Talk:HIV/AIDS/Archive 6

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NPOV Dispute

I am very concerned about the way this article tilts away from what I understand the scientific consensus to be. Specific areas of concerns include:

An estimated 60% of people with AIDS live in sub-Saharan Africa, where poor economic conditions leading to the use of dirty needles in healthcare clinics and no effective screening of blood transfusions may contribute to high rates of AIDS.

The clear implication is that this is the primary source of the high infection rates, a claim further amplified in this sentence:

Health clinics in some countries are responsible for as much as 30% of HIV transmission worldwide. reference [1] There is an urgent need to address medical transmission as a priority in these countries. see HIV transmission in the medical setting [2].

Firstly, the source of the 30% figure is based on a quote from a researcher, Yvan Hutin, in a US State Department press release. The relevant paragraph is as follows:

Hutin told the lawmakers that WHO estimates that approximately 2.5% of all HIV infections in sub-Saharan Africa are transmitted through unsafe healthcare injections but warned that his research of several "relatively reliable" HIV studies has revealed that medical transmission could actually be three to fifteen times higher than the conservative WHO figure.

To go from that, from a popular press source, to the phraseology currently in the article is inappropriate.

The second link goes to a report by a group called "Physicians for Human Rights", which argues for a higher priority to be given to medical transmission. I haven't had time to assess this report. I haven't heard of this group myself and have no idea of its credibility (one way or another; it's just that some organisations have established a reputation for getting it right over the years, and I don't know if this one has), and b) just because a report is clearly-written and has references doesn't make it credible. I've seen clearly-written, referenced reports by advocacy organizations where the references didn't actually support the article.

The article barely mentions the scientific near-consensus that the majority of cases in sub-Saharan Africa are transmitted through heterosexual sex!

Additionally, the article still talks about the "Bangui definition". My earlier concerns, noted earlier on this talk page, have still not been effectively addressed. --Robert Merkel 07:09, 27 May 2005 (UTC)

I hope this 2003 quote helps you
Voluntary testing and counselling are accepted widely for the prevention of human immunodeficiency virus (HIV) infection. Therefore, simple, accurate and affordable tests are required. The diagnosis strategy used in developed countries, based on an immunoblot confirmatory test, cannot be used on a large scale in developing countries because of its cost. [3] Sci guy 03:58, 28 May 2005 (UTC)
What does that have to do with anything? At least the paper you cite below speaks directly to your claim...--Robert Merkel 04:25, 28 May 2005 (UTC)

Robert, I have reinstated the reference that you previuously deleted

A study on Zaire published in 1993 found that of 465 patients with clinical signs of AIDS, 39.4% were seropositive. see Epidemiology and clinical manifestation of HIV infection in northern Zaire.Strecker W, Gurtler L, Schilling M, Binibangili M, Strecker K. Eur J Epidemiol. 1994 Feb;10(1):95-8.
I will try and see if I can get a copy of this paper to have a look. However, I'm pretty skeptical. In effect, this paper claims that something other than HIV is causing AIDS. This is an absolutely sensational conclusion; if there was anything to it, it should have attracted a bunch of followup by now. However, that study that has not been cited by any *other* papers in PubMedSci. Just because *one*, seemingly "orphaned", paper says something is not evidence that the scientific consensus is that the paper is correct (or, more to the point, the conclusions you've drawn from it are the current scientific consensus).

There are many other simliar studies, which I am happy to source and add.

Please do so, particularly including survey articles, articles published in the top-end journals, or reports detailing the consensus views of policy-advising bodies like the CDC, WHO, or equivalent.

If you can find any evidence of HIV testing in diagnosis of AIDS in Africa and other "developing" countries please provide it. My understanding is that few countries diagnose AIDS as thoroughly as the US - although I have read that most of the AIDS patients in Africa would not test as HIV positve in Australia, even many US and Eurpoean AIDS patients would not be considered HIV positive. This is because Australia requires more Western blot spots than any other country. The more stringent standard was required because so many Australians who tested negative on ELISA were postive on Western blot!

I am concerned that you think by adding information from WHO, CDC and UNAIDS, that neutral point of view is threatened! Indeed you have been active in deleting quotes from these sources. Sci guy 13:30, 27 May 2005 (UTC)

No I haven't. Check the edit logs if anybody is interested. --Robert Merkel 01:32, 28 May 2005 (UTC)
Oh, and as I'm in Australia, I might see if I can check that claim with some local AIDS experts... --Robert Merkel 04:25, 28 May 2005 (UTC)

Unsafe medical injections

I have just added link to CDC January 2005 update stating that "According to the World Health Organization, the global burden of disease from unsafe injections worldwide accounts for an estimated 5% of HIV infections." [4] This is recognised as a major current issue by the so called "mainstream scientific consesus" Sci guy 16:23, 27 May 2005 (UTC)

That's interesting. I'd like to know where the WHO said it. That's still a very long way from 30%.

For a fuller analysis I suggest you read HIV infections in sub-Sahara Africa not explained by sexual or vertical transmission [5] Sci guy 16:27, 27 May 2005 (UTC)

I just did. The article summary suggests that the current medical consensus is that heterosexual sex is to blame for the majority of infections; the authors dispute that consensus. What I am suggesting to you is that the consensus hasn't changed; the fact that there is scientific disagreement on the topic is worthy of discussion in the article, but implying that majority medical/scientific opinion is of the view that medical transmission is responsible for more than a fraction of AIDS cases is incorrect. ---Robert Merkel 04:43, 28 May 2005 (UTC)
I suggest you read it again. There is no scientific disagreement. The 1983 "consensus" was a political decison based on the available evidence. After twenty years of collecting data from Africa, the facts no longer support the earlier ideas. This is happening all the time in AIDS research. New facts result in changes to the hypothesis. It is called the scientific method. 203.123.69.214 02:56, 29 May 2005 (UTC)
As a working researcher (in software engineering, but the process is similar) I know something about scientific consensus. And one paper claiming the scientific consensus needs changing, doesn't mean it *has* changed. --Robert Merkel 14:22, 31 May 2005 (UTC)

It is important to note that in 2001 the issue of preventing HIV/AIDS infections in health care settings has been identified by the United Nations as needing immediate attention. [6]

Again, interesting, but not supporting your claim.

AIDS diagnosis in developing countries

I hope this quote helps you see the diffculties with the WHO simplified algorithms based on sequential screening tests, and in general confirm the lack of laboratory testing on AIDS diagnosis in many countries. The conclusion is essentially that most of the AIDS cases would not be confirmed by standard testing in France. (or any other Western country) Sci guy 04:29, 28 May 2005 (UTC)

The lack of expensive equipment and well-trained laboratory technicians in developing countries makes it difficult to use standard methods (2 EIA confirmed by western blotting) to diagnose HIV infection. This led the WHO to develop simplified algorithms based on sequential screening tests, with no confirmation by immunoblotting. These algorithms were tested in the normal diagnosis conditions of a medical unit in Maputo, Mozambique. We tested 402 sera, collected with the consent of the patients concerned. The sera were first tested for HIV according to French regulations (2 EIA with western blot if at least one EIA was positive). This strategy identified 53 sera as positive for HIV1 and 1 serum as positive for HIV2. We then tested who algorithms, one for a predicted rate of prevalence < 10% and the other for a predicted rate of prevalence > 10%. Neither algorithm performed adequately for diagnostic purposes. Further evaluation with a panel of local sera is required to select the most suitable algorithm in terms of specificity and sensitivity, and algorithms should be throughly tested before inclusion in national AIDS control strategies. [7]

Alternative Strategies for Confirmation of Human Immunodeficiency Virus Infection Require Judicious Use

This 2002 article details the problems with the World Health Organization testing strategies for alternative HIV confirmation to maximize accuracy while minimizing cost. [8] Almost half of 2,000 samples could have been mislabeled as HIV positive!

??

What has happened to this article? Suddenly it's very short, and much of the information seems to be missing... Exploding Boy 16:45, May 27, 2005 (UTC)

Well at present we are having a discussion about whether WHO/CDC/UNAIDS information is breaching the NPOV! But apart from that the article is essentially the same as when you last edited. Vaccine has been moved to treatment. Duplicated material has been consoidated and many unreferenced speculations deleted. I have been attempting to restore all the deleted references. Please feel free to add anything you think has been deleted in error. Sci guy 16:59, 27 May 2005 (UTC)

What's happened is that Sci guy has butchered what was a very complete and well-written Wikipedia article. Take a look at his 27 May 2005 edits, if you don't believe me. I've got no idea what his motive is. I'm tempted to take him up on his "feel free to add anything you think has been deleted in error" offer and revert the whole thing back to the 26 May 2005 version. Carl Henderson 02:56, 29 May 2005 (UTC)

I have compared the 26 May 2005 version with the currect one. Main changes are correcting monkey to chimpanzee and adding references. The safer sex was edited to make the main issue clear: "put a condon on the penis to stop AIDS". Ideas about AIDS have changed so much in 20 years. Should this article be about gay men and IV drug users in the United States or pregnant women and children in Africa? Should Africans be given antiretroviral drugs or blood transfusions that have been screened for HIV? Why do different countries use different tests (or even no tests) to diagnose AIDS? What percentage of AIDS cases in the "developing world" would be confirmed by testing this the United States? As most people in the world dianosed with AIDS do not have HIV antibodies, what is causing their AIDS? All of these questions are part of the UNAIDS, WHO, CDC, and RED Cross "medical consensus".

"How the crisis confronting Africa is defined, and by whom, will make a fundamental difference to the outcome. HIV is an exceptional disease which, in HIV prevalence countries, has a unique capacity to derail development progress. However, a line must be drawn between treating HIV as an exceptional disease (exceptionalism) and paying attention only to HIV at the expense of other diseases (isolationism) or development issues. The AIDS epidemic should be understood as part of the wider crisis of underdevelopment."
quoted from "AIDS in Africa: Three scenarios to 2025". UNAIDS. March 2005. 

According to the WHO the cumulative number of AIDS cases from 1980 through 1997 for all of Africa was 620,000. For comparison, the cumulative total of AIDS cases in the USA through 1997 was 641,087. But the US cases were all tested for HIV antibodies and confirmed with Western blot! The African cases were not all tested for HIV. A study on Zaire published in 1993 found that of 465 patients with clinical signs of AIDS, 39.4% were seropositive. see Epidemiology and clinical manifestation of HIV infection in northern Zaire. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7957799&dopt=Abstract)Strecker W, Gurtler L, Schilling M, Binibangili M, Strecker K. Eur J Epidemiol. 1994 Feb;10(1):95-8.

Sci guy 03:52, 29 May 2005 (UTC)

I was in error. I said May 26th when I should have said May 22nd. May 23rd was when you made the bulk of the changes I felt were unwarranted. Sorry for the confusion--this article changes so fast I just lost track.Carl Henderson 05:53, 30 May 2005 (UTC)

Big revert

This page has unfortunately been infected by one of the types that Wikipedia finds most-difficult to deal with; the well-informed zealot. Essentially, Sci Guy and his ilk are very vocal, well-informed advocates for a view well outside the medical mainstream. That doesn't make them wrong, but it does mean that they have turned this article into advocacy for their position. I'm not an expert on AIDS, but I do know that the article is pushing a very different line to the WHO and the like, and that Sci Guy is consistently misrepresenting the state of the scientific consensus. Hence, in the absence of either the expertise or the patience, I'm reverting to what appears to be one of the last "known-good" versions. --Robert Merkel 04:41, 29 May 2005 (UTC)

Your revert deletes all the UNAIDS, CDC and WHO references that were specifically sourced and added at your request. But your revert is full of outdated and unreferenced opinions. How is this good wiki behaviour? Sci guy 11:56, 29 May 2005 (UTC)
I'm not really interested in debating the issue any more with you, frankly, because you're just going to continue to selectively quote evidence in a way that doesn't represent the scientific mainstream on the issue. As a researcher in a different field, I can quote all manner of studies to "prove" things that are way outside the consensus of it, which is exactly what you're doing. I invite others to compare the way the article ended up through your edits, compared to the version I'm reverting to. --Robert Merkel 15:54, 29 May 2005 (UTC)
As a researcher in this field of HIV/AIDS, I want to try to put a more professional view on what is understood in HIV research to this date. Unfortunately, I am being reverted by Sci Guy who has no educational or knowledge basis for hs reverts. --Grcampbell 17:26, 11 August 2005 (UTC)
Precisely. I am restoring versions that have the support of two or more other editors. Your input is both valued and appreciated, but not at present understood. Perhaps you could use the discusion page of the relevant article to explain your intentions. Sci guy 17:06, 12 August 2005 (UTC)
Just because you think previous versions have 'support' of two or more editors doesn't mean they are more correct. Perhaps if you used that discusion page of the relevant article, you could ask others which version they support more before making ridiculous reverts... JoeSmack (talk) 17:17, August 12, 2005 (UTC)
Joe, restoring a version previously supported by several other editors is NOT making ridiculous reverts Sci guy 02:07, 13 August 2005 (UTC)

AIDS diagnosis in developing countries

Fred, I ask you a similar question to what I asked Sci Guy. The stuff about diagnostic criteria not involving antibody testing dates from more than 10 years ago. Is that still the case in 2005? --Robert Merkel 13:57, 30 May 2005 (UTC)

NPOV dispute

I believe that the current edit-war between Robert Merkel and Sci Guy represents a divergence of opinion which needs to be recognized in a better way than simply reverting Sci Guy's changes. I'm not saying either is right, or wrong, but that fair consideration of disputes be acknowledged. Whig 05:32, 31 May 2005 (UTC)

Thank you Whig! I have a completely open mind on where this article is going. There have been so many changes of direction in AIDS, that next year could bring anything. After the false starts of AZT, HAART and chemokines, I am reluctant to expect much of the new treatment vaccine, but the results are intersting enough to include in the article. My main interest has been to attempt to reference the article and bring it up to date. Also editing was required to remove material that was repeated within the article. The removal of material referenced from source like WHO, CDC, UNAIDS and National Institutes of Health and National Institute for Allergy and Infectious Disease is of concern to me. I would prefer to discuss how we can better summarise the facts, rather than discard the facts. Sci guy 15:51, 31 May 2005 (UTC)

Quite frankly, I agree with Robert's assment of the situation, that Sci Guy seems to be pushing his particular brand of POV. I'm not expert on the topic of AIDS, but even I can recognize that what he's saying is at odds with the consensus of the scientific community. →Raul654 19:17, May 31, 2005 (UTC)

I'm not sure Wikipedia's encyclopedia article on AIDS should be written by someone who can characterize HAART as a "false start" - it's still current treatment, or who believes that chemokines were ever a "start" of any kind - they never had any significant clinical use. All opinions aren't equal, and the denialists are already more than adequately represented in that article: it doesn't have to be brought here, where it degrades the quality of the article. - Nunh-huh 00:23, 2 Jun 2005 (UTC)

I am sorry you misunderstood my comments about HAART. HAART was orignally promoted as a therapy to eliminate HIV and prevent progression to AIDS. This was the hit hard, hit early apporoach, which has now been discredited and abandoned by the scientific consesus based on many clinincal studies. Treatment guidelines now defer HAART until CD4 count is about 200 or there is an AIDS defining condition. So effectively HAART is now used to treat AIDS rather than prevent it. Sci guy 15:51, 5 Jun 2005 (UTC)


I really think there are more constructive ways to resolve things than revert warring. Rather than agreeing or disagreeing with Robert or Sci Guy, let's discuss here what changes the article needs to make it conform to NPOV. The mainstream scientific viewpoint is not universally held, but minority views should not be given precedence. The solution is not to state viewpoints as facts, but to attribute statements with appropriate citations. While Wikipedia encourages us to be bold I think that it would be best here for changes to be made in small steps with explanations given in this Talk section to back them up. Whig 00:33, 2 Jun 2005 (UTC)
No viewpoint is "universally" held, and no fact is universally acknowledged. The fact that someone somewhere doubts a given fact doesn't make that fact a "viewpoint". - Nunh-huh 00:40, 2 Jun 2005 (UTC)
Science is not a collection of facts, but a method, by which hypotheses are tested and become generally accepted theories. Even theories which have existed for hundreds of years are subject to challenge and refinement or replacement with ones that more accurately describe and/or predict observations. In this specific case, the HIV theory of AIDS is generally accepted today, and the article should properly say so, without stating it as fact. Whig 01:26, 2 Jun 2005 (UTC)
Just the fact that some people doubt something don't turn a fact back into a theory. There are thousands of Holocaust deniers, yet nobody has agreed to call the historical account "The Holocaust legend" or "theory". Wikipedia loses credibility if it refers to the standard model of AIDS as a "theory". JFW | T@lk 02:26, 2 Jun 2005 (UTC)
That's nonsense and you know it. By your (Whig's) logic, there are no facts -- the earth doesn't revolve around the sun, it's just a generally accepted and well supported theory. Should we edit the relavant wikipedia article to state such? →Raul654 02:30, Jun 2, 2005 (UTC)
This is devolving to Godwin's Law here. The Holocaust was a historical event, not a scientific theory. Newton's "law" of gravitation was actually a (very good) theory, and was replaced by Einstein's general relativity, which in turn does not reconcile with certain observations of quantum mechanics. Biological science (and consequently medicine) also evolves over time. We don't have final answers on the causes of many diseases and disorders, from multiple sclerosis to cancer to AIDS. We have inferences and treatment modalities based upon the best scientific research available, and we apply them and study whether they cure or treat the underlying condition or the symptoms. We do not have a cure for AIDS yet, so nobody can claim to have a full understanding of the cause or causes. We do have a generally accepted theory that HIV causes AIDS, and it is the basis of almost all current research. The article should represent exactly this, and the minority who disagree should not be given precedence. I've said this before. But the objections that some people seem to be making are that we ought to state the prevalent theory as fact and denounce the possibility of error. And that violates both the scientific method and NPOV. Whig 07:37, 2 Jun 2005 (UTC)
Really minor point. According to the theory of gravitation, the sun and earth both "revolve" around one another to some extent, inasmuch as any two massive bodies each attract the other. The relative mass of the sun is so very much greater than the mass of the earth that the distinction is almost trivial, but the perturbations are real and measurable. Whig 07:43, 2 Jun 2005 (UTC)

Getting the Opening Paragraph right

We do have a generally accepted theory that HIV causes AIDS, and it is the basis of almost all current research. The article should represent exactly this, and the minority who disagree should not be given precedence. - Ok, let's take this idea and run with it. Let us compare the opening paragraph's of Sci-guy's version and Robert Merkel's version as they pertain to HIV:


Robert Merkel's version: AIDS (Acquired Immunodeficiency Syndrome or Acquired Immune Deficiency Syndrome, sometimes written Aids) is a human disease characterized by progressive destruction of the body's immune system, thus destroying the body's ability to fight infection and certain cancers. It is widely accepted that AIDS results from infection with HIV (Human Immunodeficiency Virus).
Sci-Guy's version: AIDS (Acquired Immunodeficiency Syndrome or Acquired Immune Deficiency Syndrome, sometimes written Aids) is a global, human epidemic...These global estimates of AIDS are based on HIV antibody testing of small samples of pregnant women at selected clinics rather than actual reported AIDS cases.

Which one of these more accurately represents the generally held view that HIV causes AIDs? I think the answer is quite obvious - Sci guy's version is an obvious attempt to distance any connection between HIV and AIDs, and this attempt sticks out like a sore thumb. →Raul654 08:01, Jun 2, 2005 (UTC)

If you consider it a "generally held view" why declare it as a fact, instead? Why claim a concensus when the questions of well-qualified scientists, well-documented in Wikipedia despite efforts to exclude their work, must be excluded from the notion of concensus for the notion to have merit? Sandlawould 20:45, 13 August 2005 (UTC)
On the first paragraph comparison, Robert Merkel's version is better, if we have to choose between one or the other. Fortunately we aren't forced to make these sorts of binary decisions on Wikipedia, we can work to edit things continually to a better state. I'd take a pass at proposing a revision, but it's way past time I went to bed for tonight. Maybe tomorrow. :) Whig 08:23, 2 Jun 2005 (UTC)My god is this old chestnut still being argued about? Oh I forgot, there are quite a few paranoid flat earthers out there.

I agree that getting the first paragraph right is a good start. It defines the scope of the article.

In 2005, the main issue is the global epidemic claims of WHO and UNAIDS. I assume we agree that WHO and UNAIDS are part of the consesus. I think reporting the range of these estimates is important to give a clear idea of the accuracy claimed for these estimates. Also the 60% in sub-Saharan Africa, as this is claimed to be the most affected area (and also the source of the epidemic, if we accept the chimapanzee theory).

It is also important to note that while screening of blood transfusions and using clean needles for each injection were adopted 20 years ago in the United States to "stop the spread of AIDS", these precautions have not been widely adopted in Africa. Back in 2001, the UN called for the adoption of these measures to stop the spread of AIDS in Africa. So once again this all appears very consesus to me.

Whether or not HIV causes AIDS is red herring. The fact is that since 1985 evidence of HIV antibodies has been required in the United States for an AIDS diagnosis and the WHO/UNAIDS estimates for Africa are based on HIV antibody testing of pregnant women, who had a blood test for syphilis. So by definition there is no AIDS without HIV.

The more difficult question is the thousands of US blood donors and army recruits who have tested positive in HIV antibody tests. In most cases the repeat test was negative or the western blot did not confirm. What caused all these false positive results.

I notice that "HIV carriers" is now the preferred term in RA Weis and RW Wrangham. From Pan to pandemic (http://faculty.virginia.edu/bio202/weiss%20pan%20to%20pandemic%201999.pdf). Nature 397, 385-6 (1999). Also the scientific consesus is always careful to say "estimated 23 million people with AIDS have died since 1981" rather than dying of or from AIDS. Is this pedantry or precise use of language.

I have no problem with "dumbing down" the facts for Wikipedia, as long as we avoid subtle shifts of meaning. If Sci guy has sinned in this regard, then edit his summaries by all means, but do not simply revert to delete advances in the scientiic consesus that you do not like.

Personally I think both versions need a lot of work! Fred2005 13:43, 2 Jun 2005 (UTC)


Okay, I've made a pass at editing the first paragraph. Have a look, please edit appropriately if you can improve it, and/or comment here. Whig 21:24, 2 Jun 2005 (UTC)

"In most cases this weakening is progressive"

I still don't like this phrasing. Out of tens of millions of infected people, how many long term survivors are there? Dozens? Maybe a few hundred? I don't think it's unreasonable to say it's a trivial, negligible number. Saying that it is a progressive weakening 'in most cases' falsely implies that long term survivors are a non-trivial portion of AIDS patients. →Raul654 21:50, Jun 2, 2005 (UTC)

Robert Merkel's version: AIDS (Acquired Immunodeficiency Syndrome or Acquired Immune Deficiency Syndrome, sometimes written Aids) is a human disease characterized by progressive destruction of the body's immune system, thus destroying the body's ability to fight infection and certain cancers. It is widely accepted that AIDS results from infection with HIV (Human Immunodeficiency Virus).
"Sci-Guy's version: AIDS (Acquired Immunodeficiency Syndrome or Acquired Immune Deficiency Syndrome, sometimes written Aids) is a global, human epidemic...These global estimates of AIDS are based on HIV antibody testing of small samples of pregnant women at selected clinics rather than actual reported AIDS cases.
AIDS AIDS (Acquired Immunodeficiency Syndrome or Acquired Immune Deficiency Syndrome, sometimes written Aids) is a disease, and a global human pandemic, characterized by progressive destruction of the body's immune system, thus destroying the body's ability to fight infection and certain cancers. It is widely accepted in the scientific community that AIDS is usually the progressive result from infection with HIV (Human Immunodeficiency Virus). A person with HIV that does not develop AIDS is called a HIV/AIDS nonprogressor.

That's my contribution to the opening paragraph, I like Sciguy's caracterization of it being a epidemic, i think it really is a pandemic do to it being over a certain threshold of infections. --ShaunMacPherson 23:40, 2 Jun 2005 (UTC)

I just went through and did 3 big removals - I removed the "see also" and "related diseases" lists at hte bottom --- see also is depreciated (anything worthy of a see also should be written into the prose of the article and linked; the same applies for related diseases); I removed the bolded from the phrases, because you're only supposed to use bold for the article name and phrases that redirect here; lastly, I removed that horrible section at the end of the intro that looked like links, but weren't properly formatted and didn't seem to be cited by any particular fact (someone can add these back in again if they do it properly). →Raul654 23:53, Jun 2, 2005 (UTC)

Also - the citation style on this article *sucks* and needs to be improved drastically. →Raul654 23:54, Jun 2, 2005 (UTC)

OK I'm just reverting Sci Guy. He continues to remove information about HIV causing AIDS and replace it with his "AIDS is defined as occuring..." gibberish. At least make an attempt to use proper English, Sci Guy. Rhobite 16:03, Jun 3, 2005 (UTC)
I am sorry you think the CDC definition of AIDS is gibberish. It has been the basis of all thinking on the subject since 1993. Also it is referenced to source and is factual. Sci guy 16:12, 3 Jun 2005 (UTC)

A suggestion

I think the CDC definiton of AIDS is both widely accepted and NPOV

AIDS (Acquired Immunodeficiency Syndrome or Acquired Immune Deficiency Syndrome, sometimes written Aids) is a global human epidemic. AIDS is defined as occuring in persons with HIV antibodies, who have an AIDS-defining condition or a CD4+ T-lymphocyte count less than 200 cells/uL [1] (http://www.cdc.gov/mmwr/preview/mmwrhtml/00018871.htm)

Also the Global epidemic figures from UNAIDS are both current and NPOV

UNAIDS and the World Health Organization estimated that between between 2.8 and 3.5 million people with AIDS died during 2004. [2] (http://www.unaids.org/wad2004/EPIupdate2004_html_en/Epi04_02_en.htm#P16_3133) It was estimated that between 39 and 44 million people around the world had antibodies to HIV in December 2004.

Can we at least agree on this factual, referenced start to the article? Sci guy 16:06, 3 Jun 2005 (UTC)

Um, no, as I think we've made clear. For a start, it's way too technical for the first sentence of an article. Stuff about diagnostic criteria is better covered, in detail, in a later section. --Robert Merkel 16:08, 3 Jun 2005 (UTC)
It may be technical, but it is also accurate and referenced. It defines what everyone means by AIDS. Asl it sticks to the facts and avoids POV issues Sci guy 16:13, 3 Jun 2005 (UTC)
What we already had was accurate, and it was better writing as well. Simply copying a definition from a source and calling it an introduction is inherently bad writing. →Raul654 16:43, Jun 3, 2005 (UTC)
I wonder why Sci Guy doesn't want to copy this sentence from the CDC as well? "The etiologic agent of acquired immunodeficiency syndrome (AIDS) is a retrovirus designated human immunodeficiency virus (HIV)." Sci Guy, your selective quoting and obfuscation of facts is detrimental to this article. One more thing, it's spelled "occurring". If you're going to revert war in this highly visible article, at least use a spell checker. Rhobite 20:31, Jun 3, 2005 (UTC)
Its a bad lede sentence for the same reason I think some may prefer it: it misses the point when it mentions "HIV antibodies" rather than "HIV infection". It uses a circular definition (AIDS is defined by having an AIDS-defining condition) while falsely suggesting that having a CD4 count of less than 200 is not an AIDS-defining condition. It suggests that the illness is "defined" rather than described. (And it advances Sci-Guy's preferred style of "Aids" rather than "AIDS", which is far more common, while suggesting that the idea that it is "sometimes called "Aids" is something quoted from the CDC (which it isn't)).- Nunh-huh 00:20, 4 Jun 2005 (UTC)
I agree that many people consider the CDC definition to be a circular definition. Also you are correct the CDC definiton lists CD4 count of less than 200 and AIDS-defining conditions as two bullet points. They are two different catergories. Sci guy 00:55, 4 Jun 2005 (UTC)

Incorporating all these suggestions could give this version:

AIDS (Acquired Immunodeficiency Syndrome) is a global human epidemic. The etiologic agent of AIDS is a retrovirus designated human immunodeficiency virus HIV. AIDS is defined as a CD4+ T-lymphocyte count less than 200 cells/uL or an AIDS-defining condition in persons with HIV antibodies. [9]

This avoids much of the POV unreferenced specualation Sci guy 01:49, 4 Jun 2005 (UTC)

I'm sorry, I'm missing something - what POV, unreferenced speculation? You were removing a whole lot of material that I don't really thing one could argue is not true, such as the fact that it is currently incurable or the fact that it was first noticed in homosexuals. (At least not with a straight face) →Raul654 02:03, Jun 4, 2005 (UTC)

Estimating epidemics

The methods used to estimate the spread of a disease may be very different for the methods to diagnose that disease. During the recent SARS outbreak in China, sales of vinegar provide useful information about the spread of [[[SARS]] within China, because vinegar is a traditional Chinese remedy for symptoms associated with SARS. This does not mean that eveyone who buys vingar has SARS. World wide sales of vinegar provide no useful information about the global spread of SARS.

HIV antibody tests have not been evaluated for use in Africa. Many common tropical diseases are known to cause a false positive. HIV antibody screening of all pregnant women in European coutries has confirmed no increase in positve results since 1985 and about two third of positve results are women from Africa. Also most African children who tested HIV positive have a mother who is HIV negative! The major risk factor for children in Africa appears to be unsafe medical injections. Sci guy 15:52, 5 Jun 2005 (UTC)

Fred's big deletion...

Fred, while some of the information you've deleted is redundant and belongs elsewhere, some of it isn't, and your opening sentence is less clear than what was there before. Please try to remember that we're writing for a non-expert audience. --Robert Merkel 15:12, 9 Jun 2005 (UTC) I'm reverting then C&Ping the changes here. While I think a lot of these are good, I see none of the discussion and edit summaries you'd expect. Its not good behavoir, even if you think its good editing--Tznkai 17:50, 9 Jun 2005 (UTC)


Fred2005's changes can be seen here [[[10]]] A lot of these look like good changes, but I think overall the quality has been reduced. Please discuss here, reach consensus then change article, especially one so contraversial--Tznkai 17:55, 9 Jun 2005 (UTC)

I found his information much more informative and clear. He seems like he has a good background, I favor his edits, all of them. 207.224.198.170 02:48, 10 Jun 2005 (UTC)

He's an HIV/AIDS denier, just like Sci Guy. His edits should be viewed with appropriate skepticism. Rhobite 02:59, Jun 10, 2005 (UTC)
According to his edit history, his revisions today lieft intact the connection between HIV and AIDS, in fact more bluntly than the previous. 207.224.198.170 04:07, 10 Jun 2005 (UTC)
In any case, mass deletions should always be justified. The information may be "redundant", but this is because the article follows the summary style recommended for large articles. To quote the style page: "Articles written in summary style have lead sections that are concise encyclopedia articles in their own right." Some of Fred2005's changes seemed positive, but as Tznkai and Robert Merkel have said, the overall quality had been markedly reduced. -- Hadal 03:02, 10 Jun 2005 (UTC)
I agree with the comments above that mass deletions should be disfavored unless very well justified and I have said before that we ought to be addressing this article in a more conservative fashion, despite the general principle that editors be bold. Nonetheless I think that some of Fred's changes would be worthwhile had they been made in a more careful and constructive fashion. This article is honestly getting worse from a NPOV standpoint, not better, because of the strong views of those who wish to discredit and remove elsewhere any dissent. I am not taking sides on who is right or wrong, nor have I suggested that minority views be given precedence, but they ought not to be excluded either. My own efforts to clean up the introduction have been effectively obliterated. I think I will try to selectively apply some of Fred's wordings where they seem appropriate and invite constructive comment rather than mass reversions. Whig 07:13, 10 Jun 2005 (UTC)

I restate my point. I am all for improving this article, but massive changes should come with good explanation, and superior support, not just an opinion that its superior. Revert wars are never the answer. The goal here should be comprehensive: Primarly show the majority mainstream view, "facts" and then note the minority views and where they come from--Tznkai 16:45, 10 Jun 2005 (UTC)

If you have to put "facts" in quotes, I think you recognize that the majority mainstream view is not necessarily factual. Again, the MMV should be given precedence, no question at all, but we should attribute and not state as fact. Whig 18:57, 10 Jun 2005 (UTC)
The quotes are there to indicate that there are facts, and there are facts. Fact is one of those wonderfully misused word "Evolution is a fact/Not a fact just a theory" especially in science. For a while the MMV was that AIDS is a gay disease, something that modern statistics shows totally false. Facts to me, is anything properly cited, a definition used by the medical community, or anything else which the statement itself isn't debateable, just its implications. At any rate, as it is, this article is a bit large and could use some careful editing.

I keep forgetting to sign--Tznkai 19:29, 10 Jun 2005 (UTC)

POV evolving to total dispute

The present article does not even make mention of the fact that there exists any controversy with respect to the cause and definition of AIDS, the accuracy of testing methodologies, the differing definitions in the US, Canada, Europe and Africa, the safety and efficacy of antiretroviral medications, and therefore presents a unitary POV that excludes any and all disagreement. Whether or not this POV is correct or false is not, and has not been, my concern. However, every attempt I have made to give even a suggestion of the existence of dispute has been removed, and there is not even a link now to the (very poorly written) article on AIDS reappraisal. The article now even begins by defining AIDS as infection by HIV. I am becoming increasingly inclined to mark this article totally disputed unless folks are willing to work constructively to work these issues out in a way which gives appropriate precedence to the mainstream view while respecting the existence of diverse views by respectable scientists. Whig 03:32, 12 Jun 2005 (UTC)

Yes, and you were inclined to endorse the 83% false positive rate for Western Blots in the dissenting article, too. One thing this article doesn't need is more disinformation like that. - Nunh-huh 03:43, 12 Jun 2005 (UTC)

I'm not inclined to endorse or dispute any fact that I don't have a citation for. The 83% false positive rate was stated in the article, and similtaneously claimed to be negligible. That is inconsistent. Either the false positive rate is considerably lower than 83% or it is non-negligible. Whig 03:53, 12 Jun 2005 (UTC)
Yes, and you eliminated the wrong alternative. You ought to be inclined to dispute someone who says a test in clinical use has an 83% false positive rate. If you were in doubt as to which of the inconsistent alternatives was wrong - and you should not have been - you should have cleared that doubt up by doing research rather than simply picking the alternative you favored. . - Nunh-huh 04:54, 12 Jun 2005 (UTC)
I'm not a medical doctor, and I don't claim to be capable of doing the kinds of original research which doesn't in fact belong on Wikipedia WP:NOR. I try to copyedit articles by taking the facts as given in good faith. If those facts were incorrect, they ought to be corrected by someone who can dispute the citation with a better one, and this kind of refactoring should be ongoing. Don't ask me to take sides because I won't do so, I am not going to push either POV. You obviously agree that the statements were inconsistent, and my edit history made clear the reasons for my changes, which led to changes in the article that hopefully improved the factual basis, and that is all for the better. Let's continue to work constructively to improve the treatment of this subject. Whig 05:27, 12 Jun 2005 (UTC)
That's not original research, it's actually looking at and reading the reference that was already there! The 83% figure was most likely willful misrepresentation. Assuming good faith in the AIDS revisionist article is inadequate protection against error. If you can't take sides as to whether Wikipedia should misrepresent the sources it quotes, you shouldn't be editing. That's something you ought to take sides on. - Nunh-huh 06:36, 12 Jun 2005 (UTC)