The AIDS Conspiracy: science fights back by Nicoli Nattrass (review)

South Africa has one of the world’s highest HIV prevalence rates (UNAIDS 2012:A4–7). Former President Thabo Mbeki’s adoption of AIDS dissidence, which critics have referred to as his ‘denialism’, marred his legacy, and it is also a topic which has received a great deal of scholarly attention – which is understandable, given its humanitarian consequences. A study by Pride Chigwedere and his colleagues has estimated that 333,000 AIDS deaths and 180,000 HIV infections could have been averted had antiretroviral drugs (ARVs) been rolled out between 2000 and 2005 (Chigwedere 2008).

Today the country is passing through an era of massive reductions in adult and infant mortality through the widespread provision of ARVs at state health facilities. Yet a small number of scientists, journalists, entrepreneurs and a significant minority of the general public still continue to adhere to unverifiable AIDS conspiracy theories, of which denialism – assertions of the harmfulness of HIV and questioning of the efficacy of ARVs – is but one type. AIDS conspiracy theories consist of notions of plots between multinational corporations, governments, scientists and physicians to either misrepresent the origins of HIV, the links between HIV and AIDS, the medical meaning of HIV tests, the ‘toxicity’ of antiretrovirals, or ‘overstate’ the number of AIDS deaths. These ideas are not merely disseminated on the internet, they have on occasion been published in non-peer-reviewed scholarly journals and most harmfully were taken up by the Mbeki administration. Such AIDS conspiracy theories have critical public health implications as they can encourage people to reject HIV prevention messaging and to refuse ARVs if they are living with the disease.

Nattrass’ detailed and informative discussion of AIDS conspiracy beliefs situates Mbeki’s view on AIDS transnationally and adds to our understanding of the popular dissemination of such ideas on the Internet and their uptake among young people in Cape Town (discussed in Chapter Three). While there have been multiple historical and ethnographic studies of AIDS denialism, this book adds an important quantitative and transnational dimension to the literature.

The public health consequences of AIDS denialism have been clearly demonstrated underscoring the relevance of studies of the prevalence of such beliefs and why individuals take them up, especially in a country like South Africa with its high HIV prevalence rate. Chapter Three draws on data from a survey of 2,901 young adults in Cape Town, 45 per cent of whom were African. While 16 per cent of Africans who completed the survey scored an average of ‘agree’ on the ‘AIDS conspiracy belief index’, this was true of only 1 per cent of the rest of the sample (44). As the book’s author states, this is ‘unsurprising given the history of racially discriminatory medical abuse and bio-warfare in South Africa’ (44).

Far more puzzling are the gender differences in the prevalence of these views: whereas 23 per cent of African men surveyed said they agreed with the statement ‘AIDS was created by scientists in America’, only 10 per cent of African women concurred. Nattrass draws on Isak Niehaus and Gunvor Jonsson’s ethnographic research which found a similar gender disparity in belief in AIDS conspiracy beliefs. This led them to hypothesise that men’s greater receptiveness to AIDS conspiracy theories may relate to the fact that while women tend to have state-provided child-support grants and, therefore, tend to be more focused on the domestic context, men who make up a greater proportion of labour market participants, are more vulnerable to the adverse influences of global political and economic forces which they cannot influence. It would be interesting for this gender disparity in adherence to AIDS conspiracy theories to be addressed in future social research on the phenomenon.

In her book, Nattrass offers a threefold schema for understanding the key social actors in promoting AIDS conspiracy theories, dividing them into ‘hero scientists’, ‘living icons’, ‘cultropreneurs’, and ‘praise singers’ (5). The book is especially interesting on the social and psychological reasons for the adoption of dissidence, parts...