infection; by 1988, the authors were unequivocal: the actual disease being fought was the disease of HIV infection. "It is now clear that the 'AIDS epidemic' is really an epidemic of HIV infection, and when referring to the epidemic in general, we use the terms interchangeably." In 1986, the NAS authors had reviewed, without much passion, the evidence in support of the HIV hypothesis; but the 1988 update declared in boldface type: "The committee believes that the evidence that HIV causes AIDS is scientifically conclusive." The establishment line was presented without mention of dissent—yet the adamant tone of the presentation in comparison to that of two years
earlier suggested that Duesberg's opposition had mobilized scientific experts.
Another marker of authoritative knowledge was the report of the presidential commission, which appeared in 1988. Like the NAS, the commission tended toward a phenomenological merging of "HIV" and "AIDS," declaring in its "Executive Summary" that "the term 'AIDS' is 'obsolete.'" The commission maintained that "'HIV infection' more correctly defines the problem. The medical, public health, political, and community leadership must focus on the full course of HIV infection rather than concentrating on later stages of the disease." Such formulations, of course, left little room for doubt concerning the etiologic role of HIV. The phrase "HIV disease," the codification into language of a hegemonic belief, made it harder even to think the question of whether causality had been proven.