*The Origins of AIDS*

by on November 14, 2011 at 9:51 am in Books, History, Medicine | Permalink

The author is Jacques Pepin and this is a splendid book.  It is a remarkably thorough epidemiological detective story, which breaks new ground, and on top of that it serves up an excellent (partial) history of Zaire, history of the African sex trade, and history of Haiti.  Excerpt:

In tropical Africa, the median number of infective [mosquito] bites is 77 per year, but in the rural and rainy areas of central Africa this number is generally >>200.  The record belongs to a village of Equatorial Guinea, where humans sustain 1,030 infective bites per year, three per day!

It is the most impressively researched book I’ve read all year, as suspenseful as a thriller, and tragic in mood.  It’s amazing how far back Pepin can trace back the history of AIDS and the diversity of sources and records he draws upon.  Here is one overview of the book.  Definitely recommended, one of the best books of the year.

1 alkali November 14, 2011 at 9:55 am

To answer my own (ridiculous) question: No, it’s not that Jacques Pepin.

2 el November 14, 2011 at 10:33 am

That was my first thought too.

3 David L November 14, 2011 at 5:51 pm

I was going to say–he seems like quite the polymath

4 Wade Nichols November 14, 2011 at 10:04 am

So, does anyone think that these two “scientists” will now retract their old theories:

Oscar-nominated actor Will Smith, for example, in an interview with Barbara Walters, suggested that scientists concocted AIDS as part of a conspiracy to retaliate against black people. A surprised Barbara Walters asked, “But you felt that the government was . . . deliberately trying to make people ill with the AIDS virus? This is pretty serious stuff. Do you really feel that?” Smith provided this “proof”: “Well, good question. I firmly believe that it is quite highly possible that the AIDS virus is the result of genetic warfare testing.”

Spike Lee told Rolling Stone in 1992, “I’m convinced AIDS is a government-engineered disease… [But] they never realized it couldn’t just be contained to the groups it was intended to wipe out.”

Maybe a better question: Will these two “scientists” even bother to read this book?

5 JSK November 14, 2011 at 10:40 am

I doubt that Smith and Lee have every referred to themselves as “scientists”. Anyway, the U.S. was ruled for eight years by someone who thinks God speaks to him, I would call that a much more serious delusion than “AIDS is a government conspiracy”.

6 Rahul November 14, 2011 at 10:51 am

That’s what he used quotes around the word. Duh.

7 tarbrush November 14, 2011 at 11:40 am

He used quote marks to prove that Smith and Lee aren’t scientists?

Most people probably know they are actors.

8 CBBB November 14, 2011 at 4:25 pm

I don’t get it. Actors say dumb things ALL the time, many prominent people say dumb things all the time – why the rant over these two? There’s plenty of crackpot conspiracy theories out there. By the way this coming from a commentariat who I know have big sympathies for birthirism (no no but that’s true!).

9 Jim November 14, 2011 at 10:58 am

Don’t forget Jeremiah Wright, who spent 20 years as spiritual adviser to the Leader of the Free World.

Sleep well.

10 tarbrush November 14, 2011 at 11:40 am

Let’s make a list of all the black famous people that are stupid/annoying.

11 Rahul November 14, 2011 at 10:12 am

Whose bites are we talking about here? Confused.

12 Norman Pfyster November 14, 2011 at 10:22 am

I assume chimpanzee’s biting humans.

13 prior_approval November 14, 2011 at 10:55 am

One hopes the book covers this –
‘Robert had never traveled outside the United States and, indeed, never left the Midwest, and had told doctors that he had never received a blood transfusion. Since Rayford’s infection was almost certainly through sexual contact and he had never left the country, it is obvious that he must have received the virus from somebody else already living with it in the United States, meaning that AIDS was present in North America before Robert began showing symptoms in 1966.[1] He also never ventured into cosmopolitan cities such as New York, Los Angeles, or San Francisco, which were the sites where the HIV-AIDS epidemic was first observed in the United States.’

The history of AIDS stretches back further than most common narratives – which is in no way a comment on an unread book, but Robert Rayford doesn’t quite seem to fit into the information found on the Amazon page (which again, is not a comment on the book itself), a teenager whose unusual death was so striking that the doctors involved in his case preserved as much as possible to allow later scientific inquiry. It is difficult to imagine that no one else noticed such causes of death for decades as the disease spread, but maybe the book explains this convincingly.

14 Peter Schaeffer November 14, 2011 at 10:46 pm


A Norwegian family was killed by Aids in the 1960s (they actually died in 1976). The father was a Norwegian sailor who visited Africa in the 60s. See http://articles.chicagotribune.com/1988-06-21/news/8801090263_1_infections-aids-antibodies-immune-deficiency for a few details about this case.

15 Randy McDonald November 15, 2011 at 3:29 am

The man in question, Norwegian sailor Arvid Noe, happened to have been infected in 1961-1962 with Group O strain of HIV-1, probably in Cameroon.


16 prior_approval November 16, 2011 at 6:14 am

Interesting – it appears as if AIDS was poised, and the medical profession in several Western nations were attentive, but a conflluence of events prevented us from stopping it early enough, at least within certain communities – which the earliest victims, most likely, never belonged to.

17 Rickard November 14, 2011 at 11:11 am

The quote about mosquito bites confuses me. What is its relevance? Some quick googling reveals that mosquitoes can’t transmit the HIV virus, though I can’t verify that.

18 Todd November 14, 2011 at 11:45 am

Its part of his thesis, that part of the reason for the spread of AIDS from a very small population in C. Africa was the way in which the governments tried to treat/prevent widespread diseases in their countries/colonies. This often involved the re-use of needles and other shoddy public health practices.

19 Rahul November 14, 2011 at 11:50 am

Wonder how they figure how many of the bites are infective? Heck, how do they tally mosquito bite counts anyways?

20 David November 14, 2011 at 1:40 pm

I don’t think it’s the bites spreading it. It’s that they use vaccines to fight mosquito carried diseases are done with dirty needles. The needles spread it, not the mosquitoes.

21 Careless November 14, 2011 at 4:11 pm

The repeated use of “infective bite” suggests a mosquito bite transmitting some infection.

22 dearieme November 14, 2011 at 5:20 pm

A sobering tale of doing harm by Doing Good. God certainly has a grim sense of humour.

23 Right Wing-nut November 14, 2011 at 9:47 pm

Just from the overview, but I find it very interesting that he emphasizes the “low rate of sexual transmission” so strongly, then uses a heterosexual married couple outlier as the example. What’s the rate of transmission among homosexuals, how many partners did they have, and what was the frequency of their encounters in each of the hot houses? These factors affect the doubling rate, so for instance, if you happen to be off by a total factor of two, then you might estimate that the disease spread by a factor of n when n^2 would be closer.

Second, the initial computations are excessively speculative. Surely the readers of this list are sophisticated enough to know that if a series of probabilities narrows a set from 1,350 to three as the mean, that the standard deviation is going to be quite high relatively. Someone want to estimate the 95% confidence line on that?

Third, there is an excellent chance that the virus has mutated with time. It is entirely possible that the earliest strain was more virulent early on, in fact reduced virulence is a common mutation.

His makes a sobering tale about unintended consequences. True or not, I hope that policy makers take its morale to heart before, say, attempting to reformulate the rules of commerce for a nation.

24 Peter Schaeffer November 14, 2011 at 10:53 pm

Right Wing-nut,

Of course, you are correct. HIV is not easily transmitted. With very rare exceptions, heterosexuals are not promiscuous enough to propagate the disease, Heterosexual sex doesn’t involve enough of blood-to-blood contact to facilitate spreading the disease.

Male gays are much busier and their sexual practices have a greater risk of blood-to-blood contact. Hence, HIV can spread in the homosexual community. Note that in Africa Aids is typically a heterosexual disease. Google will tell you why.

Quote from http://en.wikipedia.org/wiki/HIV#Sexual

“The majority of HIV infections are acquired through unprotected sexual relations. Complacency about HIV plays a key role in HIV risk.[3][4] Sexual transmission can occur when infected sexual secretions of one partner come into contact with the genital, oral, or rectal mucous membranes of another. In high-income countries, the risk of female-to-male transmission is 0.04% per act and male-to-female transmission is 0.08% per act. For various reasons, these rates are 4 to 10 times higher in low-income countries.[37] The rate for receptive anal intercourse is much higher, 1.7% per act.[37]”

25 Randy McDonald November 15, 2011 at 3:34 am

AIDSMAP has different statistics suggesting that the risk of transmission per encounter is relatively lower in receptive anal intercourse (http://www.aidsmap.com/Estimated-risk-per-exposure/page/1324038/), within an order of magnitude of rates of transmission via receptive vaginal intercourse in developed countries and comparable in low-income countries.

Multiple partnering actually isn’t that much more common–a 2007 study (http://www.sciencedaily.com/releases/2007/09/070913132930.htm) suggests that role versatility is at least as important a factor.

26 Randy McDonald November 15, 2011 at 3:43 am

“Just from the overview, but I find it very interesting that he emphasizes the “low rate of sexual transmission” so strongly, then uses a heterosexual married couple outlier as the example. ”

In the book Pepin describes how HIV emerged as a human illness in a social environment pretty far removed from (say) late 1970s New York City. Early 20th century central Africa–French and Belgian both–lacked large conurbations almost entirely and the possibilities for easy multi-partner sex. The odds were that if someone in central Africa became infected with SIV and developed, they’d live in rural areas and lack multiple sexual partners, progressing to AIDS and death quickly without infecting people beyond a sexual partner and perhaps children (who, in turn, would die quickly). Even now, there are several minor HIV viruses which have been documented to exist but which haven’t mushroomed into massive epidemics. How did HIV-1 break from this pattern?

“Third, there is an excellent chance that the virus has mutated with time. It is entirely possible that the earliest strain was more virulent early on, in fact reduced virulence is a common mutation.”

I’ve read the book and he does allow for that possibility. He brings it up, among other places, in connection with the “cachexie de Mayombe” identified by a French colonial doctor in French Congo in the early 1930s. It was a mysterious illness characterized by wasting, swollen lymph glands, and dementia (among other symptoms) without obvious cause. Pepin suggests that there may have been a shorter latency period at that time.

27 Randy McDonald November 15, 2011 at 3:45 am

That quote is a bit misleading. When Pepin was talking about infective bites he was _not_ talking about HIV but rather about malaria.

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